Existing Local Health Data Systems: a summary of the pre-event survey of

participants

Aishling Sheridan Research Officer (HSE)

Dr Marie CaseySpecialist in Public Health Medicine

Overview

• Background to scoping exercise

• Where this fits in the bigger picture- our collaboration

• Preliminary results from proforma

Background to Scoping Process• During our own work on area profiles a number of issues

arose• What we are asked for at local DPH level isn’t readily available• Increased demand for profiles and easy to access information in different

formats• Duplication and gaps

– Growth in numbers and types of profiles, both within the HSE and outside

• Sustainability of our process• Technical challenges

– Process of getting data was difficult– Not aware of all of the datasets

• Difficulties in eliciting feedback from users• Recognition of added value from a more collaborative approach

• Engagement with IPH and DH on HI seemed a natural starting point for exploring the potential of greater collaboration in this area to the benefit of all involved.

Our collaboration

• Discussions lead to us thinking about what a process for this might look like:– Scoping exercise and stakeholder event (today)– Report and action plan from this group (presented at

Knowledge 4 Health Conference)– Our aim is to move forward as a group to develop a

mechanism of constructive collaboration (using your feedback today and buy in) which would strengthen our health information function in Ireland and which would support our national public health strategy

Results of the pre-event Survey

Respondents

• 14 submissions received• Central Statistics Office• Environmental Protection Agency• Health Protection Surveillance Centre• Health Research Board• Health Service Executive• Institute of Public Health in Ireland• National Cancer Registry of Ireland• National Screening Service• National Suicide Research Foundation• Pobal• The Health & Positive Ageing Initiative jointly supported by The Atlantic

Philanthropies, the Department of Health, the HSE and Age Friendly Ireland.

• (1 late not included today but will be in later report)

Reports/Profiles by Organisation• Central Statistics Office

– Irish Health Survey (EU)

• Environmental Protection Agency– Ambient air quality monitoring data for pollutants– Environmental performance of EPA licensed industrial and waste

activities– Drinking water quality reports– Radiation levels in monitoring stations– Radiation levels in fish & shellfish– Radiation levels in foodstuffs– Radiation levels in water, seaweed & sediment– Radon gas levels in homes– Radon gas levels in schools & creches– Radon gas levels in social housing– Urban waste water discharges and impacts on receiving waters

• Health Protection Surveillance Centre– HIV annual report– Immunisation uptake statistics– Staph aureus MRSA quarterly and annual report– TB annual & quarterly reports– Weekly Infectious disease report

• Health Research Board

• Health Service Executive – Area profiles– Child health profiles– Health Atlas Ireland – Finder– Atlas Finder

• Institute of Public Health in Ireland– IPH Data Visualiser Tool– IPH Community Profiles Tool– Dept of Health PHIS data– Chronic Conditions Prevalence Tool

• National Cancer Registry of Ireland– Cancer Incidence

• National Screening Service– Service area uptake reports– County level coverage data

• National Suicide Research Foundation– Annual Report of the National Self-harm Registry of Ireland– Injury Database

• Pobal– Social Inclusion Community Activation Clients– Community Service Programmes, TUS, Gateway, and Rural

Social Scheme– Early childhood Care & Education (free preschool)

• The Health & Positive Ageing Initiative (jointly supported by The Atlantic Philanthropies, the Department of Health, the HSE and Age Friendly Ireland)– Positive Ageing in Ireland series of county reports

Main Uses of the Report/Profiles

• Information received on 38 profilesMain use of profiles Number (%)

of profiles

Map & identify risks 7, (18%)

Provide health related data – county level 6, (16%)

Surveillance data 5, (13%)Public information 4, (10%)Service planning 3, (8%)Provide health related data – national level 2, (5%)Administration 2, (5%)Uptake of screening programmes 2, (5%)Prevalence of chronic diseases – Ireland 1, (3%)Progress report 1, (3%)Provide health related data – regional level 1, (3%)Not documented 4, (10%)

Was this report commissioned?

• Was the area profile commissioned by another organisation?• Yes, 12 (32%)• No, 21 (55%)• Not known, 5 (13%)

• By who??– Department of Health n= 4– Department of Environment, Community & Local Government n=3– Department of Children & Youth Affairs n=1– Department of Education & Skills n=1– Department of Social Protection n=1– Health Service Executive n=1– Not known n=1

Collaboration

• Were there collaborating partners?• Yes, 20 (53%)• No, 3 (8%)• Not known, 15 (39%)

• How many??

One Two Three Four Five Six 012345678

35%

20%

30%

0

10%

5%

Number of collaborating partners per profile

Geographical Units of Profiles

National (4)Regional (1)

HSE Area (2)

County/City (7)

Local Authority (2)

Local Health Office (2)Small Area (3)

Service Area (1)

Site-specific (7)

Hospital (2)

Electoral Division (2)

School (1)

Not documented (4)

Challenges in Developing Profiles• 10/14 (71%) organisations reported experiencing challenge(s) in developing some of their

profiles.

• Main challenges reported were:1. Gathering and keeping the data up to date

Resources to manage networks, training and support needs, ensuring data accuracy/integrity, large areas, ongoing changes to be incorporated.

2. Costs associated with providing data Lack of funding and resources, large number of sites, ensuring compliance with standards e.g. EU

3. Getting data at the appropriate level on different topics eg on wider determinants of health Different administrative boundaries e.g. health (Community Health Organisations, Hospital Groups, Primary Care

Teams etc)

4. Geo-coding of addresses

5. No national agreed standard Collating comparable data across multiple platforms, no agreement on common indicators, or standard health profile

6. Access to data Lack of unique identifier, data coverage issues

Datasets in Survey

• Information provided on 61 ‘unique’ datasets from 33 source organisations.

• Of the 38 profiles featured: 79% used datasets from their

own organisation only

13% used datasets from other organisations

8% used a combination of their own datasets and other datasets in their profile

Self

Other

Self & Other

Source of Datasets in Profiles

Datasets per Profile

One Two Three Four Five Five + 0

5

10

15

20

25

30

3582%

Number of datasets

Num

ber o

f pro

files

General characteristics of the datasets:1. Frequency updated

Frequency of updating of dataset Number PercentageContinuously 1 1.3%

Weekly 7 8.8%

Monthly 2 2.5%

6-monthly 1 1.3%

Quarterly 13 16.3%

Annually 24 30.0%

2 yearly 1 1.3%

4 yearly 1 1.3%

5 yearly 7 8.8%

Other 19 23.8%

Blank 4 5.0%

Total 80 100.0%

General characteristics of the datasets:2. Method of access

Other Excel tables Downloadable Electronic file transfer

Manually pdf0%

5%

10%

15%

20%

25%

30%

35%

Method of accessing dataset from source organisation

Perc

enta

ge

General characteristics of the datasets:3. Aggregate or Individual level data

Data acquired at individual level was more likely to require manipulation by the user

Aggregate level44%

Individual level36%

Blank20%

Level of data in dataset used

General characteristics of the datasets:4. Coverage of datasets

Coverage of dataset Number Percentage

National 29 36.3%

Regional 15 18.8%

Local 21 26.3%

Blank 15 18.8%

Total 80 100.0%

Variables available in datasets

Variable Yes No

DOB (N= 64) 28% 72%

Age Group (N= 65) 69% 31%

Gender (N= 65) 55% 45%

Social Class (N= 61) 28% 72%

Deprivation (N= 60) 23% 77%

Ethnicity (N= 62) 19% 81%

Geographical level of Datasets

• County, 25 (39%)

• Small Area, 24 (38%)

• Local Health Office, 8 (12.5%)

• Electoral division, 3 (5%)

• Other 4 includes HSE Area, Regional Authority, National

Target Audiences

• Approximately 12 different target groups listed

• All have one target audience, 85% have at least two and 64% at least three

• Some commonalities – HSE (57%)– Dept of Health (50%)– Research/academia (36%)– Public (36%)– Local Authorities (29%)

End User Feedback

• Most (64%) respondents elicit feed back from end users

• Variety of mechanisms used, some multiple methods

– 29% use survey and 75% of these also use workshops and 50% had user groups

• Other methods used include comment forms, training sessions and email address

Publication format

• All respondents publish in some format

• Report most common (93%)

• Static tables or maps used by 71%

• Charts 64%

• Interactive maps or tables (43%)

• Other formats include pdf or excel documents, interactive charts, guidance leaflets, websites, infographics

In Summary

• Variations evident: • main uses/ target audiences/geographical units/mechanism

of accessing underlying data/ level of underlying data/publication of profiles

• Function of what is required or function of what is possible?

• Similar challenges across organisations

• Evidence of working on our own: Reports with one dataset and some collaboration.