A pioneering approach to data that predicts peaks in demands on health services is being developed by Betsi Cadwaladr University Health Board (BCUHB) (Business News Wales, 2017). The system, once up and running, could save the NHS across the UK millions of pounds and enable services to be closely targeted at hot spots.

Funded by the Welsh Government through SBRI, BCUHB has challenged four companies to develop ideas that will speed up the process of clinical coding. The aim is to allow BCUHB, health organisations and other public bodies to plan resources more effectively in the future.

Clinical coding involves health workers manually recording each patient’s individual care and treatment, including diseases, symptoms, operations, treatments, drugs and healthcare administration. This allows health managers to monitor peaks and troughs in demands on NHS services and manage resources accordingly. It’s a time consuming process because there is a wide variation in how medical care is classified. For example, a dog bite could be classed as a laceration, wound, bleeding, or infection. The majority of the information is also taken from paper health records, which means deciphering a variety of handwritten notes.

Dafydd Ap Gwyn, BCUHB Head of Clinical Coding, said “Every health board across Wales has to categorise patient activity – it’s something that has to be done. It allows the health service to decide where they’re going to target resources. By using coded activity and data they can decide if a hospital site requires additional cardiac services, for example, because they’ve identified an increase in cardiac patients and so there might be a need for another consultant on the ward.

“The key part of the project is the fact that at the moment it’s a slow process and takes a long time. There’s a lot of paperwork to read through. We’re looking for innovative companies to come up with an idea to speed up that process. We’ve not set out to save money initially, we’ve gone out to improve efficiency but in the long-term there will be a cost saving. It’s fundamentally about being more efficient and being able to record all our patient activity simply so the data is available much quicker for those who need to make strategic decisions. We’re always looking to make improvements and deliver a better service of health care. The ultimate aim is to make sure the patients are treated and cared for better.”

The project is expected to help overcome an anticipated increase in demand for critical coding nationally due to a growing number of treatments requiring categorisation. Over the past five years, BCUHB has seen an increase in approximately 20,000 additional episodes with the trend expected to continue in the coming years.

Dafydd Ap Gwyn said “Each major hospital in BCUHB has on average around 10 clinical coders. Clinical coders not only have to be trained in the whole host of coding rules and standards but also the anatomy and physiology of the body. A heart attack can be described in a number of different ways and has a variety of possible codes. It’s vital for the health service that the right clinical code is recorded. Across the border, there is a direct link to coded data and how trusts are funded and therefore clinical coding has a greater recognition. It’s payment by results. Health boards in Wales use the data internally to look at performance and it’s also submitted to the Welsh Government for national comparisons and targets.”

Twenty three companies from England and Wales applied to take part in the project and a shortlist of four businesses was drawn up following a robust assessment process. The companies chosen to work with BCUHB on the first phase of the project are Interaction, 6xW Ltd, Sagittal Soft Ltd and CHKS. The companies will initially receive funding of up to £10,000 each to develop their solutions over a four month period. Staff from the Clinical Coding departments across BCUHB will work with the companies to help them understand the processes involved, from patient admission through to discharge.

Once the ideas have been developed in proof of concept, two companies will be chosen to move into the second phase of the project, in which the companies to apply for up to £100,000 each to develop their concepts into fully functioning and marketable solutions over a year.

Dafydd ap Gwyn said “It’s down to the companies individually to come up with a solution. It doesn’t have to be technological. If a company came to us with something different and it worked then it would be considered but clearly some, if not all of them, will technologically-based.”

The businesses will present their ideas at the end of March 2017.