cocpit:’a’tool’for’integrated’care’pathway’ variance ... · proportion entering...
TRANSCRIPT
![Page 1: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/1.jpg)
COCPIT: A Tool for Integrated Care Pathway Variance Analysis
John Ainsworth & Iain Buchan University of Manchester, UK
![Page 2: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/2.jpg)
Care Pathway Variance Analysis (CPVA)
• IdenJficaJon of the difference between observed paJent’s record (EHR) and expected integrated care pathway (ICP)
• Requires: – Computable definiJon of expected – Observed data in electronic form – SoVware codes for analysis – Storage and processing resources
![Page 3: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/3.jpg)
ApplicaJons
• Audit – Process – Outcome – Inequality – Economic – Characterise the primary-‐secondary care interacJon
• Improvement – Inefficiency detecJon – Service redesign – Service integraJon
![Page 4: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/4.jpg)
Research Aim and ObjecJves
• AIM: Enable health professionals to perform the care pathway variance analysis (CPVA) without specialist knowledge of databases or IT systems
• OBJECTIVES: – Develop CPVA methodology – Implement methodology as web-‐based tool (COCPIT) – Test COCPIT using Stroke and Kidney disease data from Salford
– Specialise COCPIT to CPVA applicaJons
![Page 5: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/5.jpg)
SoVware Development Approach
• User centred design • Agile methodology – Task list – Sprints – SCRUM meeJngs
• C#, MicrosoV .net framework (v3), SQL server, Silverlight
![Page 6: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/6.jpg)
ICP Editor
![Page 7: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/7.jpg)
A {CondiJon}
B {branch condiJon}
Proportion Transition from non-adjacent node Proportion Entering Pathway here
Transition Times Transition Time Distribution Variance from expected Proportion of population Proportion of expected Flow capacity Proportion of capacity utilised
Proportion Transition to non-adjacent node Proportion Leaving Pathway here
Transition Times Transition Time Distribution Proportion of population Proportion of expected
Node definitions • Conditions
Branch nodes • Branch conditions
Edge definitions • Start/End Nodes • Capacity • Transition times
ICP definiJon
![Page 8: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/8.jpg)
Code set search
![Page 9: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/9.jpg)
CondiJon editor
![Page 10: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/10.jpg)
Data Requirements
• Coded Clinical Events – e.g. SNOMED-‐CT, READ, OPCS, custom
• Clinical event supporJng data – E.g. HbA1C test result value
• Timestamps – ResoluJon consistent with ICP
• Unique paJent idenJfier • OpJonally demographics – Age, gender, ethnicity, etc.
![Page 11: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/11.jpg)
Analysis
• Count of matches to each node • Count of matches of unique paJents to each node
• The point in Jme a paJent matches to each node
• From these values we can also then calculate values such as Jme between events, and summary staJsJcs for number of node visits and duraJon.
![Page 12: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/12.jpg)
Comparison of sub-‐populaJons
![Page 13: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/13.jpg)
PresentaJon of Results
![Page 14: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/14.jpg)
![Page 15: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/15.jpg)
Conclusion
• Salford Integrated Record – 2.5m events, 100k paJents
• Stroke survival analysis – ReplicaJon of analysis developed by staJsJcian
• ApplicaJon to data quality analysis
![Page 16: COCPIT:’A’Tool’for’Integrated’Care’Pathway’ Variance ... · Proportion Entering Pathway here Transition Times Transition Time Distribution Variance from expected Proportion](https://reader033.vdocuments.site/reader033/viewer/2022041705/5e447a6191a4227bc567998b/html5/thumbnails/16.jpg)
Thank you for listening