Mark Sanderson: SPARRA - recent and future developments
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    Mark Sanderson: SPARRA - recent and future developments Mark Sanderson: SPARRA - recent and future developments Presentation Transcript

    • SPARRA – Recent and Future Developments Mark Sanderson Health and Social Care Pathways ISD Scotland
    • SPARRA - Introduction• SPARRA (Scottish Patients at Risk of Readmission and Admission) is a tool developed by ISD for predicting a patient’s risk of emergency inpatient admission to an acute hospital in the next year• SPARRA is typically used to support local teams in providing pro-active, planned and co-ordinated care for patients with frequently changing or complex needs
    • SPARRA Timeline Better LTC Health, NationalDelivering Better Action 20:20for Health Care Plan Vision The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … 2005 2006 2007 2008 2009 2010 2011 2012 Classic All Ages Hospitalisation Hospitalisation Excel SPARRA Lists
    • Kaiser-Permanente Pyramid Intensive case/care Management Very Acute SPARRA High sector - Classic Interventions Disease/care management High risk - All Ages Self management Medium risk Targeted primary prevention Lower risk Population Wide Prevention, Health Improvement & Health Promotion
    • SPARRA Timeline Better LTC Health, NationalDelivering Better Action 20:20for Health Care Plan Vision The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … 2005 2006 2007 2008 2009 2010 2011 2012 Classic All Ages Version 3 Hospitalisation Hospitalisation Hospitalisation Prescribing Emerg Dept Outpatients Psychiatric Excel SPARRA Lists
    • Datasets and Risk Factors How many previous How many emergency admissions prescriptions? What age is the patient? How many outpatient has the patient had? appointments? Hospitalisation (Oct 2006 to Sept 2009) What type of Psychiatric Admission outpatient (Oct 2006 to Sept 2009) appointments did the patient have? Outpatient Any prescriptions for e.g. (Oct 2008 to Sept 2009) dementia drugs? Or Emergency Department Any A&E substance dependence? (Oct 2008 to Sept 2009) Any recent admissions to attendances in a psychiatric unit ? the past year? Prescribing Any previous admissions (Oct 2008 to Sept 2009) for a long term condition Outcome Year (such as epilepsy? (Oct 2009 to Sept 2010) PRE-PREDICTION PERIOD OUTCOME PERIOD
    • Coverage of Version 3 Population of Scotland = 5,194,000 Population covered by SPARRA Version 3 = 3,500,000 Overlap between emergency admission Overlap between patients and emergency SPARRA “All admission patients Ages” = 40% and SPARRA Version 3 = 95% Number of Emergency Population covered by Admissions in a Year = 342,500 SPARRA “All Ages” = 687,000
    • New and Current Risk Scores SPARRA - New and Current Risk Scores 500,000 450,000 Number of Patients 400,000 350,000 300,000 Version 3 250,000 All Ages 200,000 150,000 100,000 50,000 0 10-20% 20-30% 30-40% 40-50% 50-60% 60-70% 70-80% 80-90% 90-100% Risk Score Note: 2.67m patients have a SPARRA Version 3 risk score of less than 10%. The equivalent figure is 217,000 for the current tool.
    • Three Sub-CohortsNew cohorts …..• Long Term Conditions – aged 16-74• Frail Elderly – aged 75+• Younger Emergency Department – aged 16-55 – At least one ED attendance in previous 12 months…. new opportunities …
    • Version 3 Model Factors Frail Elderly Younger ED Alcohol/ Age substance All cohorts misuse Deprivation related Emergency / elective / daycase admissions Prescriptions admissions Prescriptions in specific BNF chapters LTC related ED for specific admissions attendances groups of drugs New OP Emergency New OP attendances bed days Polypharmacy attendances for MH LTC Psychiatric Prescriptions/admissions indicating admissions particular conditions Deprivation
    • Local SPARRA Model – NHSAyrshire and Arran• Development of a local SPARRA model using data sources not available at national level to support the NHS Board’s community ward pilot and to inform longer term national development of SPARRA• Data sources – practice – out of hours – emergency department – referrals – hospitalisation
    • SPARRA Timeline Better LTC Health, NationalDelivering Better Action 20:20for Health Care Plan Vision The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … 2005 2006 2007 2008 2009 2010 2011 2012 Classic All Ages Version 3 Hospitalisation Hospitalisation Hospitalisation Prescribing Emerg Dept Outpatients Psychiatric Excel SPARRA Lists
    • SPARRA Timeline Better LTC Health, NationalDelivering Better Action 20:20for Health Care Plan Vision The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … 2005 2006 2007 2008 2009 2010 2011 2012 Classic All Ages Version 3 Hospitalisation Hospitalisation Hospitalisation Prescribing Emerg Dept Outpatients Psychiatric Excel SPARRA Lists SPARRA Online
    • SPARRA Online• SPARRA online offers secure user-friendly access to SPARRA data through a Business Objects universe• It provides patient listings and risk score history• It can be used to generate own queries or use the pre- generated reports• The security settings allow access to GP, Community Health Partnership (CHP) and/or NHS Board level access to users
    • SPARRA – The Future Under 16 model Automation Version 3
    • SPARRA – The Future Under 16 model Automation Polypharmacy CMS (Chronic Medication Version Service) 3
    • SPARRA – The Future Under 16 model Automation Polypharmacy CMS (Chronic Medication Version Service) 3 QOF QP12-14
    • SPARRA – The Future Under 16 model Automation Polypharmacy CMS (Chronic Medication Version Service) 3 QOF QP12-14 iSPARRA
    • iSPARRA• Incorporate SPARRA into a Management Information System• Wider benefits of risk stratification• User-friendly front-end, dashboard and drill-down• Access to the full Version 3 dataset
    • SPARRA – The Future Under 16 model Automation Polypharmacy CMS (Chronic Medication Version Service) 3 QOF QP12-14 iSPARRA
    • SPARRA – The Future Under 16 model Automation Polypharmacy CMS (Chronic Medication Version Service) 3 NHS24 Ambulance Service … … Out of Hours? QOF QP12-14 iSPARRA
    • SPARRA – The Future Under 16 model Other outcomes Automation• Early readmission• ED attendance Polypharmacy• Admission to care CMS (Chronic home Medication Version Service) 3 NHS24 Ambulance Service … … Out of Hours? QOF QP12-14 iSPARRA