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An introduction to the use of decision
 technologies in health care

 Dr Geraint Lewis
 Senior Fellow




21 November 2011                          © Nuffield Trust
Decision technology

                      Question


       Information                 Preferences



                       Decision
                      Technology




                       Answer
                                                 © Nuffield Trust
Satellite navigation as an example of decision technology

             How do I get to the
                 Millennium
             Stadium in Cardiff?   Question


                                              •   Avoid motorways?
                                              •   Avoid toll roads?
        •   Current position                  •   Speed or fuel
        •   Destination                           efficiency?
        •   Route map UK                      •   Car share lanes?
        •   Average journey
            times at different
            times of day, and
            different days of
            the week
        •   Current time
        •   Live feed of traffic
            conditions
                                                    Turn right at the
                                                   roundabout, third
                                                           exit
                                    Answer                              © Nuffield Trust
Questions




            Patients     Clinicians




            Managers   Commissioners



                                       © Nuffield Trust
Questions
                                                How should I
    Should I be                               manage this patient
   screened for                                with suspected
 prostate cancer?                               appendicitis?

                    Patients     Clinicians




 Which patients                                     What proportion
    should I                                          of my budget
  schedule for                                       should I spend
 next Tuesday’s     Managers   Commissioners        on mental health
 operating list?                                        services?


                                                                    © Nuffield Trust
Moving from intuition to analysis




                                     Evidence




                                    Expertise   Values




                                                         © Nuffield Trust
Source: Professor Jack Dowie, London
School of Hygiene and Tropical Medicine
Annalisa decision technology




                                                                               © Nuffield Trust

Source: Professor Jack Dowie, London School of Hygiene and Tropical Medicine
Minimising early starts, turnaround times and late finishes
                                       AM                           PM




        Early start               Turnaround   Early finish    Late start   Late finish

                                                All Day List




                                                                                     © Nuffield Trust

Source: Perran Pengelly, Newton Europe Ltd.
Effect on operating theatre utilisation




                                               © Nuffield Trust

Source: Perran Pengelly, Newton Europe Ltd.
Anticoagulation decision support




                                                               © Nuffield Trust

Source: Professor David Patterson, University College London
Community-based anticoagulant and stroke prevention
     services in North London




                 *   Derived automatically from the EHR
                 *   Each site can run its own report at any time
                 *   All reports include anonymous service-wide comparisons
                 *   Reviewed at quarterly Clinical Governance Board meetings   © Nuffield Trust

Source: Professor David Patterson, University College London
www.nuffieldtrust.org.uk


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        geraint.lewis@nuffieldtrust.org.uk




21 November 2011                              © Nuffield Trust

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Geraint Lewis: The use of decision technologies in health

  • 1. An introduction to the use of decision technologies in health care Dr Geraint Lewis Senior Fellow 21 November 2011 © Nuffield Trust
  • 2. Decision technology Question Information Preferences Decision Technology Answer © Nuffield Trust
  • 3. Satellite navigation as an example of decision technology How do I get to the Millennium Stadium in Cardiff? Question • Avoid motorways? • Avoid toll roads? • Current position • Speed or fuel • Destination efficiency? • Route map UK • Car share lanes? • Average journey times at different times of day, and different days of the week • Current time • Live feed of traffic conditions Turn right at the roundabout, third exit Answer © Nuffield Trust
  • 4. Questions Patients Clinicians Managers Commissioners © Nuffield Trust
  • 5. Questions How should I Should I be manage this patient screened for with suspected prostate cancer? appendicitis? Patients Clinicians Which patients What proportion should I of my budget schedule for should I spend next Tuesday’s Managers Commissioners on mental health operating list? services? © Nuffield Trust
  • 6. Moving from intuition to analysis Evidence Expertise Values © Nuffield Trust Source: Professor Jack Dowie, London School of Hygiene and Tropical Medicine
  • 7. Annalisa decision technology © Nuffield Trust Source: Professor Jack Dowie, London School of Hygiene and Tropical Medicine
  • 8. Minimising early starts, turnaround times and late finishes AM PM Early start Turnaround Early finish Late start Late finish All Day List © Nuffield Trust Source: Perran Pengelly, Newton Europe Ltd.
  • 9. Effect on operating theatre utilisation © Nuffield Trust Source: Perran Pengelly, Newton Europe Ltd.
  • 10. Anticoagulation decision support © Nuffield Trust Source: Professor David Patterson, University College London
  • 11. Community-based anticoagulant and stroke prevention services in North London * Derived automatically from the EHR * Each site can run its own report at any time * All reports include anonymous service-wide comparisons * Reviewed at quarterly Clinical Governance Board meetings © Nuffield Trust Source: Professor David Patterson, University College London
  • 12. www.nuffieldtrust.org.uk Sign-up for our newsletter www.nuffieldtrust.org.uk/newsletter Follow us on Twitter http://twitter.com/NuffieldTrust geraint.lewis@nuffieldtrust.org.uk 21 November 2011 © Nuffield Trust