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Clinical information and clinical analytics Working with clinicians to realise the benefits within the NSW context Jean-Frederic Levesque MD PhD | Chief Executive | ACI Friday, 2 March 2018

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Page 1: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Clinical information and clinical analyticsWorking with clinicians to realise the benefits within the NSW context

Jean-Frederic Levesque MD PhD | Chief Executive | ACI

Friday, 2 March 2018

Page 2: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

The ACI acknowledges the traditional owners of the land that we work on.

We pay our respects to Elders past and present and extend that

respect to other Aboriginal peoples present here today.

Page 3: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

You have seen this patient twice as

many times in the last three months

as in the previous three years.

- Clinical analytics

Page 4: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Analytics

Page 5: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

1. What is clinical analytics?

2. What benefits could we get from clinical analytics?

3. What are the challenges in implementing and ensuring adoption of

clinical analytics?

4. What are the roles of networks and clinical governance in

supporting clinical analytics?

Presentation outline

Page 6: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

• Clinical

relates to the interactions between patients and providers

• Data analytics

relates to the automated processes enabling to produce information out of data

• Clinical analytics

relates to the automated processes enabling to produce clinical information

out of clinical data to support clinicians, patients or shared decisions

• Mobilises both data analytics and data analyses

1. What is clinical analytics?

Page 7: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

“Health analytics is the use of data,

technology and quantitative and qualitative

methods aimed at gaining insight for making

informed decisions to improve health

outcomes and health system performance.”

A definition of health analytics

Page 8: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

“Data analytics is the science of examining raw data with the purpose

of finding patterns and drawing conclusions about that information by

applying an algorithmic or mechanical process to derive insights.”

A definition of data analytics

(https://www.simplilearn.com/data-science-vs-big-data-vs-data-analytics-article)

Page 9: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Which clinical data?

Page 10: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Data capture

Clinical information Clinical Decision

Immediate (now)

Data extraction

Page 11: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Data capture

Clinical information Clinical Decision

Immediate (now)

Data extraction

Current (on going)

Clinical information

Page 12: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Data capture

Clinical information Clinical Decision

Immediate (now)

Data extraction

Current (on going)

Recent (short past)

Clinical information

Clinical information

Page 13: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Data capture

Clinical information Clinical Decision

Immediate (now)

Data extraction

Current (on going)

Recent (short past)

Latent (distant past)

Clinical information

Clinical information

Clinical information

Page 14: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

This patient’s reported outcomes

are trending down over the

last three months.

- Clinical analytics

Page 15: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

• Better decisions

• Patient engagement and self-management

• Self-reflective practice

• Improved healthcare organisations

• Integration of clinical and managerial perspectives

2. What benefits could we get from clinical analytics?

Page 16: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

A framework

Page 17: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

• Clinical alerts and prompts

• Trends in biological parameters or clinical outcomes

• Use of control charts

• Diagnostic support algorithms

• Application of predictive risks tools

• Benchmarking with peer clinicians

• Profiling of patient populations

Applications of clinical analytics

Page 18: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

This patient has biological parameters

classifying him in the top 10% of

frail patients amongst your cohort

of patients.

- Clinical analytics

Page 19: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Which decisions?

Page 20: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Clinical decisions

(bedside decisions)

Clinical decisions

(design/practice)

Clinical

information

Direct feedback loopPersonal decisions

(bedside decisions)

Page 21: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Clinical decisions

(bedside decisions)

Clinical decisions

(design/practice)

Managerial decisions

(implementation)

Clinical

information

Managerial

information

Direct feedback loopPersonal decisions

(bedside decisions)

Direct feedback loop

Page 22: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Clinical decisions

(bedside decisions)

Clinical decisions

(design/practice)

Managerial decisions

(implementation)

Managerial decisions

(planning)

Policy decisions

(funding and allocation)

Clinical

information

Managerial

information

Direct feedback loop

Ag

gre

ga

tion o

f data

Personal decisions

(bedside decisions)

Direct feedback loop

Page 23: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Clinical decisions

(bedside decisions)

Clinical decisions

(design/practice)

Managerial decisions

(implementation)

Managerial decisions

(planning)

Policy decisions

(funding and allocation)

Clinical

information

Managerial

information

Direct feedback loop

Ag

gre

ga

tion o

f data

Data

analytics

Personal decisions

(bedside decisions)

Direct feedback loop

Page 24: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Clinical decisions

(bedside decisions)

Clinical decisions

(design/practice)

Managerial decisions

(implementation)

Managerial decisions

(planning)

Policy decisions

(funding and allocation)

Clinical

information

Managerial

information

Direct feedback loop

Ag

gre

ga

tion o

f data

Data

analytics

Data

analysis

Personal decisions

(bedside decisions)

Direct feedback loop

Page 25: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Your patients tend to present to the

emergency department in the two

weeks following discharge 10% more

than your peer group.

- Clinical analytics

Page 26: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

• Disruption to clinical processes and flows

• Data capture and collection burden

• Fragmentation of data

• Complexity of clinical care

• Technological failures

• Futuristic overpromises

• Cost of infrastructure

• Security of information and privacy

• Data literacy

3. What are the challenges in implementing

and in ensuring adoption of clinical analytics?

Page 27: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

The clinical parameters of this

patient suggest he may be

experiencing an adverse event.- Clinical analytics

Page 28: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

• Designing a process to support reflective practices and accountability

• Participating in the meaningful assessment of data and tools

• Co-designing of meaningful algorithms and visualisations

• Supporting the redesign of clinical processes and technology enabled models of care

• Championing investments in hardware, software and humanware

4. What are the roles of networks and clinical

governance in supporting clinical analytics?

Page 29: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Contributing to a learning health system

• Real-time sharing of meaningful

performance data

• Formal training in problem-solving

methodology

• Workforce engagement and informal

knowledge sharing

• Leadership structures, beliefs, and

behaviours

• Internal and external benchmarking

• Technical knowledge sharing

Page 30: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

• Clinical analytics are fast appearing

• Clinicians have a role in getting the system ready for their implementation

and appropriate use

• Their implementation is going to potentially disrupt clinical processes and flows

• Harnessing their benefits requires a learning system approach where clinicians

have a strong leadership role

Conclusion

Page 31: Clinical Information and Clinical Analytics - Jean …...• Patient engagement and self-management • Self-reflective practice • Improved healthcare organisations • Integration

Level 4, 67 Albert Avenue

Chatswood NSW 2067

PO Box 699

Chatswood NSW 2057

T + 61 2 9464 4666

F + 61 2 9464 4728

[email protected]

www.aci.health.nsw.gov.au

Jean-Frederic Levesque MD PhD

Email: [email protected]

Twitter: @jfredlevesque