Splunk for Digital Health - Real-time data for efficiently run hospitals (#2300)

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Idea Description
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Innovation 'Elevator Pitch':
In healthcare settings, Splunk is a powerful, easy-to-use business intelligence tool that analyses real-time data from multiple sources — enabling managers to run more efficient healthcare services.
Overview of Innovation:
Unlike other business intelligence tools, Splunk is platform-agnostic and can address ‘ad hoc’, non pre-programmed questions. Converging Data Ltd provides secure, on-premise or a hybrid cloud solution that combines and analyses structured & unstructured data from multiple sources, including but not limited to HL7 data, even collecting data directly from internal data networks.

This data can be interpreted without the need for predefined schemas and structures, providing real-time performance monitoring across entire care pathway.

Converging Date Ltd has created specific healthcare applications utilising the Splunk software platform.

Splunk makes it simple to collect, analyse and maximise the value of big data generated by security systems and business applications and improve operational performance and results.

Healthcare Intelligence
Healthcare Services & Care Pathways can be visualised and analysed using the IT Health Intelligence solution & HIX (HL7 Health Intelligence Connector).

Gathering data from multiple sources, in different formats and without consistent standards is what Splunk does best. HIX takes HL7 data from PAS, Pathology, Pharmacy or Electronic Health Records and provide a clear picture of how care is being delivered in real time.


HIX allows organisations to easily collect HL7 data commonly transferred between clinical and administration systems.

The Care Pathway Profiling tool allows data to be represented in a form that can be mapped to local physical or logical care pathways. Alerting options ensure that the right people are notified when thresholds in service levels are reached.

Patient Flow
This powerful, easy-to-use business intelligence tool analyses real-time data from multiple sources, enabling managers to run more efficient healthcare services. By gathering existing structured and unstructured data from across the organisation Splunk allows healthcare providers to view the entire care pathway and direct resources to address rapidly changing conditions.

The Patient Flow module can easily be tuned to match local care pathways and service delivery models. Advanced analytics can be used to track organisation’s KPIs and highlight anomalies & identify root causes.

The Patient Flow module uses the Healthcare Common Information Model (HCIM) that ensures data received from multiple systems can be mapped to HL7 standards and local nomenclature. HCIM allows searching and reporting across systems which are interdependent, but not interconnected.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
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Innovation 'Elevator Pitch':
Viper360 is a configurable which creates a Intergrated Care Record or  Shared Care Record.  ReStart uses an incrementatl approach to interoperability helping team achieve targets, on time and on budget.
Overview of Innovation:
The Presentation Layer offers multiple users, across a range of services, a bespoke view of all available information about a patient. It supports the requirement to write-back to the source systems based on user RBAC status. This covers all clinicians, patients, social care and healthcare users.

Based on over 12 years of integration expertise and experience, the Viper360 Presentation Layer has been built to allow multiple users (clinicians, users and patients) to view, review and write back into multiple IT systems in real-time.

How is the Presentation Layer different to a portal?
A portal, such as a patient portal, offers patient centric visibility of their data which they can consent to being viewed by many clinicians. Information is managed and shared through a single-to-many relationship.
The Viper360 Presentation Layer goes further. It is a fundamentally a tool for care professionals that can be scaled to include patient interaction. In short, it offers a broader many-to-many relationship to patient data allowing conditions for professionals to interact in real-time.
Key features the of the Presentation Layer:
  • Many-to-many view vs single-to-many
  • Creates a Virtual Patient Record within the Presentation Layer
  • Supports Multi-Disciplinary Team (MDT) collaboration
  • Pulls information in real-time from any available source system
  • Minimises clinical risk by maximising data availability
  • Highly configurable offering role-based access and bespoke user views
  • Fast to deploy
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Flexible
  • Present users with relevant data at the point of care
  • RBAC compliant
  • Choose which business or clinical needs you address initially around patient flow. Such as
    • Delayed transfer of care
    • Digital pathology
    • Inappropriate A&E Attendances
    • Duplicated Testing
    • Etc.
Scalable
  • From single organisations source systems through to a fully Integrated Digital Care Record
  • Provides the functionality to include new organisations and systems as the need arises
 
Affordable
  • No need for Rip and Replace.
  • Save money by realising the full potential of existing systems.
  • Incremental spending providing early return on investment.
  • Cash releasing benefits can fund future developments.
  • Working in a mutually rewarding partnership.
.
Initial Review Rating
3.40 (1 ratings)
Benefit to WM population:
Although we have not had a Viper360 deployment in the West Midlands Region we have in others for example South West Yorkshire Partnership NHS Foundation Trust (SWYPFT) has gone live with a new clinical portal for its mental health, community, and learning disability services that has the potential to save staff significant time each year in unnecessary administration and phone calls by improving access to clinical information.  By bringing this vital information into a single view, staff do not have to spend precious time unnecessarily trying to find information or discussing patient cases with colleagues from different service departments.
 
The deployment supports a key element of the NHS’s Long Term Plan which placed a renewed emphasis on the adoption of technology to support ‘clinician-centric digital user journeys across all health settings’.
 
The trust’s clinical portal, called PORTIA, supports the NHS’ 10-year plan by reducing clinical risks associated with disparate information on different systems, and removes the duplication of data entry into specific clinical systems.
 
PORTIA is powered by ReStart’s Viper360® Presentation Layer which plugs the interoperability gap between Trust Integration Engines (TIEs) and enterprise-wide integration solutions such as electronic patient records, building towards a full shared care record.
 
Nichola Hartshorne, Kirklees and Calderdale Improving Access to Psychological Therapies Clinical Manager, said: “We wanted to give our Single Point of Access teams and other local care providers a full picture of a patient’s interaction with the trust at the point of referral, to make sure they had visibility of patient demographics, previous appointments, contacts and progress notes.
 
“This not only reduces the risk of missing any relevant details on referral, it also means patients will no longer need to continually provide and repeat personal information at each care episode, therefore improving their experience”, added Hartshorne. 
 
The Viper360 Presentation Layer is a tool for care professionals that can be scaled to include patient interaction. It offers a broader many-to-many relationship to patient data allowing conditions for professionals to interact in real-time  

Viper360 will if adopted hughly benefit the West Midlands population enabling fast and accurate access to infomation and reducing the need for duplicate tests.
Current and planned activity: 
ReStart are currentley looking to invest time in the West Midlands on sharing the Viper360 stories and are looking towards the AHSN for support.
What is the intellectual property status of your innovation?:
ReStart are the holder of th IP
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
2
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Innovation 'Elevator Pitch':
TeleTracking provides solutions and services that enable the highest quality of care delivery and coordination, driving access, throughput and flow from the community to the acute setting to post-acute care.
Overview of Innovation:
TeleTracking equips healthcare organisations and care providers with the IT and innovation tools needed to coordinate care across the patient’s journey. Our operational platform and services combine proprietary technology with deep domain knowledge on patient flow and healthcare operations to drive access, capacity and flow from the community to the acute setting to post-acute care. 

Through a centralised coordination centre model, TeleTracking’s IQTM Platform provides real-time visibility across networks of care, ensuring patients are cared for in the right place at the right time with the right resources. 

By providing healthcare organisations with functional and technology-driven capabilities, hospitals are able to utilise real-time and historical data for continual operational improvement and organisation intelligence, leading to a better quality of care. 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
N/A
Regulatory Approvals:
Please describe any current regulatory approvals you have achieved and how they were met/ in progress/planned.
Commercial information:
Please describe how the product/service is being developed commercially, whether in development, trials, pilot or full commercial delivery. Include the results you have from any market/demand surveys and forecasts . Please include any research you have on the broader commercial opportunity for the innovation both within the health sector nationally and internationally.
Investment activity:
Please describe what stage of investment you have reached and whether you are seeking additional rounds of investment. Please include cash investment as well as investment of soft assets such as access to specialist equipment, knowledge, trial base etc. and indicate the types/sources of your investment such as grants etc.
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
Measures:
What outcomes are you hoping to achieve and what are the measures that you will use to gauge the success of the innovation and how will these assessments be made? Please ensure that you have quality, safety, cost and people measures.
Adoption target:
What are the targets for adoption across the WM and what are the minimum viability levels?
Investment sought:
What investment are you looking for in order to support wider adoption of this innovation and what have you managed to secure to date? Please provide a breakdown of these costs if possible.
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Innovation 'Elevator Pitch':
Alamac work in partnership with health and social care organisations / systems to help diagnose challenges in real-time, identify key actions based on objective data, and implement changes which result in sustainable improvement.
Overview of Innovation:
Alamac are specialists in behavioural change and sustainable performance improvement. We apply a simple process, using a proven clinical method, and combine this with our technology to create sustainable change.

We work with our partner organisations to understand the flow of patients through different pathways of care - including acute / hospital care, community health, primary care and social care. We work alongside teams to gather relevant, current data and act upon it.

We develop the individuals and teams to use this data as information to drive action. Teams are able to identify the 'cause and effect' of pressure points and actions are then put in place to improve the system performance, the patient's journey and quality outcomes.

Our team bring a wealth of experience in clinical practice, operations management and senior leadership. 100% of our delivery team are clinically or NHS trained leaders with the experience, skill and credibility to deliver. They bring their experience and knowledge of working with over 45 systems/organisations across the NHS and Social care. We act as a critical friend, helping teams to think differently and create a disciplined culture of real-time improvement.

We deploy a simple process based around the transparency of daily data. Through our facilitated ‘Test and Learn Cycles’, daily use of this intelligence involving senior leads from across the system allows teams to diagnose system issues in real time, and use objective information to identify actions to tackle these issues.

Our approach creates a fundamental change in the way teams work. It supports collaboration and integration across organisational boundaries. Our process allows teams to work on objective intelligence and reality, rather than emotion and myth. We create a disciplined culture of support rather than blame and of action rather than story. Our encouragement of predictions means that teams drive the changes they want to see and become less reactive. This delivers a greater grip on the issues at hand, removes uncertainty and drive proactive actions.

By following our process every day, consistently and persistently, we create lasting culture change.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Wealth creation / Digital health / Innovation and adoption
Benefit to NHS:
  • We deliver transparency of information across all parts of the organisation/system- providing ‘One Version of the Truth’ that is used daily to form actions to deliver benefit.
  • We use daily forums to fix 'in-day' problems and to monitor systemic solution delivery. During this period we help teams to identify and collate measures, understand what targets they want to set, and begin to take earlier and better decisions to deliver incremental improvement.
  • We help teams to develop a system and a forum to share intense and constructive feedback, as well as a new numerate language to drive a culture of real-time improvement.
  • The process supports individuals, teams and organisations to hold to account based on objective information.
  • We develop and coach individuals and teams in improvement methodology to deliver sustainability to the organisations and system
The outputs are:
  • Integration of and patient pathway improvement and service reconfiguration
  • Rebalance of capacity and demand (management)
  • Stabilisation of operational performance to build recovery and resilience
  • Construction of associated programme management and governance
  • Deliver in excess of 10x ROI – 30% of which is cost saving
  • Leadership development and empowerment of front line leaders and senior and executive teams
  • True ‘clinical team to board’ transparency, reporting and assurance.
  • Trained and skilled workforce in continual improvement
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Through our simple process, clinical method and technology we can support the WM to deliver improved and sustained performance; integration and collaboration and a skilled workforce in improvement methodology. Some examples our outlined below:

DTOC Reduction
In a medium sized health and social care system, a key issue impacting on patient flow was identified as underutilised capacity within the community hospitals.

We developed a key set of measures to enable a better understanding of the ‘cause and the effect’ of the underutilised capacity and supported the teams in identifying and implementing appropriate actions.

The result of the approach was an increase in community bed utilisation. The effect of this was a reduction in the number of medically fit patients in the Acute Hospital.




Improving Quality
Working with the frontline teams delivering patient care, we support them to analyse their own data, take ownership of it and develop the confidence to use and make decisions based upon it. The staff and teams feel empowered to identify and implement actions that they can monitor, in real time, to ensure actions are having the intended effect.

In one ward we identified that 45% of their falls were occurring on a Sunday.

Through working with the ward to diagnose the ‘cause and effect’ of this number the ward sister adjusted her roster (at no additional cost) to ensure a dementia champion was on duty on a Sunday.

This resulted in the number of falls on a Sunday reducing to 0 which was sustained.


By impacting on quality outcomes, such as falls, there has been a cost saving associated for our clients. The average cost of a fall to an acute hospital is £3000, (The Kings Fund, 2013).

A client example:


Releasing Time to Care
In one of our clients we were able to capture key measures required for ‘Audits of Key Performance Indicator Bundles’ at the front line, and in real time, as part of the daily standard work.

Prior to this, the audits were being completed by a clinician in each team taking 1 day a month in 21 teams away from clinical care.

We enabled the staff to rapidly complete the audits as part of the daily routine releasing clinical time back to the teams. It also released time in the governance team as the manual process was no longer needed.

The clinical time saved has been costed as:
1 day/month for 21 teams = 252 days/year
Costed at midpoint Band 5 = £24,211 savings/year
Current and planned activity: 
Alamac would like the opportunity to work with healthcare providers in the West Midlands, as well as work more closely with the West Midlands Patient Safety Collaborative, hosted by the WMAHSN, that aims to improve safety and continually reduce avoidable harm by supporting organisations in working together to develop, implement, share and spread proven safety interventions that are based on rigorous, evidence-based scientific methodologies.
What is the intellectual property status of your innovation?:
Our improvement methodology - simple process, clinical method and our technology is the intellectual property of Alamac
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
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