Interview, Secondary Care

Interview Series: Geoff Bick, Civil Eyes Research

In our latest interview we spoke with Geoff Bick a co-founder of Civil Eyes Research, to explore how the company uses data and insight to drive transformational change, efficiencies and innovation. HTN asked Geoff a few questions:

Could you tell me a bit about yourself and Civil Eyes Research?

I have worked in healthcare for about 30 years, I started in medical records in a mental health facility, spent years at the audit commission and then 11 years at CHKS as the consultancy and product development director.

A colleague, John Smith and I decided to set up Civil Eyes Research 14 years ago. We wanted to work a bit more closely with clinicians, managers and stakeholders to not just use information but to have more dialogue around that information.

Civil Eyes Research is in essence a facilitated benchmarking organisation with clinicians at the heart of what we do, we look at studies and analysis in particular areas. We often run workshops that are multi-disciplinary, and we use information to highlight performance achievements.

We have two leading benchmarking programmes, the first is Valuing Medical Resources – twenty teaching hospitals across the UK have joined together to work on productivity issues. Our second programme is The Specialist Children’s Hospitals network working on shared data and developing specialist benchmarks.

Could you tell me about some of your recent customer successes?

One of our clients is an English Academic Medical Centre, we curated and facilitated a benchmarking service that helped highlight opportunities to both better explain and improve the hospitals performance. Of greatest concern in the brief was the seemingly ‘hard to explain’ rise in hospital standardised mortality ratio (1.15:1 and rising).

Our work was to explore with the COO detailed population and service profiles with carefully curated peers to identify immediate areas for improvement. From this initial exercise it was clear that the hospital either had a unique population of elderly patients – the data suggested few if any had the sort of complex co-morbidities expected in patients of this age group or there was a significant issue with data-quality – capture and episode / diagnosis coding.

By providing the hospital with a detailed breakdown of the services and clinical areas most out of sync with their peers they were able to implement a significant data capture and coding improvement scheme. As more accurate and appropriate profiles of the patients being treated by the hospital was captured, the relative risk of what was clearly a higher-risk, multiple co-morbidity patient population was more accurately captured and as such a much more accurate HSMR was reported; at the time the HSMR had fallen to lower than expected at 0.97:1 and falling.

Improved data-capture and coding produced a significant improvement in income; the correct capture of co-morbidities and diagnoses increasing income by circa £8m in 2016/17 and an additional £7m (£15m total) in 2017.

What is your biggest achievements over the past 12 months?

One that comes to mind is within the specialist children’s group there is a specialty of paediatric allergy. National activity data isn’t in line with how clinicians see this, so they aren’t able to see activity clearly, the national data doesn’t follow clinical practice. We delivered a successful work stream to define activity, resources and pathways, in an area without clinical information.

One interesting theme with our work with specialist children’s hospitals was on transformation. One hospital talked about they have introduced virtual outpatient services, using technology and a virtual clinic suite, that has resulted in a massive saving of clinical time.

We try and go into areas where the information is a bit less certain and try to work it out, like a translation role to provide insight. With experience you can both engage and analyse data to understand its relevance and status. Then you can think how it can be deployed to facilitate structured clinical conversation.

We worked with the Children’s Matron to explore moving more surgery to day cases – such as hypospadias, ENT procedures and operations on children aged under one. It also involved looking into pathways, exploring opportunities for early discharge into the community, to out of hours assessment of children following deliberate self-harm without hospital admission.

What does the future hold for Civil Eyes Research?

The link with Draper & Dash is a symbiotic relationship where the Civil Eyes experience of clinical conversation can positively influence the Draper & Dash offerings and also where the tech can be leveraged to improve Civil Eyes impact.

It’s important for empathetic informatics development, and to be in the position of the clinician and end user. These people are busy, they don’t want to do an A level in informatics, they’re busy and need information instantly. Joining together we will take this into account and be in the shoes of the end user.

In the medium term it is to work with Draper & Dash to develop empathetic products and work on the delivery of Civil Eyes work programme.

We will accelerate the adoption of analytics, improve benchmarking and importantly make analytics more accessible to healthcare professionals to drive performance improvement.