Assura Intelligence

The key to any successful business wishing to provide a quality and cost effective service is understanding its population and the needs of its customers. In our case, our patients and commissioning bodies.

Access to patient data is vital in developing new services and monitoring the effectiveness of those services once in place. Hence, Assura provides Assura Intelligence (AI) to support the information needs of GPCos.

The availability of information varies considerably between organisations and therefore AI can be used to support existing information or provide a total information solution. AI provides GPCo staff access to a library of information gathered from a number of sources and stored in one place.

Primary Care

As we know, primary care provides the richest source of clinical information with regard to our patients. Clinical systems provide good reporting tools, yet this information is stored discretely, based on individual practices and often geographically dispersed. It is important that a GPCo can access this information easily and centrally, in a standard format, without placing unnecessary burden on practice staff, and without having to access many, often varying systems. AI overcomes these limitations by collating and storing data in standard formats in one location within the GPCo.

AI provides a software tool to extract anonymous information from practice clinical systems which is compliant with the DPA and Caldicott rules. The software is robust and already in use within many practices. It has been used by PCTs and SHAs to obtain information from GP practices and is used for clinical and planning purposes. AI does not affect system performance and only reads information from a system.

This information can be used to support both the GPCo and practices, for example:

Identify specific ophthalmic conditions for patients referred to Ophthalmology services, for example Cataract, Glaucoma and Diabetic Retinopathy. This may be used in conjunction with secondary care data and used to look at the feasibility of an Ophthalmology service.
Use of clinical coding and drug data to attach a risk score to each patient. This can be used across multiple service provision, for example, by a specialist nurse to target patients at high risk and deal with these patients first. Perhaps patients with history or potential of heart failure or COPD. This would reduce secondary care attendance, particularly A&E, drug costs and enhance the disease management.
Analysis of GPCo population for disease areas associated to potential services. Breakdown of age/sex, risk scores, geography and significant chronic disease for any potential services.
Geographic analysis of population to assess best location for new services.

Secondary Care

Secondary care information can be stored as summary or by individual episodes of care. AI can store individual episodes records received electronically, from PCT or, when available, from the Secondary Uses Service (SUS, formally the NHS Wide Clearing Service).

Alternatively, summary or record level information may be available to practices. This may take the form of CDs containing episode data, or access to web based summaries, perhaps supplied by a PCT.

AI can store both individual episodes and document based summary information. In addition referral and waiting list information is often available and may be key to consideration and monitoring of services provided by a GPCo.

Examples of how this can be used are as follows:

Outpatient referral rates by GPCo population by specialty under consideration for service provision
Monitoring of services provided by the GPCo where referrals and attendances are occurring outside of GPCo provision.
Analysis of Outpatient first/follow up ratios
Use of waiting list information to identify potential services where a current local service may not be coping with demand.
Monitor A&E and Inpatient admission rates to either assess a service to reduce admissions by delivering proactive care in a primary setting or to monitor the reduction of admissions of services being provided by the GPCo.

Service Operation and Performance Monitoring

When an GPCo has a service operational and is treating patients, it is vital these services are monitored. This allows the GPCo to ensure quality of care is maintained and cost effectiveness monitored.

GPCo services will capture attendance and treatment information via a shared clinical application.

AI can extract and store this information allowing GPCos to continually monitor the services it provides. In addition, it may often be a requirement that commissioners will require detailed feedback on services, perhaps at an individual episode or attendance level. This will include electronic submissions to SUS (Secondary Uses Service).

Examples of service support and monitoring are as follows:

DNA rate analysis
Quality and Outcome monitoring.
Contract monitoring. To manage service levels against contracts.

Integration

AI also provides a hub for integration of additional specialised software (e.g. X-Ray).