Integrating Data into Decision
Making
Tony O’Connor CBE
Deputy Director, DH Strategy Group
June 2014
2
The financial pressures on the health and care system
are well understood
The NHS Productivity Challenge - The King’s Fu...
3
Delivery of a more patient centred targeted
care system and reducing hospital admissions
should lead to more efficient r...
4
Breadth of Integration
Vertical
Strategies that link different levels of specialisation from primary, secondary and
tert...
5
The larger systematic reviews including a recent one by the
Centre for Health Economics failed to identify clear evidenc...
6
Studies of successful integration schemes suggest that the
most important factors relate to
• simplifying the way people...
7
Overall evidence for the impact of integration on outcomes
and secondary care utilisation is mixed at best
1
2
1
5
2
12
...
8
Compared to other countries, in England there have been more
integration initiatives but methods applied have lacked rob...
9 The Age of Analytics, April 30th 2014 – Sir Mark Walport – Gov Chief Scientist
In general privacy controls are not binar...
10
• Agreed taxonomy
• Clear, collectable metrics
• Clarity around what is success
• Robust evaluation methods
• Patient c...
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Tony O'Connor: Integrating Marketing Data into Decision Making, 30 June 2014

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In this slideshow, Tony O’Connor, National Director for Patients and Information, Department of Health discusses integrating marketing data into decision making.

Tony O’Connor spoke at the Nuffield Trust event: The future of the hospital, in June 2014.

Published in: Health & Medicine
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Tony O'Connor: Integrating Marketing Data into Decision Making, 30 June 2014

  1. 1. Integrating Data into Decision Making Tony O’Connor CBE Deputy Director, DH Strategy Group June 2014
  2. 2. 2 The financial pressures on the health and care system are well understood The NHS Productivity Challenge - The King’s Fund May 2014 Funding flat? Cost Pressures UP
  3. 3. 3 Delivery of a more patient centred targeted care system and reducing hospital admissions should lead to more efficient resources. But where is the evidence?
  4. 4. 4 Breadth of Integration Vertical Strategies that link different levels of specialisation from primary, secondary and tertiary care services. Horizontal Strategies that link similar levels of care such as primary, community and social care services. Level of Integration System Structures, processes and techniques are tailor-made to fit the needs of the population served across the continuum of care. Organisational The extent to which organisations coordinate services through inter-organisational relationships (e.g., contracting, strategic alliances, knowledge networks, mergers), including common governance mechanisms. Professional Inter-professional partnerships based on shared competences, roles, responsibilities and accountability. Service The coordination of services in a single process across time, place and discipline to deliver person-focused care. Degree of Integration Normative The development and maintenance of common vision, values and culture between organisations, professional groups and individuals. Functional Key support functions (i.e., financial, management and information systems) are structured around the primary process of service delivery to support accountability and decision-making. Source: Adapted from Valentijn et al (2013) Different forms of integration
  5. 5. 5 The larger systematic reviews including a recent one by the Centre for Health Economics failed to identify clear evidence for cost reduction. Reasons? • Complex nature of the concept • Lack of a consistent taxonomy; • Lack of clearly defined outcomes and use of appropriate controls  hard to attribute effects to the intervention; • Nature of the client group and types of intervention mean improvements in health are unlikely and benefits may be realised in other areas over long time periods; • Strong supply side drivers make it difficult to effectively reduce hospital use. We need to have a clearer understanding of what is realistic; The evidence base on integration is still in its infancy
  6. 6. 6 Studies of successful integration schemes suggest that the most important factors relate to • simplifying the way people interact with services though adopting single assessment processes, • co-location of services and • maximising each care contact. This can be enhanced by having a single individual in a co- ordinating role to act as single point of contact with authority to refer to other services. Characteristics of successful integration
  7. 7. 7 Overall evidence for the impact of integration on outcomes and secondary care utilisation is mixed at best 1 2 1 5 2 12 15 Impactoncost Impact on quality PositiveMixedNone Source: Adapted from Centre for Health Economics (2012) PositiveMixedNone Impact of 38 international integrated care schemes on outcomes and secondary care costs
  8. 8. 8 Compared to other countries, in England there have been more integration initiatives but methods applied have lacked robustness 0% 20% 40% 60% 80% 100% QualitativeUncontrolledMixed methodsAnalysis of routine data Non-randomised controlled trials Randomised controlled trials Proportion of integration studies by primary research method Seven other countries (N=25) England (N=13) Source: Centre for Health Economics (2012)
  9. 9. 9 The Age of Analytics, April 30th 2014 – Sir Mark Walport – Gov Chief Scientist In general privacy controls are not binary but fall on spectra Obfuscation Openly identifiable Anonymised to the point of losing valuable content Access / Environment Free on the internet Locked in a steel- lined room Governance and accountability Little legislation Highly legislated (Everyone) (Accredited researcher) The challenge is to find the appropriate level of control for each data system More safe?More Useful? Big Data - Confidence, Access and Security
  10. 10. 10 • Agreed taxonomy • Clear, collectable metrics • Clarity around what is success • Robust evaluation methods • Patient centred data collection (big data, data analytics) What do we need to evaluate integration

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