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The past ….

SPARRA – Past, Present and Future Mark Sanderson Health and Social Care Information Programme ISD Scotland. The past …. The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach ….

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The past ….

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  1. SPARRA – Past, Present and FutureMark SandersonHealth and Social Care Information ProgrammeISD Scotland

  2. The past ….

  3. The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … Hospitalisation Hospitalisation SPARRA Timeline LTC National Action Plan Better Health, Better Care 20:20 Vision Delivering for Health 2005 2006 2007 2008 2009 2010 2011 2012 Classic All Ages Excel SPARRA Lists

  4. Kaiser-Permanente Pyramid Intensive Acute Case/care Very Management Emergency High sector admissions Disease/care High risk management Interventions Self management Medium risk Targeted Primary Lower risk Prevention Population Wide Prevention, Health Improvement & Health Promotion SPARRA - Classic - All Ages

  5. …. the present ….

  6. The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … Hospitalisation Hospitalisation Hospitalisation Prescribing Emerg Dept Outpatients Psychiatric SPARRA Timeline Better Health, Better Care LTC National Action Plan 20:20 Vision Delivering for Health 2005 2006 2007 2008 2009 2010 2011 2012 Classic All AgesVersion 3 Excel SPARRA Lists

  7. Datasets and Risk Factors

  8. Coverage of Version 3 Population covered by SPARRA Version 3 = 3,500,000 Population of Scotland = 5,194,000 Overlap between emergency admission patients and SPARRA “All Ages” = 40% Overlap between emergency admission patients and SPARRA Version 3 = 95% Number of Emergency Admissions in a Year = 342,500 Population covered by SPARRA “All Ages” = 687,000

  9. New and Current Risk Scores Note: 2.67m patients have a SPARRA Version 3 risk score of less than 10%. The equivalent figure is 217,000 for the current tool.

  10. Three Sub-Cohorts New cohorts ….. • Long Term Conditions • aged 16-74 • Frail Elderly • aged 75+ • Younger Emergency Department • aged 16-55 • At least one ED attendance in previous 12 months …. new opportunities …

  11. Version 3 Model Factors Frail Elderly Younger ED Alcohol/ substance misuse related admissions Age All cohorts Deprivation Emergency / elective / daycase admissions Prescriptions in specific BNF chapters Prescriptions for specific groups of drugs LTC related admissions ED attendances New OP attendances for MH Emergency bed days New OP attendances Polypharmacy LTC Psychiatric admissions Prescriptions/admissions indicating particular conditions Deprivation

  12. Local Collaborations • Development of local algorithms/tools • Support local initiatives e.g. virtual ward model • Informs longer term national development of SPARRA • Use of data sources not available at national level • Two active projects • NHS Ayrshire & Arran • West Lothian CHCP

  13. Use of SPARRA • Wide variation in take-up and use • Primarily used for case-finding • Limited strategic application • Knowledge café • NHS Ayrshire and Arran • Aberdeenshire CHP • East and Midlothian Anticipatory Care Service

  14. The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … Hospitalisation Hospitalisation Hospitalisation Prescribing Emerg Dept Outpatients Psychiatric SPARRA Timeline LTC National Action Plan Better Health, Better Care 20:20 Vision Delivering for Health 2005 2006 2007 2008 2009 2010 2011 2012 Classic All AgesVersion 3 Excel SPARRA Lists

  15. The shift from a health care system geared towards reactive hospital-based treatment of acute conditions to one which is founded on a preventative, anticipatory approach … Hospitalisation Hospitalisation Hospitalisation Prescribing Emerg Dept Outpatients Psychiatric SPARRA Timeline LTC National Action Plan Better Health, Better Care 20:20 Vision Delivering for Health 2005 2006 2007 2008 2009 2010 2011 2012 Classic All AgesVersion 3 Excel SPARRA Lists SPARRA Online

  16. SPARRA Online • SPARRA online offers secure user-friendly access to SPARRA data through a Business Objects universe • It provides patient listings and risk score history • It can be used to generate own queries or use the pre-generated reports • The security settings allow access to GP, CHP and/or NHS Board level access to users • Roll-out at an advanced stage

  17. …. and the future

  18. SPARRA – The Future Tools and accessibility iSPARRA Version 3

  19. iSPARRA • Incorporate SPARRA into a Management Information System • Wider benefits of risk stratification • User-friendly front-end, dashboard and drill-down • Access to the full Version 3 dataset

  20. SPARRA – The Future Tools and accessibility iSPARRA Version 3

  21. SPARRA – The Future Tools and accessibility iSPARRA NHS24 SAS … … Out of Hours? Version Data sources 3

  22. SPARRA – The Future Tools and accessibility iSPARRA NHS24 SAS … … Out of Hours? Version Data sources 3 SPARRA Version 3 Under 16 model Automation

  23. SPARRA – The Future Tools and accessibility iSPARRA NHS24 SAS … … Out of Hours? Version Data sources 3 SPARRA Version 3 Benefits Under 16 model Automation Evaluation

  24. SPARRA – The Future Tools and accessibility iSPARRA NHS24 SAS … … Out of Hours? Version Data sources 3 SPARRA Version 3 Prescribing data Benefits Under 16 model Automation Polypharmacy Evaluation

  25. SPARRA – The Future Tools and accessibility iSPARRA • Other outcomes • Early readmission • ED attendance • Admission to care home NHS24 SAS … … Out of Hours? Version Risk prediction Data sources 3 SPARRA Version 3 Prescribing data Benefits Under 16 model Automation Polypharmacy Evaluation

  26. SPARRA – The Future Tools and accessibility What Else? iSPARRA • Other outcomes • Early readmission • ED attendance • Admission to care home NHS24 SAS … … Out of Hours? Version Risk prediction Data sources 3 SPARRA Version 3 Prescribing data Benefits Under 16 model Automation Polypharmacy Evaluation

  27. Website:www.isdscotland.org/sparraE-mail: nss.isdLTC@nhs.net Further Information

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