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FPH exam > 3C Applications of health services information > Flashcards

3C Applications of health services information Flashcards

1
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2
Q

Healthcare evaluation: formative Vs summative evaluations

A

FORMATIVE: Evaluations can be conducted whilst an intervention is ongoing/ being developed in order to inform ongoing intervention
SUMMATIVE: evaluation is conducted at the end of the intervention or evaluation of an established intervention/programme

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3
Q

Use of data for healthcare planning: how can data help with planning services, what 3 stages are needed

A
  1. ASSESS NEED
    - requires an epidemiological, qualitative and comparative approach. Need to consider need and future need (population forecasts)
  2. DEFINE PRIORITIES determine priorities based on the most effect use of resources
  3. HEALTHCARE REVIEW define current services and how these compare to those that will be needed to identify services which are deficient and those which are superfluous
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4
Q

Use of data for performance management: what are performance management useful for

A
  • performance management indicators are used to identify how services are performing against a dimension agreed to be important for that service
  • they are particularly useful in identifying when services are inadequate or there are problems with service delivery
  • if problems are identified further evaluation is needed
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5
Q

Use of data for healthcare evaluation: describe broad structures of healthcare evaluation frame works

A
  • healthcare evaluation often considers metrics covered by donabedians framework (structure, process, outcome)
  • cost and impact are almost always considered
  • quality should also be considered ie maxwells 6 dimensions effectiveness, efficiency, equity, Acceptability, Access, Revelance
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6
Q

What is an information system?

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  • an information system is a process in which raw information is transformed (usually by a computer) into meaningful information that can be used
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7
Q

What is an information system specification?

A
  • an information system specification is the set of requirements agreed between the user and developer of the system
  • development requires a high level of user engagement
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8
Q

Give 6 examples of information system uses

A

SEAL CAC

  1. SECURITY
    - information systems can ensure data is not lost or corrupted
  2. EXCHANGE
    - information systems can enable secure exchange of information
  3. ANALYSIS
    - information systems can analyse, display and report data
  4. LINKAGE
    - information systems can link information from multiple data sources
  5. CLINICAL INFORMATION
    - information systems can ensure a clinicians can access all relevant patient information ie bloods, xrays, notes
  6. AGGREGATION
    - information systems can aggregate data so that health care can be evaluated and monitored
  7. CLINICAL GUIDELINES
    -information systems can ensure clinicians can access appropriate clinical guidelines
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9
Q

measures of health care provision: give examples of primary care measures

A
  1. Number of GPs per 1000 population
  2. Average distance to nearest health centre
  3. Practice list size per GP
  4. waiting time for a GP appointment
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10
Q

measures of health care provision: give examples of secondary care measures

A
  • number of consultants per 100000 population
  • number of beds per 100000 population
  • average distance to nearest hospital
  • wait list time for elective surgery
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11
Q

measures of healthcare usage: what factors affect health care usage

A

Healthcare suage is a complex relationship between:
- Need
- Provision
- access

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12
Q

measures of healthcare usage: Primary care

A
  • average number of consultations per patient
  • number of secondary care referrals
    -average time spent with practitioner
  • number of prescriptions per patient
  • uptake of screening services
  • uptake of vaccination
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13
Q

Measures of healthcare usage: secondary care

A
  • emergency hospital admissions
  • number of outpatient appointments
  • bed occupancy
  • length of stay
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14
Q

Mathematical modelling: what is mathematical modelling

A

The process of analysing and simplifying a complex real-world problem/ situation using maths

The process enables observations to be analysed, using statistical or other techniques, so they can be used to predict events or provide solutions

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15
Q

Mathematical modelling: Advantages of mathematical modelling

A

used properly mathematical modelling can:
- support decision making process
- deal with complexity
-create alternative scenarios
- model an issue
- create short, medium and long term plans

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16
Q

Mathematical modelling: Uses if mathematical modelling in healthcare

A
  • model costs/benefits of different interventions as part of an economic evaluation
  • depict different possible outcomes and their probabilities in order to aid decision making (clinical and mathematical)
  • model communicable disease outbreaks
  • predict future trends in disease
  • predictive risk modelling (analyses the probability of an outcome depending on the presence of dependent variables)
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17
Q

Mathematical modelling: limitations of mathematical modelling

A

The usefulness of a model may be constrained by:
- the availability of data
- the quality of data
- the appropriateness of the assumptions made in the model
- use of inappropriate or flawed techniques

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18
Q

Mathematical modelling: What is predictive risk modelling

A
  • a technique of using historical pseudonymised data to determine the relationship between an outcome variable and a range of independent variables
    -outcome variable may be emergency hospital admission, readmission, care home admission
  • trying to predict who is most at risk of an unfavourable outcome
  • may be built using a range of techniques such as multiple regression or decision tree analysis
  • once the algorithm is built it is used to examinee current data on order to make predictions about the future.
19
Q

Mathematical modelling: What must apply to use predictive risk modelling

A
  • there most be enough appropriate historical data to build the algorithm
  • Data sources must be routinely available and updated regularly
  • must be able to link all data sources required
  • outcome must be unfavourable
  • there must be an efficacious intervention which could be employed to reduce risk of the outcome
  • the intervention must be cost effective given the positive predictive value of the algorithm
20
Q

Mathematical modelling: Give an example of predictive risk modelling

A
  • Kings fund
  • 2005
  • examined pseudonymised historical data to establish an algorithm to predict which people in the population were at highest risk of unplanned hospital admission in the next 12 months
  • algorithm allows GPs to rank their patients in terms of risk so preventative measures can be employed (ie community matron)
21
Q

what is an index/ what are indices?

A
  • an index summarises a set of data, that might be derived from different sources, in order to rank organisations/areas according to a particular characteristic
22
Q

Indices of health care need: name 3

A
  1. health poverty index
  2. Mental illness need index
  3. Index of multiple deprivation
23
Q

Indices of healthcare need: health poverty index

A

-collates 3 data on 3 dimensions in order to highlight health inequalities in a geographical area or ethnic group. These domains are:

1 ROOT CAUSE (eg education, income, social capital)
2. INTERVENING FACTORS (eg. lifestyle, effective preventative healthcare)
3. SITUATION OF HEALTH (eg premature mortality, access to secondary care(

24
Q

Indices of healthcare need: mental illness need index

A
  • aims to predict mental health need at a small area level using:
  • previous admissions
  • employment
    -overcrowding
  • indicators of deprivation
25
Q

Indices of healthcare need: Index of multiple deprivation

A
  • used to rank level of deprivation of a LSOAs using:
    1. income
    2. education
    3. crime
    4. barriers to housing and services
    5. living environment
    6. employment
    7. health
26
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A
27
Q

Indices of health service outcome: name 4 types of index for measuring health service outcomes

A
  1. output indices
  2. welfare indices
  3. performance management indices
  4. composite indices
28
Q

Indices of health service outcome: output indices (what are output indices and describe 2 different ones)

A

-Output indices consider how much of a service is being produced (ie number of patients treated)
- when combining multiple outputs of health services the data need to be weighted appropriately, there are different ways of doing this

IDEAL VALUE-WEIGHTED OUTPUT INDEX
- value attached to each output reflects its relative contribution to health outcomes
- other characteristics valued by patients are also incorporated

COST WEIGHTED OUTPUT INDEX
- this index weights separate outputs according to how much they cost to provide
- equates the costs with the benefits of the service provided:
- criticism: healthcare is not about cost btu patients, cost decisions should be made more explicitly ie using cost benefit analysis

29
Q

Indices of health service outcome: welfare indicies

A
  • combine data on value to final users (eg reduction in pain)
30
Q

Indices of health service outcome: Performance management indices

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-combine data on how the service is provided (ie was appropriate treatment used, were patients seen in a timely manner)

31
Q

Indices of health service outcome: composite indices

A
  • composite indices of health service outcome are constructed using several types of outcome/ performance measures
  • used world wide to rank health systems
  • need to pay careful attention to how they are constructed otherwise misleading conclusions may be drawn
32
Q

what is routine data?

A
  • data that is collected systematically from automated or semi-automated data collection systems
    ie births, deaths, HES, cancer registries, statutory notifications of infectious disease
33
Q

What is routine data used for in healthcare?

A
  1. ASSESSING BURDEN
    - calculate disease incidence, prevalence, mortality
    -assess health needs
    - assessing disease severity
  2. DRAWING COMPARISONS
    - over time
    - benchmarking against other areas
    -between population subgroups (health inequalities)
  3. HEALTH SERVICES
    - Assessing current provision
    - service planning
    - commissioning
  4. RESEARCH AND EVALUATION
  5. healthcare service evaluation
  6. epidemiological studies
34
Q

Strengths and weaknesses of routine data

A

STRENGTHS
- readily available
- low cost
- often has been collected over a long time period
- large population coverage
- often relatively up to date

WEAKNESSES
- coverage is not complete (even statutory notifications do not get 100% compliance)
- some data is not collected/ poorly collected (ie details on ethnicity)
- Data is often poorly collated, analysed and presented
- may contain bias if healthcare workers who report are systematically different to those who don’t
- contain more information on process rather than patient experiences or outcomes
- data may not be available at the geographical level desired

35
Q

How can routine data be improved?

A
  1. Computerised data collation and analysis (improves accuracy and timeliness)
  2. Feedback (feedback to data providers can improve engagement)
  3. Improved presentation (use a variety of means of presentation to engage policy makers, professionals and public)
    4,. Training (training on coding/input for those entering data)
36
Q

How have advancements in information and communication technology advanced healthcare?

A
  • faster/ different methods to communicate (email, text, video call)
  • near instant access to vast amounts of information (guidelines, studies etc)
  • digital threats which may pose risk to information security
    -Emergence of new inequalities (digital divide)
37
Q

what is health informatics

A

The field of health informatics is concerned with the application of information technology to the acquisition, processing, interpretation, storage, transmission and retrieval of health or health care related data

It aims to facilitate and improve health care delivery, education, management and research

38
Q

List 5 applications of health informatics

A
  1. patient monitoring
  2. clinical care
  3. electronic patient records
  4. video consultations
  5. GIS used in public health surveillance
39
Q

Information governance: what is information governance?

A

Involves ensuring that the collection, storage, processing and sharing of data within organisations adheres to legal standards and best practice

40
Q

Information governance: list 4 laws and guidelines relevant to information governance

A
  1. data protection act 2018 (was GDPR under EU)
  2. Freedom of information act 2000
    3 International information security standards ISO27001
  3. The confidentiality NHS code of practice
41
Q

Information governance: data protection act 2018 what is it and what are the pricniples

A
  • the confidentiality of UK patients data is protected by the data protection act
  • the act has 6 principles. Everyone responsible for using personal data must make sure the information is:
  1. used fairly, LAWFULLY and transparently
  2. Used for SPECIFIED, explicit purposes
  3. Used in a way that is LIMITED to what is necessary
  4. ACCURATE and kept up to date
  5. Kept for no LONGER than is necessary
  6. handled in a way that ensures appropriate SECURITY
42
Q

information governance: Caldicott guardianship- what is it

A
  • Caldicott report was published in 1997
  • found that adherence to data protection statutes was variable
  • In response every NHS trust had to appoint a Caldicott Guardian who was responsible for protecting patient-identifiable information
  • other caldicott recommendations were:
    1. develop protocols to manage the sharing of patient information with other organisations
    2. Permit access of patient information to only those who need to know
    3. Review and justify all use of patient information
    4. install a culture of data protection through training
43
Q

Information governance: electronic data storage what standards govern it

A
  • Information security standards apply to electronically stored data
  • ISO27001:2005 provides guidance on best practice for information security management and a standard against which an organization information security management systems are assessed and certified.
44
Q

Information governance: confidentiality- how should confidential information be managed (6 principles derived from caldicott guidelines

A
  1. justify the purpose for using
  2. only use confidential information when absolutely necessary
  3. use the minimum data that is required
  4. use information on a need-to know basis
  5. everyone must understand their responsibilities
  6. Understand and comply with the law

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