Presentation by Aaron Brizell, Population Health Programme Manager, Wirral University Teaching Hospital NHS Foundation Trust: The benefits of system-wide population health and analytics at ECO 17: Transforming care through digital health on Tuesday 4 December at Lancaster University, Lancaster

1. Aaron Brizell
Population Health Programme Manager
Wirral University Teaching Hospital
Digital Wirral:
The Benefits of System-wide Population Health and Analytics

2. The Wirral - Healthy Wirral Partners
Type All Ages
Elective IP 7,908
Elective Daycase 43,037
Elective Regular Day/Night Attenders 18,220
Emergency IP + Transfers 46,650
Maternity 7,751
Births 3,239
A&E 94,605
OP - New 109,739
OP - FU 292,825
Wirral CCG
• 51 Practices
• Population 334,500
Wirral University Teaching Hospital (WUTH)
• 5,600 employees
Wirral Community Foundation Trust
• Nursing: 24hr Community Nursing, Heart Support, Specialist
Nursing
• Therapies: Physiotherapy & Rehabilitation, Podiatry, Speech
& Language Therapy and Wheelchair Services
• Unplanned Care: Walk-in Centres, Minor Injuries Unit, DVT,
Phlebotomy, Single Point of Access
• Lifestyle: Health Visiting, Infant Feeding, Sexual Health Wirral
• Other services: Infection Prevention & Control, Quality &
Governance, Safeguarding
Cheshire Wirral Partnership – Mental Health
St John’s Hospice
Clatterbridge Cancer Centre
Wirral Council – Social Services

3. The Wirral
Our Vision
People will live longer healthier lives regardless of where they are born or
live on Wirral

4. Life Expectancy Variation
By over 10 years between the wards in Wirral

5. Meeting Healthcare Needs
We asked our population
Confidence
Services
Confidence in personal
interactions with health
services
What matters to you?
Instead of
What is the matter with you?
Personal fulfillment and
emotional wellbeing
Confidence in the future of
NHS as a sustainable entity
Accessibility
High quality experience
Community
Use of community assets
Making community assets
accessible
Integrated, joined up services

6. Wirral Partner Approach
KNOW
ENGAGE
MANAGE

7. Healthy Wirral Partnership Goals
Reduce premature
mortality from long
term conditions
Improve the timeliness
and quality of patient
care, delivered in the
right place by the right
person
Support patients to
self-manage their
long term
condition
Enhanced
integrated working
across the whole
system

8. The Programme
Service
Transformation
Analytics
Health
Information
Exchange
The Wirral
Care
Record
Enabled by Cerner
Health Information
Exchange and
HealtheIntent

9. Organisations in Scope
Acute (WUTH)
All 51 General Practices
Community Trust
Mental Health Trust
Social Care
Hospice Care
Cancer Centre
Phase 1
Phase 2

10. LIVE
PER
CONTACT
NO DATA
STORED
Health Information Exchange

11. Health Information Exchange
Usage: Primary care and Secondary care
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18
3681
6374
4637
5633 6223 6902 6573 673632
179 3729
5267
6642
7657
9341
10017
Secondary Care
Primary Care

12. Wirral: Measuring value
Overview
• Baseline and post-implementation surveys disseminated to all GP practices in Wirral CCG
• Demonstrable and quantitative value obtained from comparative analysis
• To be constructed into a case study along with corroborative user stories
Analysis
• 68 respondents (baseline) and 44 respondents (post)
• Comparative analysis of the same questions from each of the baseline and post-implementation surveys
• The results exclude those responses of N/A and in the case of duplicate investigations the extrapolation excludes
non-clinical staff
• A 20% risk score was applied during extrapolation to enable realistic estimates representative of the CCG
Assumption
• Extrapolation performed on the basis of on average each GP practice having 4 GPs, 2 nurses and 1 practice
manager

13. Wirral: Measuring value
Metric Result per user
Extrapolated
saving across
Wirral
Time spent
searching for
admission /
appointment
information per
day
12 to 17 minutes
saved per day
58 - 80 hours per
day
Time spent
searching for
pathology
results per day
6 to 10 minutes
saved per day
30 - 46 hours per
day
Time spent
searching for
imaging results
per day
6 to 9 minutes
saved per day
28 - 43 hours per
day
Role Saving Per Day
GP £3662.75
Practice nurse £803.89
Practice Manager £401.95
Annual Saving £1,270,701.99
Figures above based on 4 GP’s, 2 Practice Nurses, 1 Practice Manager at each of the 51
practices in Wirral. Annual days based on 261 days per year excluding weekends and bank
holidays. Hours saved is based on average per metric and is combination of all hours
saved. Hours saved and numbers of staff at practices may vary.

14. Wirral Care Record
GP
Hospital Record Community Record
Mental Health
Social Care
Specialist Providers
HealtheIntent Platform

15. Wirral Care Record
HealtheAnalytics

16. Benefits
Targeted intervention and
Prevention
Support and enable targeted interventions and
prevention and contribute to reducing inequalities
and gaps in care, both an individual patient and
service user level, and on broader population
health basis. ,
Interconnect
Enable staff across all organisations to view patients
and services users holistically, and have an informed
history and relevant information to identify the most
appropriate treatment, care and support,
Patient Data Sharing
Improve patient experience by enabling
information to be shared to prevent patients
having to tell their story and provide
information more than once
Culture change
Enable culture change and true integration, by
sharing information and working together across
existing boundaries. Provide insight and analytics to
inform commissioning and resource management for
the whole population.
Communication
Inform the changes of the funding and
contracting model and future landscape of
services
Avoid waste
Reduce duplication and waste, enable and
drive end –to – end service redesign to
maximize efficiency and reduce cost.

17. Patient Registries
Identifying
Gaps in care

18. Wirral Care Record
Wellness & condition Registries
PHASE 1
• Adult diabetes
• Child diabetes
• Asthma adult
• Child wheeze
• COPD
PHASE 2
• Cardiovascular Disease: AF, HF
• Substance Misuse
• Wellness
• Mental health
• Frailty
• Supportive Care

19. Longitudinal Record

20. Organisation Registries Status

21. HealtheAnalytics
Self service views of data from uploads

22. Analytics - high level
Measure Value
Population of Wirral 334,489
ED attendances in Wirral 17/18 94,627
Ratio 0.28
Patients on Asthma, COPD and Diabetes registers (36 /51 practices) 5,422
Number of ED attendances from this group 9369
Ratio 1.73
The three groups on registries so far are 6 times more likely to attend ED

23. ED Encounters (2)
HealtheAnalytics visualisation of ED encounters by practice and condition
Note: This visualisation is a
snapshot of current Registries
measures status and the future
use of the Registries might change
data over time.
Importantly, the Dashboard must
still undergo further quality checks
and review, which might result in
possible alteration of the
outcomes.

24. UTI and Prescribing AntiMicrobials

25. UTI and Prescribing AntiMicrobials

26. UTI and Prescribing AntiMicrobials

27. Theory to Practice
Full roll out to all HWP’s
Support service redesign
Imbed into neighbourhood
and MDT meetings
GDE Blueprinting

28. … and the journey continues …

29. THANK YOU!
Any questions?