NHS Digital Data Release Register - reformatted
Health IQ Ltd
Project 1 — DARS-NIC-15293-R6V2H
Opt outs honoured: No - data flow is not identifiable (Does not include the flow of confidential data)
Sensitive: Non Sensitive
When: 2016/04 (or before) — 2020/07. breached contract — audit report.
Legal basis: Health and Social Care Act 2012, Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii)
Categories: Anonymised - ICO code compliant
- Hospital Episode Statistics Accident and Emergency
- Hospital Episode Statistics Admitted Patient Care
- Hospital Episode Statistics Outpatients
- Hospital Episode Statistics Critical Care
- Emergency Care Data Set (ECDS)
Health iQ is a provider of data-based insight, who produce tools and reports used by health and social care to achieve the following broad aims: 1. Understand and quantify the burden of disease. 2. Support service improvement in terms of treatment and efficiency of service. Health iQ wishes to provide such insight to Healthcare Providers and the Life Sciences industry. Health iQ will use the data solely for the following purposes: 1. Vantage System and Related Support (current use) Vantage is an online system that produces aggregated, small-number supressed, non-sensitive, non-identifiable HES-based dashboards and reports to support the delivery of healthcare. It supports the delivery of a range of key healthcare strategic priorities, including delivering the Five-Year Forward-View, Quality, Innovation, Productivity and Prevention (QIPP) targets and Joint Strategic Needs Assessment (JSNA) targets. Vantage enables users to: • Plan healthcare provision with the support of real world data. • Benchmark performance against peer groups. • Pinpoint areas of inefficiency. • Validate the impact of a service improvement programme or new pathway model. The potential users of Vantage are: 1. NHS users (Provider Trusts, GPs, Commissioners, Area Teams, Strategic Clinical Networks (SCNs)). 2. Commissioning Support Units (CSUs). 3. Governmental organisations (NHS England, Department of Health (DH), NICE, Academic Health Science Networks (AHSNs)). 4. Social care (Local Authorities, Health & Wellbeing Boards). 5. Charities and not-for-profit organisations. 6. Life Sciences organisations (Pharmaceuticals, Medical Technology, Biotechnology). Though the sub-license users of Vantage can be from any of the above listed groups, it is made clear that the allowed purposes of use are restricted to those mentioned in this document, with the ultimate beneficiary being healthcare as a whole. This is enforced through sub-license agreement between Health iQ and users. Life Science organisations are a user of Vantage exclusively for the purpose of providing benefit to healthcare. As with all user groups, they will only ever have access to aggregated outputs and are bound by sub-license agreements which ensure the usage of the data is in line with this document. In addition, Health iQ insist that all users of the tool undergo information governance training by a Health iQ trainer, and all reports produced by the tool come with a pre-written disclaimer statement. 2. Reports (new use) Health IQ will produce reports either as responses to specific data requests, or as part of wider projects. These Reports will take the form of suppressed, aggregated, non-sensitive and non-identifiable data tables. As these Reports will be constructed in response to a specific need, the content will vary, though all conform to all the restrictions outlined in this document. Examples of such reports could be: • A report by Hospital on total activity which falls within a Best-Practice Tariff (BPT) area, and the proportion of such activity which achieved the BPT. • A report of the tariff cost of Irritable Bowel Syndrome (IBS) patients by CCG, including all related symptoms and associated conditions to produce a ‘true burden’ analysis of the cost of IBD (Irritable Bowel Disease) to the healthcare system. To be absolutely clear, Reports will never: • Relate or link HES data to the use of commercially available products, such as the prescribing of an individual pharmaceutical product. • Present data in a way which patient or clinician identity can be identified, even by linking to other datasets. • Break suppression rules. The potential users of Reports are: 1. NHS users (Provider Trusts, GPs, Commissioners, Area Teams, Strategic Clinical Networks). 2. Commissioning Support Units (CSUs). 3. Governmental organisations (NHS England, DH, NICE, AHSNs). 4. Social care (Local Authorities, Health & Wellbeing Boards). 5. Charities and not-for-profit organisations. 6. Life Sciences organisations (Pharmaceuticals, Medical Technology, Biotechnology). Though the sub-license users of Reports can be from any of the above listed groups, it is made clear that the allowed purposes of use are restricted to those mentioned in this document, with the ultimate beneficiary being healthcare as a whole. This is enforced through our sub-license agreement, which is signed between Health iQ and any client. 3. Public Access ‘Health iQ Insight’ Reports (new use) These are reports based on aggregated, suppressed, non-sensitive, non-identifiable HES data with the aim of: • Highlighting trends in demand and activity in a disease area. • Raising awareness of a disease area. • Providing high-level analysis of the management of a disease area. These reports will be made publically available through a number of channels, including a dedicated area on the Health iQ website and via healthcare journals and other industry publications. Health IQ will present a full schedule of publications for 2017 via a dedicated page on their website.
Health iQ has provided examples below of how the data has been used, including the benefits to healthcare that have resulted from this use. These are typical of the type of usage their customers offer to the NHS. Health iQ have listed some of the main benefits, and will continue to provide (on renewal of the data) further examples of what specific benefits have been given through the use of the data. Relating to Objective 1: (Vantage System and Related Support) A growing user base across NHS and non-NHS, hence a greater number of users benefiting from the intelligence provided by the tool. Relating to Objective 2: (Reports, Studies and Analysis) 1. Co-authored a poster titled ‘Health-Care Resource Utilization following Trabeculectomy: An Analysis of English Hospital Episode Statistics (HES) Data’. The study helped to demonstrate the value of new interventions with comparable interocular pressure and less resource burden. 2. Worked with Salford Royal NHS Foundation Trust to analyse the pathway of MS patients and compare to the NICE recommended standard, hence identifying any deviation from best practice. 3. Developed a ‘Mortality Risk Predictor’ algorithm for patients undergoing a range of surgical procedures, based on criteria such as age, co-morbid conditions and procedure type. This allowed Health iQ to produce a risk index which can be used to guide decision-making prior to surgery. 4. Conducted a study titled ‘Characterisation of Atrial Fibrillation and Bleeding Risk Factors with Chronic Lymphocytic Leukaemia’. The aim was to identify risk factors for AF or bleeding for CLL patients, to support the treatment of these patients with appropriate medication. Relating to Objective 3: (Public Access ‘Health iQ Insight’ Reports) Reports published in 2017 (http://www.healthiq.co.uk/public-reports): Report of Market Intelligence for NOAC Market: analysis of the growth in NOAC usage, relative to AF/Stroke burden of care in hospitals. Report on DVT Activity in Hospitals: analysis of the burden of care due to DVT in hospitals across England. Report on MS and Neurology Activity in Manchester (http://www.healthiq.co.uk/images/reports/Report%20on%20Multiple%20Sclerosis%20and%20Neurology.xlsx).
• The West Midlands Epilepsy SCN use Vantage on an ongoing basis to focus and review its main project of reducing non- elective admissions in the locality (see details at http://www.wmscnsenate.nhs.uk/strategic-clinical-networks/our-network/mental-health-dementia-and-neurological-conditions/current-projects/epilepsy/). Stated benefits include: - A West Midlands wide template care plan for epilepsy patients (March 2015) - Development of a care pathway to optimise care and reduce repeat admissions (March 2015) - Information pack provided to CCG commissioners (May 2015) - 5% Reduction in non elective admissions within 14 days where epilepsy is the primary reason for admission (Sept 2015) - 100% of patients presenting at A&E with a primary diagnosis of epilepsy will either be referred to a first seizure clinic or epilepsy specialist following a non-elective presentation. • Vantage data is used at Parkinson’s Excellence Networks and SCN's on an ongoing basis to review regional services and variation. The data continues to be presented to hospital departments and large scale regional meetings to demonstrate evidence of need to change. Health-IQ has provided two examples above of how the tool will be used , including the benefits to healthcare that will result from this use. These are typical of the type of usage our customers offer to the NHS. While Health-IQ cannot list every individual usage of the tool due to the nature of a licensed product, Health-IQ have listed some of the main benefits, and aim to provide each year (on renewal of the data) further examples of what specific benefits have been given through the use of the tool.
Some examples of on-going uses of the data are included below. As with all outputs, all of these will be small-number suppressed according to an agreed methodology (which at minimum ensures suppression in line with the HES Analysis Guide), aggregated, non-sensitive and non-identifiable: • Quarterly public-access reports, covering the disease areas of diabetes (Q4 2016) and MS (Q1 2017). • Vantage data used to produce ‘Burden of Hospitalisation’ paper in Parkinson’s disease. This is now cited by Parkinson’s UK, and has also been quoted to support business cases for new Parkinson's nurses in a number of NHS Trusts (including Addenbrookes, Hertfordshire and Staffordshire) and to support new Parkinson’s pathway /guidelines standards (at Trusts such as Ipswich and Dudley). • Vantage keeps a log of all activity (queries run etc.), a sample of which can be provided as an example of the outputs produced on a regular basis. • The West Midlands Epilepsy SCN’s annual report on reducing epilepsy-related non- elective admissions in the locality.
All data processing is done within the UK, and is carried out according to the following process: 1. Data is received from HSCIC (via HSCIC’s secure FTP link), by either the Head of Delivery or Senior Project Manager 2. Data is uploaded by either Head of Delivery or Lead Developer via an encrypted external drive onto a secure local server (server is security protected and locally based in the head office). 3. Data is deleted from encrypted external drive 4. Calculations are run against the HES data 5. Calculated HES Data uploaded into secure local data warehouse 6. Data undergoes testing process 7. A subset of the HES data is exported from the secure local server, and uploaded via an encrypted connection into the Vantage backend system on external UK data centre. 8. Aggregate data is made available through the Vantage presentation layer to the live system users who access Vantage via a secure password login system. 9. Health iQ analysts will access record level data via the local data warehouse and secure connection only. 10. Backup of the Vantage system is held on a dedicated, secure, private encrypted backup drive The Vantage system is held entirely on the secure server, and accessed only via secure web link (no record level data is held on any customer’s local machine at any time). The above processing means that the Vantage tool only presents aggregate data, and thus only aggregate data is available to customers of the tool. The HES data protection policy has been enforced as follows: 1. The record level data (pseudonymised, non-identifiable) will only be stored in secured local data warehouse, hardware encrypted disk (for in house backup) or secure vantage hosting environment in UK Data centre 2. All Health iQ staff are instructed not to download any record level HES data to local PCs, laptops or any non-encrypted device. 3. Health iQ developer and analyst teams use PC/ laptops with encrypted drives 4. All data transmission must be encrypted to minimise the risk. Pre-defined reports are exportable, in CSV and PDF formats. All reports are of aggregate data only. Users can create their own reports and export them. All staff who have access to the raw record level data are Health iQ staff, and this function is never outsourced to anyone else. Small numbers in the Vantage system are suppressed with a methodology agreed with HSCIC, which ensures that at minimum data is suppressed in line with the HES analysis guide. Health-IQ’s team includes consultants and data specialists the majority of whom are former NHS employees, who have worked at senior levels in Commissioning, Performance and Information management functions. Health iQ have utilised this insight into the needs of NHS commissioning and provider organisations to design the Vantage tool. All individuals with access to record-level data are employees of Health iQ. Full data is required, as Health iQ's analysis is not limited to any particular age, region or any other sub-group. The Vantage hosting infrastructure will be regularly penetration tested by an external independent vendor.