Ipswich Hospital NHS Trust (IHT), like many healthcare providers across the UK, faces tough challenges in managing demand for its services.
To respond quickly and improve services, it needs tools and technologies to help predict demand.
Spreadsheets did not provide effective insights into demand patterns, so the trust is now piloting location-based technology. This delivers data visualisation to help the trust improve its healthcare services.
IHT has 75,000 emergency department attendances a year and nearly 30,000 unplanned emergency admissions.
It provides healthcare services to more than 356,000 people in the area. One of the hospital’s key objectives is to move to the centre of a network of co-located and integrated services, delivered to meet demand for healthcare across the region as well as driving education and research.
To meet this goal, the trust needs to map out where that demand is coming from.
“Our existing information solutions rely on extensive use of spreadsheets,” said Paul Scott, director of finance and performance at IHT.
The hospital had been using spreadsheets to capture information about public behaviour in core populations for insight on where demand was coming from.
“They are therefore simply unable to provide us with the level of insight into patterns of behaviour in core populations that we urgently need," says Scott.
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"So we decided to find a solution that would give us greater insight into where demand is coming from, within our catchment areas, and what form that demand will take.”
Currently, the escalating demand faced by the hospital’s A&E department adds up financial pressures on the IHT system.
This is making it impossible to efficiently manage patient flows, Scott said. It also has a knock-on effect on inpatients and outpatients’ departments and affects the wider care-flow pathway, he said.
The challenge facing the hospital is made more difficult by the need to meet tough key performance indicator (KPI) metrics, including keeping waiting times below four hours.
It wanted software tools that will help the trust staff understand demand patterns and identify ways of intervening more effectively.
So the trust decided to implement a feasibility programme. This would assess how location analysis and actuarial analysis, working together, could provide insight into demand management that could shape future services for the better.
Working with geospatial data provider Esri, which provided analysis into financial trends and risks, the trust found a location analytics solution to meet its needs.
The solution provides IHT with a combination of insight from Esri’s geographical information systems (GIS) and location analytics technology as well as clinical and financial data analysis, feeding into long-term financial modelling.
Compared to consumer-based location services, GIS is designed to link into enterprise systems.
Esri UK’s location analytics solution was important in delivering data visualisation to provide the required insight, according to Scott.
Using the provider’s core tool ArcGIS platform on IHT’s infrastructure behind a secure firewall, ArcGIS for Server and ArcGIS for Desktop were deployed to provide services to a management insight dashboard.
The hospital will be able to bring in more clinical support staff to meet increased demand
The hospital now gains additional insight by being able to map out the number of cases going to A&E by a range of variables. The information is visualised as a hotspot analysis for example, highlighting the source of demand.
The dashboard also provides a set of KPI reporting tools, giving managers a dramatically improved understanding of the status of demand in the hospital by enabling them to break down A&E attendees by number of cases, average waiting time or mode of travel, and then split the figures down by timeframes, Scott explained.
According to IHT, studying data in a “visual” heatmap format helps IHT staff understand where the hotspots are for certain diseases, admission methods and average time to treatment.
Understanding where demand comes from in emergency admissions, and the type and level of that demand, has allowed IHT to pinpoint areas of intervention to mitigate it and channel more resources to high-demand areas.
The hospital will be able to bring in more clinical support staff to meet increased demand on certain days of the week, for example, and alleviate resource pressure. This could help minimise costs while maintaining performance and clinical standards, said Scott.
Adoption of geographical information systems is rising. Remote management and analytics overlaid with geospatial data is being used to manage real-world networks.
While consumerisation of IT is driving adoption of mapping, enterprise organisations are using specialist geographical information systems to build spatially aware applications.
"While this remains an R&D project, it has highlighted a different way of looking at our organisation, and the demand pressures we face," says Scott.
"It has also demonstrated the huge potential of looking at demand from a population rather than individual attendance basis.”
“It also allows us to try out ‘what if’ scenarios.
“In short, it has given us a new platform for discussion and changed the conversation at board level to focus on moving to a more sophisticated way of visualising and reporting data.
"The IHT board has even requested that geographic information and location is included in its business intelligence strategy.”
In future, the outputs from patient demand analysis, mapping insights and possible interventions could provide a basis for service reconfiguration and therefore wastage reductions, according to the hospital’s IT team.
The use of GIS information, in conjunction with actuarial services, could put IHT ahead of other National Health Service Trusts in terms of innovative IT.
This ground-breaking project has potential to revolutionise the future of healthcare demand management not just in Ipswich but across the whole of the UK, Scott added.
Other Esri users in the UK include TfL, Met Office, Metropolitan Police Service, Energy Saving Trust, and other NHS Trusts.