My colleague and director of healthcare industry solutions for Europe, Middle East, and Africa, Sean Price, visited the NHS recently. He chatted with Mark Singleton - the head of BI at NHS WWL - about their journey with QlikView and their real-time predictive emergency department app.
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WWL’s Mark Singleton on using data to slash NHS waiting times
Patient data is often sought by healthcare organisations to improve the services and care that citizens receive, but Wrightington Wigan and Leigh NHS Foundation Trust (WWL) has taken a step back and looked at its operations to see if there are ways it can better use the information it already has to make efficiency savings and improve its quality of care.
Mark Singleton, the organisation’s head of business intelligence and acting associate director of IM&T, explains that WWL is often referred to as a data-driven organisation – and this goes back to some of the groundwork it put in place back in 2012. It was then that WWL put together a voluntary ‘Quality Champions’ programme for all staff – from finance managers to cleaners to management. The programme was aimed at empowering staff to make service improvements, including modules on how to use information to monitor changes for the short-term and long-term and ensure they are successful.
After six years, the organisation has had 365 employees go through the programme and it has helped to initiate 200 projects that are aimed at improving the organisation’s operations. These include reducing cancellations for pre-operations, safe discharging and human factors and incident reporting.
One of the main takeaways from the initiative is that more data was needed on how improvements could be made and how this could be monitored.
Success and failure when using Qlik
Coinciding with the programme, the NHS offered trusts help with service line reporting – to show which areas were making a profit and which areas were making a loss.
“It was based on [software provider] Qlik’s QlikView product, but the first few projects using this – including the service line reporting – weren’t particularly successful,” Singleton explains.
It wasn’t until a few years later that the trust finally managed to use QlikView effectively; it developed a finance app using QlikView which was aimed at reducing the need for an accountant to produce an A3 paper for each budget holder and explain to them what their budget looked like.
“We have hundreds of different budget holders so it was a bit of an impossible task. It was taking up all their time and they weren’t able to look at anything strategic,” says Singleton.
With the QlikView app, budget holders can log in to see their monthly budgets, and can drill down to invoices, staffing costs and income.
“It was a very visual way for non-finance people to engage with data and it was the first project that really changed the organisation’s perception of information,” Singleton explains.
This led to other departments wanting to use QlikView for clinical information, and ultimately led to the organisation having nearly 30 Qlik applications that support the way it operates in different ways.
“One of the targets in the NHS is when you go to the GP and they may refer you for a hip replacement. If you are referred to one of our hospitals, we have 18 weeks from referral to ensure the patient is treated. So we built an app to monitor our performance on that national target,” he says.
Prior to the app, WWL was struggling to meet the national target with a backlog of patients; now, according to Singleton, it is the “seventh or eighth best in the country around referral to treatment target”.
Meanwhile, the A&E department has a real-time forecasting app to predict how many people are going to be coming throughout the day; this helps the A&E to be as prepared as it can.
But while Singleton says that QlikView has helped the organisation to check how its performing against national targets, he says it is more of a static dashboard with limited interaction. This is why the organisation also recently purchased Qlik’s QlikSense product to complement QlikView.
“Qlik Sense would enable apps that have gathered data for the last few years to then ask questions such as ‘how many ambulances do we have arriving from care homes between 11pm and 7am, and how many come from Wigan and from outside of Wigan?’. This can help us to decide whether there is an opportunity of putting telehealth in our care homes,” he says.
QlikSense also provides the opportunity for employees to see data on their devices – enabling them to walk around wards or be available in the A&E department.
Another use case of Qlik’s software is a ward application which will appear on a large touch screen in WWL’s A&E department, executive offices and surgical theatres. This will replace the paper charts that nurses had to print off with specific information about the department.
“We’ve developed a Qlik app to provide just that; it will free up time for nurses so they don’t have to maintain and print off paper charts, but it’s also pulling in information from a range of our systems including HR, clinical, incident and risks and infections. This will harmonise all of the information and bring it into one place, making it far more conclusive,” he says.
The next step for the organisation is to introduce cloud computing as part of its IT environment. Currently, WWL has in-house infrastructure but it is working on a project to use Microsoft Azure to help set up a single version of the truth, enabling different providers in the health system to share data more effectively. The organisation wants to continue to be referenced as a data-driven NHS trust – and this seems like the logical next step.