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Qrious acquired NOW Consulting, the New Zealand-based data consulting division of WhereScape Software, in September 2019. This case study refers to work done by NOW Consulting prior to this acquisition.
With the support and expertise of data specialists at NOW Consulting (now Qrious), the organisation has established a data warehouse which consumes and standardises information from 23 general practices and over 100 000 patients located across the eastern suburbs of Auckland.
With clean, accurate data, it now produces reports directly from the warehouse to meet the statutory requirements of the Ministry of Health, as well as providing immediate access to detailed insights into the health realities of the patients it serves. This in turn delivers the information required to target services appropriately to meet the health needs of our community. The solution is considered revolutionary for the healthcare industry and is held up as a model of using data for improved health outcomes for other providers across New Zealand to follow.
Headed by chief executive officer Loretta Hansen, East Health empowers personal and community health and wellbeing by promoting quality information, facilitating innovative programmes and endorsing healthy lifestyle choices. It provides quality preventative and interventional medical care, enhances the skills and knowledge of personnel and providers, and helps to achieve greater equity in health outcomes.
Like many healthcare providers across New Zealand, East Health found itself in an increasingly difficult situation with data access and reporting. Senior business analyst Jody Janssen explains: “We’re at a scale where we need to work across multiple locations. Our practices are spread around a large geographical area, and they all run different Practice Management Systems.”
Data extraction and standardisation was therefore the first problem it faced. “Getting standardised and validated data sets was difficult. There were the different software vendors and each of the practices have their own ways of doing things. The way we were collecting data before engaging with NOW Consulting often involved a person accessing the practice management software at each practice and running several queries while trying to identify and select the right data.”
In other words, a decidedly analogue process. “Once that was complete, we’d have multiple different files that we would need to connect. This meant it was practically impossible to get and use any reports outside of the standard ones which could be produced by the various Practice Management Systems. It just took too long, was very labour intensive, and at times it was just too difficult.”
As Janssen puts it, “It was really hard to get data beyond patient registers and a few clinical performance indicators. There was no access whatsoever to the back end of any database at any of the practices - anything you wanted took several ‘query builds’ to get the information.” In addition, some systems were not well understood. Equally of concern was security with the workarounds that were being used to collect and exchange data.
But East Health recognised the enormous potential which was hidden in the data it had such difficulty in accessing. That’s why it sought out NOW Consulting, initially for its expertise around the WhereScape RED automated data warehousing solution. The relationship with NOW Consulting was a true partnership. They made a point of understanding our business, and this made them a pleasure to work with.
Janssen explains: “On the one hand, we have daily reports which provide relevant information on how the organisation is tracking. Then, with accumulated data, we have the flexibility to look at different aspects of healthcare – use of antibiotics, prevalence of diabetes, smoking cessation. With a population view of what is happening with patients, we can better support our practitioners to provide proactive care and receive funding for specific health needs in our community.”
Having worked with NOW Consulting in the past – Janssen spent time at Auckland Council, where the solution provider has played a key role in enabling data driven decision making for the City – she says she knew where to get the required expertise to ‘information-enable’ East Health.
As part of its design of a complete data insights platform, NOW Consulting has implemented the WhereScape RED data warehouse automation solution and created a secure data platform for the healthcare provider. “RED allows us to gather data directly from the Practice Management Systems in its raw state. It allows us to easily transform and validate the different data sets into the data warehouse in a standard fashion,” says Janssen.
With the platform, security concerns are eliminated, as well as the need for a ‘man (or woman) in a van’ driving around trying to collect information. “Now everything is done remotely and automatically over a secure VPN connection. The data warehouse pulls data in, delivering a major time saving, and while the system is flexible it has the scalability to meet our current and future needs. By classifying data correctly at capture, data quality is improved, and this contributes to better information outputs.”
Data which her team couldn’t even find in the past is now accessible at the click of a mouse. “Through this exercise, we’ve realised we had no idea of what was in the systems simply because we had no way of getting it out. Thanks to NOW Consulting, we don’t only have the reporting we initially wanted, but a whole lot more: we have information describing medications and classifications, screening and lab results, patient demographics, data on alcohol consumption, smoking, cardiovascular disease. With all that data available, there is huge flexibility in terms of the analysis and reports we can create, which better guide how healthcare is delivered and ultimately contribute to better treatment and health of patients.”
An added benefit is the establishment of a feedback loop: information goes back to the practices to improve the way they use their Practice Management Systems, particularly as it relates to data quality, data cleansing and standardisation. The improved data quality leads to useful information in discussions with clinicians. They are reassured that the data is validated and therefore reports can be trusted.
Laying the foundation for analytics
East Health’s data capability today means that they can be leaders in the sector. “It has taken many years to get to this point and it wouldn’t have been possible without the support of the organisation’s board and executive management. It is an investment which started with a proof of concept. The board immediately saw the potential and the value of having quality data that would allow improved health care decision making. We have been developing it over time to the point where it is today: a great foundation for analytics which sets the scene for anything from ad hoc reports, through to regular reporting for management, District Health Board (DHB) and the Ministry, as well as routine insights into the health status of the patients we care for.”
Enhanced reporting capabilities
Flexibility is a valuable feature of the solution. “The reports required by the Ministry and District Health Boards change from year to year; that’s now no problem for us in terms of our reporting capability. With the data warehouse, we have all the data and we can find it right away.”
East Health’s system provides the ability to accurately assess different healthcare needs and provide targeted services based on different demographics of the population: for example, certain ethnic groups have higher prevalence of diabetes or cardiovascular related diseases. Securing funding for this, or any other specific purpose, from DHB or the Ministry is far more likely when real data is presented as a motivator. “When you can present decision-makers with information, it justifies the funding. You go from anecdotal observations to the facts based on data,” Janssen notes.
Moving towards data-driven storytelling
With the help of NOW Consulting, East Health is in the process of rolling out the next phase of its information delivery platform: Qlik business intelligence and visualisation software. “Right now, there are several spreadsheet-based reports which are ‘fed’ by data from the data warehouse, which means we can repeat what we are doing, which makes it rapid and predictable. But as we move towards better visualisations, Qlik will enable data-driven storytelling,” Janssen says.
Moreover, she says future delivery of data insights with Qlik will allow them to combine data sets for new insights, something it is already doing. “We can add information from the accounting system if we want. Or we include extra data sets such as files from the Ministry. This gives us a view of the patient’s journey through the health system, it provides the ability to explore ways of getting more information from the data.”
Bringing together data from multiple sources
She says the ability to easily capture and use data from multiple practices and sources is a nut that East Health has cracked with the help of NOW Consulting. “We believe that other health providers see our achievement as something to aspire to. When, for example, the DHB asks if people are screened for alcohol consumption, we can answer within hours. In the past, it was very hard to respond as the data wasn’t available – now, we can quickly pull together the information.”
“The board and CEO can see the benefits of our investment and are thrilled with the result. It takes time and cost, but they saw and understood the value to the business and today, we’re seeing the benefits of that vision.”
