County Durham PCT was established on 1 October 2006 from 5 predecessor PCTs and the two PCTs, which work closely together and share key corporate services and management roles, now support 86 GP Practices and serve a population of approximately 600,000. . The PCTsâ role is to engage with local people to improve health and well-being, and reduce health inequalities; ensure that patients have access to and choice of a range of high quality health services by commissioning services within allocated resources; and directly provide high quality responsive and efficient services where this gives best value.
âWe have highly complex data,â said Roger Haydon, Head of Information Services for County Durham PCT. âOur minimum data set for a single patient comprises around 300 fields, which typically grows to over 500 fields once the meta data and other derived data is added. We commission services from acute NHS trusts as well as indpendent sector providers. As a result, we have many different sources of data. Each provider has different handling processes, which means we have to manage and sort through numerous sets of inconsistent data, be able to understand and examine it all as well as spot any anomalies. This was not only time consuming but difficult to manage, as you had to know what you were looking for. We did a market evaluation of several products over a three month period and selected Datanomicâs dn:Director as our platform of choice.â
As part of its drive for accuracy and consistency in line with the Department of Healthâs mandated requirements, County Durham PCT and Darlington PCTs needed to automate and streamline the handling of their data quality management processes and achieve high levels of efficiency. Previously, data quality checks were handled through the use of multiple SQL queries in response to issues identified by data analysis after data had been loaded to the data warehouse.
âThe risks arising from inaccurate data are understandably high,â added Haydon. âIf data is incorrect, a patient could be allocated the wrong treatment code. This not only determines patient care, but also the associated cost to the commissioner and can affect the budget for the PCTs and GP Practices. As an extreme example, a mistake in the dates of a patientâs hospital stay could lead to an in-patient spell of 2 years rather than 2 weeks and can cost a hundred thousand pounds rather than a thousand pounds but other errors are often a lot smaller and a lot more difficult to identify. Our main source for secondary care data is the NHS SPINE Network. These data sets are provided to us through the secondary uses service. During any quarter, we will get an initial download of the first shot of data from providers followed by refreshes of data throughout the quarter until the data is frozen at the end of the period. We are pulling down substantial data sets that are used constantly and which a large number of records.â
The PCTsâ Data Management Team will go live with Datanomicâs dn:Director in March 2008 and it will be used on a daily basis to work with a range of data flows.
âOur objective is to be a world class commissioning organisation with a fully modern business intelligence system,â said Haydon. âIn our system we have many reference tables holding codes, values, tariffs and GP names and addresses and this data changes constantly as these are kept up to date. These reference tables sit inside our data warehouse and, with dn:Director, we can automatically pick up any changes, without having to manually import the tables into the dn:Director environment. This was an important consideration for us, which no other vendor could fulfill. Working in the NHS means handling very complicated and sensitive data. You canât afford to wait for someone to tell you thereâs a problem. You need a dedicated tool to help ensure accuracy and quality, and help make best use of limited public sector resources, which is why weâve adopted dn:Director as our platform of choice for forensically examining data.â
Described by industry analysts as âthe most flexible data quality product on the marketâ, dn:Director offers a comprehensive interactive learning environment for organisations to profile, audit, cleanse, parse, match and merge both structured and unstructured data, using clearly defined processes and full accountability to data owners and stakeholders. Using the data quality management and reporting features of dn:Director, enterprises have gained measurable business benefits such as reductions in costs and decreased customer or employee churn, and have implemented fast and effective solutions to data issues caused by market and regulatory changes.
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âAs part of our initiative, we are also completely rebuilding our data warehouse, building online data cubes and upgrading the delivery of business intelligence to the PCT,â concluded Haydon. âDatanomic will be an important tool in the process of rebuilding that system and in defining the rules used to routinely audit and load data and report on data quality. dn:Directorâs dashboard will not only save us time and money, but also change the way we work by giving important information to senior management. It will enable us to spot any problems before data is used in strategic analysis and in decision making and reveal when things are not being done appropriately. We have critical data in the NHS. It must be accurate and it must have an audit trail. dn:Director will help us achieve both of these objectives.â