Allied Health and informatics: Identifying our voice - can you hear us?
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This document discusses allied health professionals and their role in the healthcare system. It lists various allied health roles and describes how they rehabilitate and enable patients by taking a collaborative and holistic approach focused on patient needs. The document emphasizes that allied health professionals help reduce health service needs by facilitating patients' independence and ability to remain in their communities. It argues that capturing allied health data can help provide visibility into their services, allow for quality improvement, and ultimately benefit patients through a more coordinated system where the "right intervention" is delivered at the "right time". The challenges of engaging stakeholders and integrating passive data extraction are also addressed.
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Allied Health and informatics: Identifying our voice - can you hear us?
- 2. Allied Health Identifying our voice: can you hear us? Rebecca George Occupational Therapist Clinical Lead - Allied Health Informatics
- 3. Take a walk with me…
- 4. Alcohol and Drug Clinicians Audiologists Dental Therapists Dietitians Genetic Associates Needs Assessors Occupational Therapists Optometrists Orthoptists Psychotherapy Physiotherapy Play Specialists Pharmacists Pharmacy Technicians Podiatrists Psychologists Social Workers Speech Language Therapists Visiting Neurodevelopmental Therapists
- 7. What do we do? Rehabilitate We enable Provide connections Maintain their health status
- 8. How do we do this? Focus on the patient’s needs Strongly collaborative Broad perspective of patient journey
- 9. Our significance We enable the patient in their situation Reduce health service need We create safe living situations Maintain patients in their communities
- 10. Our significance We facilitate their potential Increase their participation in daily activities We support their healthy status Reduce risks at home, work, in the community
- 11. If we benefit the patient then we reduce the service need. If we solely benefit the service then are we perpetuating the patient’s need?
- 12. Helping us to help you Clarity Greater coordination Efficacy
- 13. Making the most of Allied HealthCorrelation of prior AH input to readmissions Positive and negative Correlation between patient flow and AH input Service demand, timing, activity type Correlation between demographics and community AH service access
- 14. “There isn’t someone else in a room who will do this for us,…AHPs must be in the race too…[we need to] set informatics and technology right back center stage of clinical practice”. Middleton K, 2012. https://www.youtube.com/watch?v=QZ4Ks_rhacw
- 15. Internationally
- 17. Nationally Ground up Approach Focus on: Activity content Case weighting Casemix
- 18. Nationally
- 19. What are we trying to achieve?Engagement via ownership Create a platform for comparative data Give visibility to staff and services ‘right person, right time, right place, right intervention’ Facilitate quality measures
- 20. What are the challenges? Engagement with key stakeholders Collection of data - ‘A01’ Integration – ‘passive data extraction’ Relevant reporting at all levels
- 21. To benefit the patient we need the information Enhancing scope Consistency Availability Peate I, 2015
- 22. Can you hear us? We are... Essential to effective Patient care Different and distinct Valuable contributors to Informatics Keen to use data to improve Patient’s journey
Editor's Notes
- …play a significant role…health services….but often feel….invisible – unheard and undervalued….
- When your elderly neighbour fell over and they diagnosed a condition affecting her nerves and muscles, A Physiotherapist worked with her to educate her about her balance, her falls risks and how to keep a safe walking posture. She needed a Dietician because she had lost her appetite as a result of the medications, her reduced food intake wasn’t giving her the energy she needed to keep her body healthy and give her the energy to walk around the house. So the dietician prescribed the appropriate food supplements which she can now take to maintain her energy levels and the integrity of her skin when she bumps into furniture. The Occupational Therapist came to assess her home, remodel the bathroom design for a safe wet area shower and spent time working out how to help her keep on gardening - advising her to raise the height of the flower beds and designing a daily plan to pace her energy levels. When her speech began to slur the Speech and language therapist advised her on vocal techniques and breathing patterns to support her volume, she also advised her about food types, knowing that her swallow was weaker, - so that she didn’t cough on strawberry seeds or lettuce leafs. And when her family became concerned for her independence the Social Worker took the time to listen to her reluctance and plan with her what community services would fit with her needs.
- There are many different Allied Health professions, the International Chief Health Professions Officers in 2012 – all encompassing definition to the Allied Health collective term. Distinct group Many domains of care Today I will be focussing on the five highlighted in red;
- Total number of AH staff by profession – as listed within the NZ AH standard. As of June 2015…. Largest number is SW Followed by OT, PT and further down DI and SLT. Fewer FTE does not mean of any less value though to the patient’s journey.
- Proportions are similar across the DHBs Did you know that for the cost of 1 SMO you can purchase 5 AH FTE positions? (Data excludes all staff on long term leave or with zero contracted hours)
- We retrain, teach, regain skills lost by illness or injury – body can relearn, Help patients to adapt – modify movement patterns, change their techniques, use an item of equipment Our patients…live in…. an interconnected society, dependent on connections – people, social groups, services in their network and location. They need …obtain medicines in a timely manner They need ….. communicate with others and manage their finances They need ….access supermarkets and get the food into their home. We inform, educate, facilitate safe environments
- 5 AHPs Emphasised today share crucial similarities that make them so effective Advocate for the patient – one person’s perspective will differ from another Excellent communicators, multidisciplinary approach - think laterally to solve problems They view the patient’s entire journey – looking ahead rather than focusing just on the now
- Supporting them ….meeting needs in context Provide equipment, modify environments, reduce elements of risk
- Small changes can shift an entire task from dependence to independence Reducing risk and maintaining health ... creates collaborative engagement with patients
- I.e. cutting the length of stay following a surgical process without engaging with patient need, can impact on health service dependence/access
- Achieve Clarity….standardised data classifications, information fields, (relevant AH IT solutions) Coordination….ability to cross match data from other disciplines…services with AH Efficacy…of data to benefit patient and service
- Demonstrate to which cohorts AH input effective Conversely which aligned cohort would benefit. Match activity type, frequency, establish a benchmark Demonstrate optimal timing and activity type at the location of demand for AH input to patient flow (ALOS) Demonstrate which demographic areas have AH input, activity type are there similar pockets that not receiving AH input – what are their rates of acute health access?
- 2012 Karen Middleton – Chief AH Professions Officer for NHS UK Call for engagement and momentum…. The Nutrition and Dietetics journal last year reported that ‘’If we do not engage or actively participate in the Health Informatics arena we put ourselves in danger of inheriting technologies that do not support our work practices, and missing opportunities to enhance our practice.’’
- The UK has a National AHP Informatics Strategic Taskforce – Top of their aims: “An information-led culture where all health and care professionals – & local bodies whose policies influence our health …– take responsibility for recording, sharing & using information to improve our care.” Led by ….clinical division, informatics directorate, department of health The Health Foundation, UK (2014) ….quality of health care Recommendations… .. AHP activity …implementation …information systems. ….development of ways to link information with care records. ….development …ways to use information …..quality-assure the care …AHPs deliver.
- Scotland, England Wales, all working together collaboratively within the strategic taskforce – addressing national implementation regionally. The NHS Scotland, have Informatics Staff working on AHP data and standardised data sets, including the application of quality outcome measures. Australia has taken the initiative from the Health Round Table to progress the AHP agenda and use this platform for standardisation. However they are also developing a National MDS to bring all AHP services together under one data set, since the HRT data is not available for ministry access.
- Ground up approach – quantifying ….in detail, addressing …..complexity ….locally – variety ….classification methods ….locality based ..past couple of years TAS has supported …development ….activity classification amidst a small group of AHPs
- In 2014 we formed the NAHDC – to prioritise the standardisation of data and its collection and reporting for our services. drivers …been the clinical questions for our services, staffing and activity. National data audit completed….diversity, inconsistency, lack of comparative capability, lack of validity Developed…1st edition of service level MDS “top down approach” - Working with key stakeholders for endorsement and road map for implementation
- no one else is doing it… Apples with apples comparison…. Clinical quality, benefit, efficiency, Comparative quality for national benchmarking Unless we capture complexity of AH activities Responsibilities Service delivery patterns In service specific ways …AH therapy services Be overlooked, in healthcare quality evaluation and reporting”
- Why I am up here today Current lack of differentiation at a national code set level. AH classed as A01 medical specialty. Need for comprehensive engagement with MOH …looking ahead to NPF Need for Integration …working collaboratively …establish systems for clinical efficiency…..don’t waste clinician’s time Manual data entry additional Huge potential …. IT systems used in daily processes….capture data Information … applicable to all …visual
- Ian Peate, Oct 2015 ‘the contribution of allied health professionals’ …more indepth…better...understanding…of levels and quality … AHPs,…important….fiscally constrained NHS. “’enhancing the scope, consistency and the availability of routine data is key to understanding the contribution that AHPs make and can make to high quality care”” He suggested AHPs continue to be often …overlooked and undervalued despite providing high quality essential care.
- We are not just a collective, our differences and distinctions to and from each other – make us all the more significant. Questions: Waffly or hard – suggest that it would take longer to be of benefit - lets touch base later Briefly …. Explained more clearly in depth (later)