Pieter van Dijk Coordinating / Specialist AdvisorResearch & InnovationDutch Health Care Inspectoratep.v.dyk@igz.nl

IRiS,(Early) Risk Detection in

Health Care with Public Data(in 10 minutes)

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Some figures (2011):

Dutch health care:€ 90 billion = € 5392 per capita3.000 providers on 40.000 locations800.000 professionals

Health care inspectorate:€ 56 million = € 3 per capita and 0,06% of total costs500 employees25 Acts of Parliament

Supervision must focus on risks!

EPSO | 11 october 2012

IRiS: Inspectorate Riskdetection System

EPSO | 11 october 2012

Elements- data sources (extern versus intern; structured versus unstructured)- data model (presentation)- risk model (analysis)- business rules (analysing risks)- data warehouse (staging datasources)- reporting (dashboards/alerts)- analysis (ad hoc, mining)

Purposes- initially: clean up the mess of Excel-files!- primary goal: support riskbased supervision (early detection)- additional I: support management reports (performance)- additional II: support strategic en tactical decisions (riskmanagement)

How- by translating data into information, based on:- a set of business rules and- a datamodel reflecting our information requirements- a riskmodel for detection non-compliance, poor performance, potential risks

ConceptData Information Knowledge Arrangements Action

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External sources (structured)

1. Annual quality of care reports:- hospitals (since 2007), safety since 2009- mental health care (2010)- pharmarcies (2011, upcoming)- eldercare (2012, upcoming)- private clinics (2012, upcoming)- general practitioners (….)- ….

2. Mandatory annual reports Corporate Information (financie, HRM, etc.)

3. National registers:- medical registers (LMR)- production (diagnoses and treatments)

4. Other structured sources that meet our needs

EPSO | 11 october 2012

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External sources (unstructured; not yet available)

1.Social media topics, trends, signals, sentiments, fraud, reputation- Twitter- Facebook- Linkedin- ….

2.Crowdsourcing

3.Documents and files

Advanced tools are needed: search, find, integrate analyse and interpretunstructured data and combine data with structured data.

EPSO | 11 october 2012

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Internal sources (structured and unstructured; not yet available)

1.Complaints

2.Consumer or Provider Reports

3.Results from inspections

4.Filesystems

Advanced tools are needed: define, measure, search, find, integrateanalyse and interpret structured and unstructured data.

Challanges:- connecting different data-sources- combining structured and unstructured data- different level of aggregation- ambiguos definitions of ‘providers’- ….

Internaldata

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Riskmodel (business rules):

Deviation- Non-compliance to regulations, fieldstandards etc.- Poor performance (10th percentiles)

Trends early warning- Continuing deviation (3 years or more) !- Diverging trends- Unexpected trends (ipsative)- Forecasting (1 year)

Reliability of measures

Output:operational: - riskprofile and trends per provider (extern)

- organizational risks (intern)strategic/tactical: - risks per care sector

Internaldata

External data

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Future functionality

What if-scenario’s- how many staff do we need for supervision when thresholds change

Data mining (or backwards enginering)-have we missed important data?-are there underlying patterns that can explain incidents?-goals:- evidence based riskmodel- early warnings

EPSO | 11 october 2012

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Better & more data•Improve data-quality•More frequent data•Including results of supervision•More data to cover information needs•Social Media / Crowdsourcing•Better connections (= uniform definition)

Improving risk model business case = better supervision•Improve validity (systematic review)•Fit for use•Cover more risks•Early warnings & predictions•Integrated analyses Risk Matrix

Reporting ‘on the job’ (iPad), deliveries & alerts

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SHOWTIME!

EPSO | 11 october 2012