HSMR

Breaking new ground to help hospitals better understand mortality ratios

A digital and IT services organisation is breaking new ground by using predictive analytics to accelerate the understanding of mortality ratios at an NHS hospitals trust.

The pioneering work is being done by The Health Informatics Service (THIS) on behalf of its host trust, the Calderdale and Huddersfield NHS Foundation Trust (CHFT), which runs Huddersfield Royal Infirmary and Calderdale Royal Hospital in Halifax, West Yorkshire.

It means the hospitals have near ‘real time’ mortality ratios instead of waiting for the national publication of the Hospital Standardised Mortality Ratio (HSMR) data, which is delivered three months in arrears and is some of the most acutely monitored data available to health trust leaders and healthcare professionals all over UK.

THIS’ information services team is collating data from CHFT’s Cerner Millennium EPR and other far-reaching clinical systems to gather information that then populates predictive R analytics software, an open-source software used for all kinds of data science, statistics, and visualisation projects.

Initial findings show an accuracy level of 85 per cent when compared to the HSMR, thus providing invaluable insight for CHFT’s medical directors, mortality surveillance group, and medical review co-ordinators.

Oliver Hutchinson, THIS’ Performance Information Lead for Primary Care, who is leading the mortality ratio analysis, explains: “The benefits are twofold. The first is to be three months ahead of the national HSMR data, so that when the national publication does arrive, we’ve had a foresight that will help to dispel any undue concerns.

“The second is that it will help us pinpoint potential clinical areas to improve. For example, if we have a patient with a low likelihood of death and they died, we can investigate that case and hold a clinical review to see if there is anything we can learn to prevent a death in similar circumstances in the future.”

Predicting a patient’s chance of survival

Anyone arriving at hospital is assessed on several criteria – these include a patient’s age, gender, exposure to deprivation, how they were admitted, comorbidity, whether they have a palliative care code and the actual diagnosis.

Based on the information gathered, predictive analytics allocate an expected death calculation (EDC) ranging between 0 and 1 – a score approaching 1 indicating an increased likelihood of death, while a score towards 0 indicating almost certain survival.

Considering all known factors, the scores are worked out incrementally, so for instance, someone might be given an EDC of 0.376 – which can be expressed as a percentage, i.e., they have a 37.6 per cent chance of dying.

The head of THIS’ Information Structure team, Gawaine Carter believes the data will allow the Trust a clearer focus on which cases to review.

He says: “The trust has always reviewed a good proportion of deaths but there weren’t pointers to which ones they really should be focusing on to learn from. The difference now is that it helps to focus a limited resource. Prior to this, we didn’t know where to focus until way after the event.”

Another use for the system is to potentially shed light on errors in recording a patient’s medical history. For example, a clinical review into someone who died despite a low EDC could check to see if certain factors had been missing from their medical record, which would decrease their survival chances and therefore would have produced a different EDC.

Predictive analytics – an emerging asset

Creating the near real time HSMR is THIS’ latest predictive analytics project. Two previous projects have focused on ICU admissions during the pandemic and, more recently, A&E admissions, to predict the percentage of patients arriving at A&E being admitted to hospital or sent home – currently running at an average accuracy level of 85 per cent.

It has also published a white paper entitled Predictive Analytics – An Emerging Asset in the Healthcare Industry, exploring how this fast-growing area of informatics can be strategically applied to support the healthcare sector in the UK and globally.

You can download the White Paper here.

NOTES:

About The Health Informatics Service

Established in 2006, The Health Informatics Service (THIS) is a well-established, innovative and award-winning digital healthcare and IT specialist.

It is the only NHS informatics service to hold three ISO standards of ISO9001 (Quality Management), ISO20000 (Service Management) and ISO27001 (Security). It was also the first to gain Informatics Skills Development Network (ISDN) accreditation in the Yorkshire and Humber region. 

Based in Elland, West Yorkshire, it works with public, private and charitable health and care organisations across the UK and Ireland. It is hosted by Calderdale and Huddersfield NHS Foundation Trust. 

It has over 230 expert staff leading and helping the digital transformation of primary, secondary and third sector care. Being linked to the NHS, its deep knowledge of public healthcare systems and values are unrivalled and its digital healthcare services have played a key role in the Covid-19 pathology testing and vaccine roll-out.

THIS works across four main areas of operational support, professional services, website design and information management:

  • Operational support includes collaboration, data centres, networks, IT service desk, Microsoft Active Directory (AD) and cyber security.
  • Professional services feature programme and project management, Registration Authority, IM&T training and Microsoft Office Specialist training.
  • Web development includes design and graphics.
  • Information services offer business intelligence consultancy, clinical coding and web-based knowledge portals.

Press release enquiries:

Nigel Wareing, Cornerstone Design and Marketing: 07834 835 922, [email protected]

National Health Executive, Nov/Dec, Cover

NHE Nov/Dec 22

How active travel can help staff save money, improve wellbeing and help meet net zero targets

This issue highlights the latest topics within the health sector, from the NHS outlining its net zero strategy, Virtual hospitals, sustainable healthcare, How the NHS can achieve financial stability and more with articles featuring industry leaders such as Rory Deighton, Acute Network Director for NHS Confederation, Dr Tom Milligan, Clinical Lead for Diabetes in Humber and North Yorkshire, Misha Garcia, Value Programme Lead, NHS Property Services and many more.

Videos...

View all videos
National Health Executive Presents

National Health Executive Presents

NHE365 Virtual Events

NHE has created a full calendar of events to address the most important issues that influence the delivery of healthcare services. Over 365 days you'll have the opportunity to hear from a range of highly motivating, informative and inspirational speakers. These speakers will equip you with the knowledge and unique insight to enable you to overcome the challenges that you face.

Finger on the Pulse

Ep 14. Health messaging is a science, Professor Craig Jackson

On Episode 14 of NHE's Finger on the Pulse podcast, we're joined by Professor Craig Jackson, Professor of Occupational Health Psychology
Birmingham City University to discuss the coronavirus pandemic, the health messaging around it and how those in power have missed a trick by overlooking the key role of psychology in informing the public of restrictions, measures and the ever-changing situation

More articles...

View all