Evolution vs Revolution - #DataRevolution
Blog thoughts by Andy Begley, Co-Chair of WM ADASS and Director of Adult Social Care and Housing, Shropshire Council
At Shropshire Council and across our ADASS region, we have been considering how we can better use data to make more informed decisions. By looking beyond the data at hand, we are able to define the wider benefits of choices made in the health and social care economy, even grasping a glimpse into the future...
Up to now, the evolution of health and social care has focused on the management of supply and demand. Our world operates using the currency of beds and hours, and many of our decisions are based on these factors alone.
Over time, other factors have entered the fray for consideration. National data sets are readily available and can be merged into localised information, albeit defining information from the past – normally the previous month, quarter or year. That said, we were suddenly able to use data sets such as crime statistics and deprivation with existing local knowledge. This evolution was a step in the right direction, but no revolution.
In Shropshire, we identified another rich source of information, namely from our housing register. In early 2017 we pulled together a series of data sets to better understand Shropshire's position, in regards to thermal efficiencies of houses, and individuals’ ages and whether they lived alone or not. The thought process was clear: as a person living alone in a cold house, such factors could have a physical and psychological impact on their behaviour. This could mean the person often residing in just the one room, not moving around, and becoming reluctant to leave the room on regular basis, whether to make a drink or use the toilet. This behaviour could lead to potentially significant health issues, such as UTIs, that can result in hospital admission and/or entry into social care.
Image: Andy Begley demonstrating ‘big data’
This example became part of an initiative around falls prevention and one of many attempts to predict the future. Historically, a falls prevention visit would be part of either another service or routine or after an issue has occurred – but what if we could predict if someone were more likely to fall, using data?
This concept has evolved in Shropshire and become an integral part of our work with Fire and Rescue Services in relation to their ‘safe and well visit’ initiative.
A trigger for this visit uses three pieces of information:
- Is the resident over the age of 85?
- Are they living alone?
- Do they live in a thermally-inefficient house?
Simply taking those three pieces of data, we have been able to construct a risk profile that, working with colleagues from the fire service, has allowed us to target ‘safe and well checks’ on those individuals’ who tick these boxes, then offering a package of pre-emptive support. Although it is too early to tell if this has had a dramatic impact, this sows the seeds of how potentially unrelated pieces of information can complement one another. In this instance the inefficient house has specific outcomes – such as staying in one room, lack of movement and visiting the toilet less – all precursors for other potential issues. It has been suggested that those who fulfil all these criteria have an 80% chance of turning up at A&E in the next 12 months. Clearly, reducing these sort of numbers, will have a profound impact on admission avoidance and subsequent care costs.
In this article alone, we're building up a new set of data that offers insights into things we previously had fairly time-consuming and costly methods for trying to rectify or, in rare instances, prevent. ‘Big Data’ multiplies these data sets by not just hundreds but thousands, offering new opportunities for managing care and looking to the future.
As part of our early intervention and prevention work, we are using these data sets to trigger targeted and logical intervention – refining what was previously more of a ‘spread-bet’ of resource allocation. This has the potential to deliver enormous savings for the health and social care economy but most importantly – helping residents to stay safe and well in their own homes.
I explored this further at a presentation I hosted at the recent spring ADASS conference in which I talked about our progress to date, and how we are using game engine technology to drive predictive analytics and real-time modelling.
Although we can't see the future yet, we are now at a point where the revolution is at our fingertips, and it's no small change as the data revolution seems to be upon us...
Andy Begley is Shropshire Council’s director of adult social care and Chair of West Midlands Association of Directors of Adult Social Services (ADASS).
For information visit WM ADASS (link opens in a new window) or follow us on Twitter @wmadass
Issued to The MJ: 11 May 2018