Mapping and GIS helps counter Ebola

issue 62 : February 2015

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Reflecting on ten years of GI

INSPIRE: the first seven years

What’s in a name? GIS or geospatial

MapAction maps Ebola

Geography and the NHS: GIS for A & E

The geography of books

and much more withNews | People | Products & Services | GiSPro’s columnists

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. . . GIS andlocation

analytics withhigh-qualityclinical and

financial dataanalysis. . .

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REFERRING TO THEIR NEW GIS, Paul Scott, Directorof finance and performance at the Ipswich HospitalTrust, said “it has given us a whole new platform fordiscussion and changed the conversation at boardlevel to focus on moving to a more sophisticatedway of visualising and reporting data. The IHT boardhas requested that geographic information andlocation is included within its business intelligencestrategy”

Ipswich Hospital NHS Trust (IHT) provideshealthcare services to more than 356,000 people.One of the hospital’s key objectives is to become thecentre of a network of co-located and integratedservices, delivered to meet demand for healthcare inthe region as well as driving education and research.It’s an ambitious goal and to meet it IHT needs tomap the demand – from where, and by what means,do patients come to the hospital?

Spreadsheets can’t cope IHT has over 75,000emergency department attendances a year andnearly 30,000 unplanned emergency admissions.Like many healthcare providers in the UK, it thereforefaces tough challenges managing the demand for itsservices. The provision of healthcare is an essentialservice and an emotive topic, so it is vital to be ableto predict demand from the population and respondby meeting it quickly. Visualising that challenge canprovide real insights and can ultimately lead to abetter service for the population relying on thehospital.

According to Paul Scott “Our existinginformation solutions rely on extensive use ofspreadsheets. They are therefore simply unable toprovide us with the level of insight into patterns ofbehaviour in core populations that we urgently need.So we decided to find a solution that would give usgreater understanding of the geography of demandwithin our catchment area, as well as what form thatdemand will take.”

The escalating demand now being faced by theA&E department continues to increase financialpressures on the IHT. It is also making it all butimpossible to efficiently manage patient flows. Thereare increasingly urgent knock-on effects oninpatients and outpatients’ departments and thewider ‘care flow’ pathway.

These challenges are made even more difficult bythe need to meet tough key performance indicators(KPIs), including keeping waiting times below fourhours. IHT has therefore set itself the followingpriorities:

Improving clinical outcomes;•Overcoming financial challenges and making•savings, critical in light of potentially failing tomeet KPIs;Making systems more efficient.•

Integrated locational and actuarial analysisNot only did IHT need an objective understanding ofcurrent demand, but it also needed to know how tointervene more effectively in the future. It decided toimplement a feasibility programme to assess howlocation analysis and actuarial analysis, workingtogether, could provide insight into demandmanagement that could shape future services for thebetter.

Esri UK worked with an actuarial servicesprovider, for analysis of financial trends and risk, anddelivered the location analysis solution to turn thisvision into reality.

This combination of GIS and location analyticswith high-quality clinical and financial data analysis,feeds into a long-term financial modelling systemprovided by the actuarial service provider.

Esri UK’s input was vitally important in deliveringdata visualisation to provide the required insight. AnArcGIS platform has been implemented on IHT’s in-house infrastructure behind a secure firewall. ArcGISfor Server and ArcGIS for Desktop have beendeployed to provide services to a managementdashboard. IHT management now gain additionalinsight by being able to map out the number of cases

GIS for A&E – part of the answerIpswich Hospital NHS Trust tackles escalating demand with help from geographic

information, reports Dr Ed Wallington, Health & Social Care Lead, Esri UK.

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Issue No 62 February 2015

GIS for A&E

www.gisprofessional.co.uk

. . . it hashighlighted a

different way oflooking at ourorganisation,

and the demandpressures we

face.

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going to A&E by a range of variables visualised as‘hotspots’ highlighting, for example, the sources ofdemand. The dashboard also provides a set of KPIreporting tools, giving managers a dramaticallyimproved understanding of the status of demand inthe hospital. It enables them to break down A&Eattendees by number of cases, average waiting timeor mode of travel, and then split the figures down bytimeframes.

Visualising the geography of demand TheTrust now recognises the huge potential of thesystem to provide relevant insight much more quicklythan before. Visualising data on a map helps IHTunderstand where there are hotspots for certaindiseases, admission methods, and average time-to-treatment. Understanding the geography of demandfor emergency admissions, and the type and level ofthat demand, has enabled IHT to pinpointinterventions that can mitigate it. The Trust believesthis will enable it to improve its resourcing processes.It will, for example, be able to bring in more clinical

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support staff to meet increaseddemand on certain days of the weekand therefore alleviate resourcepressure. This should help minimisecosts while maintaining performanceand clinical standards.

According to Scott, “While thisremains an R&D project it hashighlighted a different way oflooking at our organisation, and thedemand pressures we face. Inaddition, it has demonstrated thehuge potential of looking at demandacross the whole population ratherthan just on the basis of individualattendance. It also allows us to tryout ‘what if’ scenarios. In short, ithas given us a whole new platformfor discussion and changed theconversation at board level to focuson moving to a more sophisticatedway of visualising and reportingdata. The IHT board has evenrequested that geographicinformation and location is includedwithin its business intelligencestrategy.”

Moving forward, the analysis ofpatient demand and the mapping ofvarious insights and possibleinterventions could provide a basisfor reconfiguration of services andtherefore reductions of wastage.The use of geographic information,in particular in conjunction withactuarial data, could position theIpswich Hospital Trust as a leader in

the innovative use of IT in healthcare provision. Thisexciting, groundbreaking project has the potentialto revolutionise the future of healthcare demandmanagement, not just in Ipswich, but across thewhole of the UK.

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About the authorDr Ed Wallington is theHealth & Social Care Leadat Esri UK. Ed utilisesgeospatial technology andlocation analytics tosupport improving clinicaloutcomes and moreeffective spend. Ed workswith a range of healthprofessionals in publichealth, primary andsecondary care, and socialcare, including hospital

trusts, clinical commissioning groups, commissioningsupport units and national public health agencies.

Issue No 62 February 2015

GIS for A&E