Our first HTN Now Focus event of 2022 took place on 10 January, with sessions focused on how to support digital mental health.
The first of our two live presentations of the day featured the specialist digital transformation consultancy, Ideal Health, and focused on the challenges and benefits of validating data within the mental health space.
Katy Lethbridge, Ideal’s Marketing Director and Basil Badi, Practice Director for Data Management, hosted the webcast, providing their insights on all things related to data quality and data management.
“Good data management is a golden thread”
Following the introductions, Katy kicked-off the session by discussing the importance of data management within the mental health sphere. “Our experience has shown that good data management is really a golden thread that needs to run throughout transformation, in order to make it work,” she said.
“A good example is some work we’ve been doing with a large mental health trust in the South East,” Katy continued, “we’ve been their strategic digital transformation partner since 2017.”
“We’ve done data centre migration, interoperability integration projects, EPR optimisation, an electronic data management system, various health tech projects, we’ve also worked with primary care and GPs on the PCN (Primary Care Network) programmes, and also through the pandemic on an Attend Anywhere roll-out.
“So, a huge variety of different things. But that theme of data quality and the need for validation and management was definitely a core component of those projects [and], also, of the ongoing transformation programme there,” she stated.
However, Katy also noted the challenges within the mental health data validation space, recognising both the need to “get data right” and the “increasing demand” on mental health services, which she said had “highlighted the need for better data quality through NHS services and in the mental health space.”
“Data validation is crucial to understanding where patients are”
Katy then asked Basil about the work required in digital mental health around data validation, as well as for his wider take on why data validation and management is important.
“In an ideal world, it shouldn’t be required…systems are becoming more intuitive and better integrated…[but] in the reality we live in today, data validation is crucial to understanding where patients are on their pathways,” Basil said.
He went on to explain: “Data validation is about reviewing the clinical information stored about a patient and their condition, and then comparing it against the activity recorded on the electronic records. In most cases, it’s about correcting that information so that it’s accurate and reflects the truth…it’s a bit like investigating and piecing the story together, so we can map a patient’s journey from beginning to end, until they are discharged.”
“We recently did a short piece of work over the festive period and the amount we were able to close down – in terms of patient pathways – was more than 60 per cent,” Basil continued.
“That means, out of every 10 patients [who] were listed as a priority, [it] reduced that just to four patients. That has a tremendous impact…if you scale it up across the entire patient tracking list…that’s 60 per cent less administration time required to manage patient pathways, that’s 60 per cent less capacity to plan for, that’s 60 per cent less clinical attention. That means that 40 per cent [then] becomes 100 per cent of the focus for operational clinical staff,” he stated.
“Validation basically provides an accurate view of waiting times and facilitates prioritisation, escalating patients at risk. Having an accurate waiting list just improves your ability to plan for the future, [and to] understand your capacity and demand. Ultimately, this saves time and money, and improves patient safety.”
“Mental health trusts need to get their data into a better position”
Moving on to why data quality is becoming more of a focus for mental health, Basil added: “As part of the Long Term Plan for the NHS, there has been increased focus on mental health trusts. Services are now having to submit data about the access and waiting times, as the acute trusts have been doing since 2007…mental health trusts need to get their data into a better position and understand how to manage it.”
On that topic, Katy quizzed Basil further, asking, “with that reporting in mental health now becoming more of a requirement, what are the challenges going to be?”
Basil said: “The biggest challenge working in this space [is] there isn’t a defined road to follow. We’re working closely with the services to help pioneer this by working together and reviewing current practices, and by helping them refine and standardise the processes to manage their mental health data more effectively.”
“[With] RTT (Referral to Treatment), we have over a decade of experience working with NHS trusts, and we’re used to the management of pathways with multiple specialities, and there are established best practices to turn to, to ensure that the clinical information and the data management practice have been integrated.”
He later added: “Within the mental [health] services we’ve worked with, they don’t currently use pathways and this is something quite new to them…it’s different and slightly nuanced…because they have different teams that cover different aspects of a patient’s mental health. It’s crucial that all the stakeholders – clinical and operational – work together to help understand that and ensure it’s done in the right way.”
“There are fundamental aspects of data validation that we had to adapt”
Providing a recent example through his work with a mental health service in London, Basil commented: “There are fundamental aspects of data validation that we had to adapt. We wanted to ensure we got the fundamentals about the patient record accurate. It was about working with them to categorise the data into three distinct groups – either the patient is discharged back to their referrer, has some kind of activity booked, or they require some kind of intervention…that helped them to understand what the bird’s-eye view of their data should look like.”
On how he helped the example trust with their data issues, he elaborated: “Initially we did a proof of concept and that was 1,000 patients – that covered a section of the most voluminous mental health teams with the most patients. As this was a new space, we worked very closely with the clinical and operational leads to ensure we were all on the same page and completed the validation according to the right parameters.
“Once we completed it, we were able to categorise…and then we drilled down further and, in terms of the discharge [rates], we were able to discharge roughly 35 per cent of the referrals that we validated. Using that data, we were able to provide the trust with a report that gave that bird’s-eye view on patient outcomes, which prompted wider discussion across the remaining teams and was shared internally.
“We had very positive feedback and, as a result, it fostered more engagement and we’re currently working on a follow-up project with that trust.”
“They just hit that point where they’re beyond capacity”
Summarising the benefits of data validation for mental health trusts, Basil highlighted planning capacity and forecasting of the demand, better clinical management, escalation of the patients who are at risk and ensuring that patients are prioritised according to urgency and length of wait. He also noted understanding data issues and how they relate to discharge rates, making it easier for staff on the ground to make changes, and allowing services to have more control of their data.
“We work with a number of trusts – again and again – and not because we’re not helping them to understand their root causes. But because they just hit that point where they’re beyond capacity and need that extra elbow room. We can come in and support them for a month or two,” he explained.
Asked by Katy to summarise how he feels about data validation in mental health services, Basil concluded: “I feel privileged…this is an area I’m really passionate about…I’m an IT person but I do my part to help improve patient lives…I want to be a flexible and approachable resource for trusts to turn to.”
Watch the full session via the video below: