The Expert:

Andrea O'Brien

Andrea O’Brien has 12 years’ experience as a clinical analyst and a senior analyst in the Health Intelligence and Informatics unit at Ko Awatea. Her current role focuses on data analysis for the Women’s Health and KidzFirst services of Counties Manukau Health. She also has experience of frontline clinical practice as a former registered nurse and midwife.

Their View:

Do you need to know what kinds of patients your ward is going to see more of in the future? Or how much it costs your organisation to provide care? Are you making decisions that require reliable information about these things?

Then you need a clinical analyst.

This article illuminates the often unseen, yet vital, role that clinical analysts play in a healthcare organisation.

Clinical analysts have two core functions: supporting evidence-based decision-making, and understanding the cost of care.

Supporting evidence-based decision-making
Clinical analysts spend a lot of time on retrospective analysis of hospital data and identifying trends in response to queries from clinicians, managers and researchers. For example, a typical query might be: ‘How many births have we had this year versus last year?’ or ‘Why was the length of stay for Paediatrics so high that month?’ In response, we provide regular monthly reports or undertake ad-hoc investigations.

The information we provide enables healthcare providers to understand what’s happening in wards and services. We can tell the difference between a developing trend that service managers need to plan for (the birth rate has dropped) and a blip in the data (the length of stay in Paediatrics was high because one child who’d had a very long stay was discharged that month). Using these insights, healthcare organisations make informed decisions about capacity and target areas to invest resources and develop the workforce.

Clinical experience is useful for analysts because it bridges the gap between data and clinical practice. Many clinical staff need to interpret data, and having clinical experience helps us to elicit the data they need and provide information in a meaningful and appropriate way. For example, we can draw on clinical experience to understand conditions or risk factors that may be contributing to a trend we have been asked to investigate.

Understanding the cost of care
The second core function is patient-level costing. We pull together data from a variety of sources to work out the cost of a patient’s episode of care (the care provided to a patient during one admission). Patients use a wide variety of resources during an episode of care – medicines, equipment, the time of doctors, nurses, orderlies and other staff – and each has a cost. Clinical analysts take each resource into account to create an overall cost profile per episode of care. We follow national DHB costing standards to ensure consistency.

Painting this picture of the cost of patient care means amalgamating data from many sources in a costing database called CostPro. We use information derived from clinical coding, the Patient Information Management System (PIMS), and the maternity clinical information system, MCIS (BadgerNet). There are also many others, such as the theatre database, clinician contacts, and specialist information systems used by pharmacy and radiology.

Part of our job is to integrate new data sources into CostPro as they become available. We figure out how to assimilate data from the new source with the data sources already in CostPro or create new ways to interpret the new data. For example, when MCIS was introduced, we integrated the new maternity clinical data into CostPro and undertook extensive audits to ensure data integrity.

We can use the data created by patient episode of care cost profiles by ‘slicing-and-dicing’ it in different ways to provide the answers wards and services need. To slice-and-dice data is to break it down in order to extract and analyse the information needed for a particular purpose. For example, a question from Maternity Services might require us to look at data on the cost of tubal ligation versus vasectomy.

The cost insights clinical analysts provide help healthcare organisations to understand how resources are being used and whether they’re performing cost-effectively.

To sum up, clinical analysts pull together information from many different sources to compile a picture of the care that we, as a healthcare organisation, are providing for patients and for groups of patients, how much it’s costing us, and how it’s changing over time. We make sense of the data that supports future decision-making in healthcare.

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