WSICdashboards: Accountable Care Partnership View

Transcription

1 WORKING DRAFT Last Modified 29/05/ :53 GMT Standard Time Printed 29/05/ :00 GMT Standard Time WSICdashboards: Accountable Care Partnership View April 2015 User Guide Whole System Integrated Care

2 This user guide covers 4 sections This dashboard is for the management of the Accountable Care Partnership (ACP) to help track activity, outcomes, and spend Setup and login Key uses of the dashboard Good to know Page by page guide Provides a step-by-step guide to logging on to the dashboards Explains the web browsers and platforms supported by the system Explainsthe most impactful ways to use the tool Provides detail on each of those uses and the relevant pages in the tool Highlights the key assumptions behind the WSICdata warehouse and this particular dashboard Describes for each page in the dashboard Overview of the page Explanation of function on the page (e.g., filters) Details on the calculations on the page and notes 1

3 This is one of three main dashboards developed for WSIC and feeding off of the WSIC data warehouse Data feeds WSIC data warehouse WSIC dashboards GP (EMIS/System One) Acute (SUS/SLAM) Community (CDS) Mental health (MHMDS) Social care (multiple) Secure environment WSIC data warehouse Care professionals view Practice view Accountable care partnership view Patient identifiable data For care professionals involved in patient s direct care For prioritizing interventions and understanding patients history Patient identifiable data For care professionals and manager involved in patients direct care For planning workload related to patients care and tracking outcomes Anonymized data For managers and analysts involved in the ACP management (providers and commissioners) For tracking activity, outcomes and spend across the ACP 2

4 Last Modified 29/05/ :53 GMT Standard Time Printed 29/05/ :00 GMT Standard Time 3 Contents Setup and login Primary purpose of the tool Good to know Page by page guide

5 The dashboards are set up in Tableau and are supported by most major web browsers Web browsers supported Chrome Firefox (3.x or later) Internet Explorer (IE 8 or later) Safari (3.x or later) Platforms supported Windows XP or above OS X or ios 5.x or later Android 3.2 or later 4

6 The dashboards are accessible through the web with a unique username and login Logon steps required Open your web browser from a computer or tablet (e.g. ipad) within the N3 network Navigate to the URL: /dashboards Click on the icon for the ACPView to go to the landing page for this dashboard pack Enter your username and password 1 On the home page select the CCG/ACPthat is applicable to you 1 To be arranged with local IT leads and WSICteam Note: User requires an NHS LOCAL account in order to access the dashboards 5

7 Last Modified 29/05/ :53 GMT Standard Time Printed 29/05/ :00 GMT Standard Time 6 Contents Setup and login Primary purpose of the tool Good to know Page by page guide

8 There are 3 main uses of the ACPview dashboard 1 Track overall performance of your ACP across a set of metrics and drill down deeper into the drivers of those metrics 2 Understand the ACPspend over time and across different settings 3 Understand your capitated budget calculation and track spend against it See the subsequent 3 pages for more information on each of these points 7

9 1 Track overall performance of your ACPacross a set of metrics and drill down deeper into the drivers of those metrics Track your ACP or network/gp s performance across a set of key metrics (overtime and against peers) Understand priority areas to focus management attention and click through to more detail 8

10 2 Understand the ACP spend over time and across different settings Analyse spend across care settings Understand how spend allocation is changing across care settings as a result of integrated care Click through to see move detail by provider, point of delivery or by GP 9

11 3 Understand your capitated budget calculation and track spend against it Track monthly spend against an implied capitated budget per month to understand performance and identify any issues Understand how the capitated budget is calculated across its different elements, including number of people in the population group, historical spend per person and potentially additional transition funding 10

12 Last Modified 29/05/ :53 GMT Standard Time Printed 29/05/ :00 GMT Standard Time 11 Contents Setup and login Primary purpose of the tool Good to know Page by page guide

13 It is important to understand the following regarding the data available in the WSIC data warehouse and this particular dashboard User access to patient data Data timelines Sensitive data Long-term conditions and QOF Spend No patient identifiable data is available in this dashboard since it is for the use of users with an indirect care relationship with patients In order to ensure aggregated data displayed in this dashboard can never be traced back to an individual patient a constraint is placed on the charts Wherever the number of patients behind a particular metric in the dashboard is 5 or less, no data is displayed. This means that some cuts of the data will show no entry when in fact some data should be displayed. This is more likely to be a problem when small amounts of data are loaded into the system, or when many data filters are selected A patient may opt out or dissent from sharing data across any care settings, meaning that no data will appear for those patients in any of the pages or calculations in the dashboards The data available in the system is based of feeds that are updated daily, weekly, or monthly. As such, some of the data in the system may be lagged by as much as a month or 6 weeks The system is therefore intended as an enabler in understanding the long-term needs and history of patients and the patient group, not for urgent response planning Each page of the dashboard includes a time stamp in the top right corner explaining when the most recent data is available to and an information i button in the bottom right corner where more information on data timelines can be found including a link to a data validation report showing data timelines by data source Sensitive data such as sexual health and HIV codes, abuse codes, etc.are not included in the system and are, in fact, never shared with the WSIC dara warehouses The grouping of patients into long-term condition (LTC) groupings is based on the Quality and Outcomes Framework (QOF) flags, rather than just the diagnosis. For example, a patient will be marked in the dashboard as having the LTCof asthma if that patient has bothbeen diagnosed with asthma andhas recently been receiving medication for that condition. The diagnosis itself is not sufficient. This is relevant for the LTCs, of asthma, epilepsy and mental health Spend figures included in this chart are for categories of patient spend for which the ACPis accountable, rather than all spend. For example, ambulance service spend is not included Patient level spend in some care settings is based on inferred average prices per services, based on financial and activity totals for those services. In other care settings, such as acute, more granular unit prices/tariffs are the basis of the spend figures Needs groups In the WSIC dashboards, patients are grouped into population segments (e.g., older people, 65+, with LTCs) and Needs Groups (e.g., 2 LTCs including mental health). Note, patients cannot appear in more than one grouping. Therefore, for example, if a patient suffers from both depression and COPD, he/she will appear in the Needs Group 2 LTCsinc.mental health rather than in the Needs Groups depression or COPD. Using the filter for LTCallows the user to see a total of patients by LTCacross Needs Group groupings 12

14 Last Modified 29/05/ :53 GMT Standard Time Printed 29/05/ :00 GMT Standard Time 13 Contents Setup and login Primary purpose of the tool Good to know Page by page guide

15 Structure of this section The following section includes information on each page in the dashboard, including (where relevant): An overview of the page and summary of how to use it Explanation of the functions available on the page (if applicable) Detail on the calculations included on the page 14

16 OVERVIEW The ACPView: home page Notes on usage Use this page to enter the ACPview dashboards Select the appropriate CCG and ACP and then enter the dashboards Use the navigation icons at the bottom of the screen to move from one page to another 15

17 EXPLANATION OF FUNCTIONS ON THE PAGE The ACPView: home page Select the appropriate CCG and ACP Navigate to other pages within the workbook by clicking on these icons Hover cursor over i to see information about the page or to jump to the data validation report 1 1 The data validation report provides more detail on the timelines of the data available in the dashboards 16

18 OVERVIEW The ACP View: Overview Notes on usage Compare your ACPagainst the benchmark chosen, and last year. Use the filters to choose your population segment, filter by needs group and select your GP practices to benchmark against Select comparator to compare against Note, when filtering by GP practice make sure that the 'Benchmarking' field is selected (at the top of the list in the select GP drop down) to display benchmarks 17

19 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Overview Select patient segment, needs group and filter by LTC 1 Select comparator, GP and/or GP network Hover over chart to move to more detailed analysis Compare your ACP to selected benchmark Navigate to the other pages within the workbook 1 LTC = Long-term condition 18

20 DETAIL ON THE CALCULATIONS The ACP View: Overview Calculation definitions Average patient age in selected population, years: weighted average Percentage of population with comorbidities, %: patients with 2 or more long term conditions in the selected population group Average spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Acute spend as a percentage of the total, %: share of acute spend in total Percentage of population with care plan, %: share of population with care plan Percentage of population using Community services/ Mental Health, Social Care, %: share of population using different services Average number of days outside of an acute hospital (YTD), days: calculated as total number of days in fiscal year to date minus number of days stayed in acute hospital as elective or nonelective patient in that period. For previous year it is scaled to the same date range Non-elective admissions per 1,000 population, rate: number of emergency admissions per 1,000 population Total average length of stay (EL and NEL), days: elective and non-elective average length of stay 19

21 OVERVIEW The ACP View: Population Overview Notes on usage View analysis by Needs Groups, by age and by gender to provide a view on the demographic profile of the selected patient group Use the filters to choose your population segment, filter by needs groupandselect fiscal year. Click on one side of the chart to filter the other side 20

22 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Population Overview Select patient segment, filter by LTC 1 and fiscal year Select comparator, GP and/or GP network Click to view population pyramid for specific needs group Click to view needs group comparison for specific age group Navigate to the other pages within the workbook 1 LTC = Long-term condition 21

23 DETAIL ON THE CALCULATIONS The ACP View: Population Overview Calculation definitions Number of patients, #: count of patients according to different criteria, needs group, age, gender Patients are assigned to Long-term condition (LTC) based on the QoF flags rather than just diagnosis. This means that some patients officially diagnosed with an LTC, but not receiving treatment or medication for it may not appear in that LTCgrouping. This is of particular relevance for asthma, epilepsy, mental health conditions Note that patients can only appear in one category. For example, a patient suffering from COPDand hypertension would be counted in the 2 LTCs grouping not in either the COPD or hypertension groupings, which refer to patients with just that one LTC. to see a total of patients with, for example, COPD, use the select LTC filter 22

24 OVERVIEW The ACP View: Care Planning and Service Usage Notes on usage View your population's use of care planning, community, mental health and social care services Use the filters to choose your population segment, filter by Needs Group, select either the current or previous fiscal year, and the set of GP practices to benchmark against Click on one side of the chart to filter the other side 23

25 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Care Planning and Service Usage Select patient segment, filter by LTC and select metric to be displayed Select GP network Click to view data by needs group for specific practice Click to view data by GP for selected needs group Navigate to the other pages within the workbook 24

26 DETAIL ON THE CALCULATIONS The ACP View: Care Planning and Service Usage Calculation definitions Percentage of population with care plan, %: share of population with care plan Percentage of population using Community services/ Mental Health, Social Care, %: share of population using different services 25

27 OVERVIEW The ACP View: Spend Overview Notes on usage Analyse spend by care setting and compare with the previous year Click through using the icons to see more detail on spend by provider, Point of Delivery or GP Use the filters to choose your population segment, filter by long term conditions and select your GP practices to benchmark against Note, when filtering by GP practice make sure that the 'Benchmarking' field is selected (at the top of the list in the select up dropdown) to display benchmarks 26

28 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Spend Overview Select patient segment and filter by LTC Select comparator, GP and/or GP network Compare this year s spend Click to view spend breakdown by different care settings with last year s spend Compare your ACP to selected benchmark Navigate to the other pages within the workbook 27

29 DETAIL ON THE CALCULATIONS The ACP View: Spend Overview Calculation definitions Spend/total spend, : total including acute, community, mental health, GP, social care spend for all patients in selected population group Spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Forecast outturn is calculated separately for each care setting and based on the amount of data loaded to date together with the ratio of total annual spend that this represents based on previous page 28

30 OVERVIEW The ACP View: Spend By Provider Notes on usage Analyse spend by provider across the different care settings and compare with the previous year Use the filters to choose your population segment, filter by longterm conditions and select your GP practices to benchmark against Click through using the icons to see more detail by Point of Delivery or by GP Note, when filtering by GP practice make sure that the 'Benchmarking' field is selected (at the top of the list in the select GP dropdown) to display benchmarks 29

31 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Spend By Provider Select patient segment, filter by LTC and care setting Select GP and/or GP network Track spend by providers month by month Compare this year s forecast spend with last year s spend Navigate to the other pages within the workbook using these icons 30

32 DETAIL ON THE CALCULATIONS The ACP View: Spend By Provider Calculation definitions Spend/total spend, : total including acute, community, mental health, GP, social care spend for all patients in selected population group Spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Forecast outturn is calculated separately for each care setting and based on the amount of data loaded to date together with the ratio of total annual spend that this represents based on previous page 31

33 OVERVIEW The ACPView: Spend and Activity by Points of Delivery Notes on usage Analyse spend and activity by point of delivery (level 1) across care settings and compare with the previous year) Use the filters to choose your population segment, filter by long term conditions and select your GP practices to benchmark against Click through using the icons to see more detail (e.g., by POD level 2) Note, when filtering by GP practice make sure that the 'Benchmarking' field is selected (at the top of the list in the select GP dropdown) to display benchmarks 32

34 EXPLANATION OF FUNCTIONS ON THE PAGE The ACPView: Spend and Activity by Points of Delivery Select patient segment, filter by LTCand care setting Select metric to be displayed (spend or activity) Select GP and/or GP network Track spend or activity across points of delivery month by month Navigate to the other pages within the workbook 33

35 DETAIL ON THE CALCULATIONS The ACPView: Spend and Activity by Points of Delivery Calculation definitions Spend/total spend, : total including acute, community, mental health, GP, social care spend for all patients in selected population group Spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Forecast outturn is calculated separately for each care setting and based on the amount of data loaded to date together with the ratio of total annual spend that this represents based on previous page 34

36 OVERVIEW The ACPView: Spend and Activity by Points of Delivery (Level 2) Notes on usage Analyse spend and activity by Point of Delivery (level 2) across different care settings and compare with the previous year Use the filters to choose your population segment, filter by long term conditions and select your GP practices to benchmark against Note, when filtering by GP practice make sure that the 'Benchmarking' field is selected (at the top of the list in the select GP dropdown) to display benchmarks 35

37 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View Spend and Activity by Points of Delivery (Level 2) Select patient segment, filter by LTC and care setting Select metric to be displayed Select GP and/or GP network Track spend across points of delivery month by month Navigate to the other pages within the workbook 36

38 DETAIL ON THE CALCULATIONS The ACPView: Spend and Activity by Points of Delivery (Level 2) Calculation definitions Spend/total spend, : total including acute, community, mental health, GP, social care spend for all patients in selected population group Spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Forecast outturn is calculated separately for each care setting and based on the amount of data loaded to date together with the ratio of total annual spend that this represents based on previous page 37

39 OVERVIEW The ACP View: Spend by General Practice Population Notes on usage Analyse total spend for patients registered to different GP practices and compare with the previous year Use the filters to choose your population segment, filter by long term conditions and select your GP practices to benchmark against Note, when filtering by GP practice make sure that the 'Benchmarking' field is selected (at the top of the list in the select GP dropdown) to display benchmarks 38

40 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Spend by General Practice Population Select patient segment, filter by LTC and care setting Select GP and/or GP network Compare spend this year and last year across GP practice populations Navigate to the other pages within the workbook 39

41 DETAIL ON THE CALCULATIONS The ACP View: Spend by General Practice Population Calculation definitions Spend/total spend, : total including acute, community, mental health, GP, social care spend for all patients in selected population group Spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Forecast outturn is calculated separately for each care setting and based on the amount of data loaded to date together with the ratio of total annual spend that this represents based on previous page 40

42 OVERVIEW The ACPView: Spend by Needs Group Notes on usage Analyse spend across care settings by Needs Group Understand build-up of spend across care settings for different groups of patients Use the filters to choose your population segment, filter by longterm conditions and by GP practice or network 41

43 EXPLANATION OF FUNCTIONS ON THE PAGE The ACPView: Spend by Needs Group Select patient segment, filter by LTC and year Select GP and/or GP network Compare spend across needs group and care settings Navigate to the other pages within the workbook 42

44 DETAIL ON THE CALCULATIONS The ACPView Spend by Needs Group Calculation definitions Spend/total spend, : total including acute, community, mental health, GP, social care spend for all patients in selected population group Spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Forecast outturn is calculated separately for each care setting and based on the amount of data loaded to date together with the ratio of total annual spend that this represents based on previous page 43

45 OVERVIEW The ACP View: Spend versus Capitated Budget Notes on usage Track forecast spend for the year against the capitated budget Understand build-up of spend across different care settings over time Choose your population segment, select fiscal year and select method for capitated budget growth rate 44

46 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Spend versus Capitated Budget Select patient segment, year and growth rate Forecast spend for the ACPfor the year vs. the capitated budget See build-up of spend across different care settings Navigate to the other pages within the workbook 45

47 DETAIL ON THE CALCULATIONS The ACP View: Spend versus Capitated Budget Calculation definitions Spend, : spend provided in data feeds or calculated based on agreed assumptions Capitated budget, : total spend included in capitation plus transition funding Capitated budget per population, : total spend included in capitation divided by number of people in the target group 46

48 OVERVIEW The ACP View: Spend versus Capitated Budget on a monthly basis Notes on usage Track monthly spend vs. implied average monthly spend for the capitated budget Choose your population segment, select fiscal year and select method for capitated budget growth rate 47

49 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Spend versus Capitated Budget on a monthly basis Select patient segment and year to analyse Select annual growth rate assumed as part of the capitated budget calculation Monitor monthly spend vs. capitated budget Navigate to the other pages within the workbook 48

50 DETAIL ON THE CALCULATIONS The ACP View: Spend versus Capitated Budget on monthly basis Calculation definitions Spend, : spend provided in data feeds or calculated based on agreed assumptions Capitated budget, : total spend included in capitation plus transition funding Capitated budget per population, : total spend included in capitation divided by number of people in the target group 49

51 OVERVIEW The ACP View: Capitated Budget Calculation Notes on usage This page displays capitated budget, actual and forecasted spend information Choose your population segment, select fiscal year and select method for capitated budget growth rate 50

52 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View Capitated Budget Calculation Select patient segment and growth rate Benchmark your capitated budget agains other ACPs Understand how capitated budget has been calculated Navigate to the other pages within the workbook 51

53 DETAIL ON THE CALCULATIONS The ACP View: Capitated Budget Calculation Calculation definitions Spend, : spend provided in data feeds or calculated based on agreed assumptions Capitated budget, : total spend included in capitation plus transition funding Capitated budget per population, : total spend included in capitation plus transition funding divided by number of people in the target group 52

54 OVERVIEW The ACP View: Capitated Budget Details Notes on usage Understand the breakdownof capitated budget This page displays capitated budget, actual and forecasted spend information. Choose your population segment, select fiscal year and select method for capitated budget growth rate. 53

55 EXPLANATION OF FUNCTIONS ON THE PAGE The ACPView: Capitated Budget Details Select fiscal year Understand how capitated budget has been calculated Navigate to the other pages within the workbook 54

56 DETAIL ON THE CALCULATIONS The ACPView: Capitated Budget Details Calculation definitions Spend, : spend provided in data feeds or calculated based on agreed assumptions Capitated budget, : total spend included in capitation plus transition funding Capitated budget per population, : total spend included in capitation plus transition funding divided by number of people in the target group 55

57 OVERVIEW The ACP View: Outcomes Overview Notes on usage Track the ACP sperformance against key metrics in the 5 outcome domains of the WSIC Choose your population segment and select the set of GPs to analyse When filtering by GP practice make sure that the 'Benchmarking' field is selected to display benchmarks 56

58 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Outcomes Overview Select patient segment and filetr by LTC Select comparator, GP and GP network Monitor your population performance against key WSIC outcome metrics Note the exact metrics to be tracked for this outcome domain are to be determined Navigate to the other pages within the workbook 57

59 DETAIL ON THE CALCULATIONS The ACP View: Outcomes Overview Calculation definitions Average number of days outside of an acute hospital (YTD), days: calculated as total number of days in fiscal year to date minus number of days stayed in acute hospital as elective or nonelective patient in that period. For previous year it is scaled to the same date range Total average length of stay (EL and NEL), days: elective and non-elective average length of stay Excess bed days as percentage of total length of stay (EL and NEL), %: total number of excess bed days divided by total length of stay Average spend per person, : total including acute, community, mental health, GP, social care spend per person in selected population group Non-elective admissions per 1,000 population, rate: number of emergency admissions per 1,000 population A&E attendances per 1,000 population, rate: number of A&E attendances per 1,000 population 58

60 OVERVIEW The ACP View: Funnel Plot Notes on usage Analyse population statistics on a funnel plot chart GP practices that are more than 2 standard deviations away from the median will appear outside of the funnel (and be noted on the right hand side of the chart) Choose your population segment and select metric to be displayed on a chart 59

61 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: Funnel Plot Select patient segment and metric Identify outlier GPs on key WSIC metrics Navigate to the other pages within the workbook 60

62 DETAIL ON THE CALCULATIONS The ACP View: Funnel Plot Calculation definitions Spend per patient, /patient: spend provided in data feeds or calculated based on agreed assumptions over number of population registered for selected GPs and assigned to selected population group. Spend per activity, /patient: spend provided in data feeds or calculated based on agreed assumptions over number of activities for population registered for selected GPs and assigned to selected population group. 61

63 OVERVIEW The ACP View: WSIC impact Notes on usage Note that WSICimpact dashboard is conceptual and should be further developed Analyse the impact of WSICon key metrics across the ACP Choose CCGand set of GPs to analyse Compare performance of early adopters vs other GPs 62

64 EXPLANATION OF FUNCTIONS ON THE PAGE The ACP View: WSIC impact Select CCG and GP Compare performance of early adopters vs other GPs Evaluate the impact on WSIC on your population Navigate to the other pages within the workbook 63

65 DETAIL ON THE CALCULATIONS The ACPView WSICimpact Calculation definitions All admissions: number of all admissions for selected CCGand GPs before and after implementation of WSIC(0 on time scale) Non-elective admissions per 1000 population, : number of non-elective admissions divided by population (in 000) for selected CCGand GPs, data is presented separately for early adopters and other practices 64