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Initiative to Revolutionise Health Data Recording in Wales

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A pioneering approach to cracking data that predicts peaks in demands on health services is being nurtured in North Wales.

The system, once up and running, could save the NHS across the UK millions of pounds and enable services to be closely targeted at hot spots.

Four companies have been shortlisted by Betsi Cadwaladr University Health Board (BCUHB) in the trial, which will slash paperwork and reduce the burden on staff throughout the whole of the NHS.

Dafydd ap Gwyn, head of clinical coding at Wrexham Maelor Hospital with Sarah Creane and the patients records they are working on.

Thanks to funding from the Welsh Government through the Small Business Research Initiative (SBRI), the Health Board has challenged the four firms to develop ideas that will speed up the process of clinical coding.

The aim is to allow BCUHB, health organisations and other public bodies to plan resources more effectively in the future.

Clinical coding covers the systems where health workers manually record each patient’s individual care and treatment, including diseases, symptoms, operations, treatments, drugs and healthcare administration.

This allows health managers to monitor peaks and troughs in demands on NHS services and manage resources accordingly.

However, it is a time-consuming process as there is a wide variation in how medical care is classified. For example, a dog bite could fall into a number of categories such as laceration, wound, bleeding, or infection.

The majority of the information is also taken from paper health records, so  deciphering a variety of handwritten notes can further hinder the process.

Following a stringent application process, the five successful companies chosen to work with BCUHB on the first phase of the project are Interaction, 6xW Ltd, Sagittal Soft Ltd and CHKS.

The companies will initially receive funding of up to £10,000 each to develop their solutions over a four-month period. In the second phase, two of the companies will be selected to apply for up to £100,000 each to develop their concepts into fully functioning and marketable solutions over a year.

Dafydd Ap Gwyn, BCUHB Head of Clinical Coding, said:

“Every health board across Wales has to categorise patient activity – it’s something that has to be done.

“It allows the health service to decide where they’re going to target resources. By using coded activity and data they can decide if a hospital site requires additional cardiac services, for example, because they’ve identified an increase in cardiac patients and so there might be a need for another consultant on the ward.

“The key part of the project is the fact that at the moment it’s a slow process and takes a long time. There’s a lot of paperwork to read through. We’re looking for innovative companies to come up with an idea to speed up that process.

“We’ve not set out to save money initially, we’ve gone out to improve efficiency but in the long-term there will be a cost saving.

“It’s fundamentally about being more efficient and being able to record all our patient activity simply so the data is available much quicker for those who need to make strategic decisions.

“We’re always looking to make improvements and deliver a better service of health care. The ultimate aim is to make sure the patients are treated and cared for better.”

The project is expected to help overcome an anticipated increase in demand for critical coding nationally due to a growing number of treatments requiring categorisation.

Over the past five years, BCUHB has seen an increase in approximately 20,000 additional episodes with the trend expected to continue in the coming years.

“Each major hospital in BCUHB has on average around 10 clinical coders. Clinical coders not only have to be trained in the whole host of coding rules and standards but also the anatomy and physiology of the body,” said Dafydd.

“A heart attack can be described in a number of different ways and has a variety of possible codes. It’s vital for the health service that the right clinical code is recorded.

“Across the border, there is a direct link to coded data and how trusts are funded and therefore clinical coding has a greater recognition. It’s payment by results.

“Health boards in Wales use the data internally to look at performance and it’s also submitted to the Welsh Government for national comparisons and targets.”

A total of 23 companies from England and Wales applied to take part in the project and a shortlist of four businesses was drawn up following a robust assessment process.

Staff from the Clinical Coding departments across the Health Board will now work with the companies to help them understand the processes involved, from patient admission through to discharge.

Once the ideas have been developed in the ‘proof of concept’ phase, two companies will be chosen to move into Phase Two of the project, which will see the solutions built into fully marketable products.

“It’s down to the companies individually to come up with a solution,” said Dafydd. 

“It doesn’t have to be technological. If a company came to us with something different and it worked then it would be considered but clearly some, if not all of them, will technologically-based.”

The businesses will present their ideas at the end of March 2017.