South Tyneside Trust cuts costs with business intelligence

South Tyneside NHS Foundation Trust is using business intelligence software to cut costs, reduce hospital waiting lists, and combat its data duplication problems.

South Tyneside NHS Foundation Trust is using business intelligence software to cut costs, reduce hospital waiting lists, and combat its data duplication problems.

The trust has a turnover of £90m and 600 beds in multiple sites, but having a good business intelligence system means it employs only two data analysts and a data quality analyst.

The trust was faced with the government's reforms and plans to modernise the NHS through the implementation of the NHS National Programme for IT. At the heart of this strategy is the introduction of a national Care Records Service, based on an electronic patient record system that will span five geographic clusters across England.

Vast amounts of clinical and non-clinical patient data will be available to thousands of healthcare professionals throughout the patient care process, and these individuals will also update and create more data as they go. So, information governance and quality has become a major issue for NHS provider organisations.

The two core challenges for NHS trusts such as South Tyneside, are that the government wants all NHS patients to have a choice of hospital, so data must be available to healthcare professionals in multiple locations. Secondly, the government is introducing a 'payment by results' system where NHS trust income is directly linked to the quantity of services provided. This has forced NHS trusts to re-examine how services are managed, ensuring services are high-quality and cost-effective.

South Tyneside NHS Trust saw business intelligence as the solution to its problem, and invested heavily in 2001 to ensure that it could meet the challenges of organising data correctly, mining it effectively, and meeting performance and clinical governance requirements.

Its business intelligence system is based on Microsoft Windows NT Server, Oracle 10g databases, Silverlink Software, and a range of Cognos business intelligence tools. These tools allow the trust to manage, access, analyse, interrogate and report on information across the organisation.

South Tyneside NHS Trust implemented the Cognos business intelligence systems across all its major areas, including waiting list management, accident and emergency, radiology and pharmacy.

The IT system draws information from three main relational databases to model and build data sets with more than 50 million consolidated rows of data and up to 500,000 categories.

The IS department works closely with the trust's management team to develop specific data sets, containing specialised information for various departments across the hospital.

These are made available to other managers, either from their desktops or via the web, allowing them to view and analyse information specific to their area of the trust, says Martin Alexander, head of information systems at South Tyneside NHS Foundation Trust.

Alexander says the business intelligence system has allowed the trust to manage its business information better than ever before, and turn that data into knowledge. This is because a typical patient will intersect with many hospital departments and consume resources across the trust. So a complex set of data will be held on that individual on between four and 10 core business systems, from finance through to hotel services, operations, radiology and pathology. "All of those system are usually from different technology suppliers," says Alexander.

South Tyneside Trust chose to pool much of that disparate data onto a central electronic patient clinical records system, from UK supplier Silverlink Software, which resides on an Oracle database and client server system. The single electronic patient records system combined the A&E, maternity, and in and out patients systems, among others. Besides this core database, there are two additional core systems: pharmacy and pathology.

The trust then effectively uses Cognos as its datawarehouse and middleware layer, offering its users a web interface to access data, which is reported on using Cognos Impromptu and analysed using Cognos Powerplay.

It uses Cognos to tap directly into the data, extracting the data overnight into Cognos cubes, which are worked on during day, says Alexander. "We tend to take a question, build a Cognos cube, publish it and that question is never asked again. But we gradually grow the cubes and incorporate the managers' requests into the cube, answer the requests and republish the cube. It is a bit like building a picture, except you are building a large and complex cube instead.

"We have found Cognos easy for users to pick up and use with very little training. After a two-hour course, they are playing with it, slicing and dicing and moving data around. A lot of our users are internet-savvy, and the system also creates an internet/intranet news digest that gives you a view of your information data set. Managers can drill through the data sent to them and ask questions electronically. This has cut down the number of questions we are sent."

The ways in which South Tyneside has measured the success of its business intelligence system are through indicators such as low waiting lists, managing hospital processes more quickly, and having high data quality. "This means making sure you have got the name and address right, and are not asking the same question more than once. Data quality is at the centre of that," says Alexander.


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