1. Pieter van DijkCoordinating / Specialist Advisor Research & Innovation Dutch Health Care Inspectorate p.v.dyk@igz.nl IRiS, ( Early) Risk Detection in Health Care with Public Data ( in 10 minutes )

2. 2 Some figures (2011): Dutch health care: € 90 billion = € 5392 per capita 3.000 providers on 40.000 locations 800.000 professionals Health care inspectorate: € 56 million = € 3 per capita and 0,06% of total costs 500 employees 25 Acts of Parliament Supervision must focus on risks! EPSO | 11 october 2012

3. IRiS:Inspectorate Riskdetection System EPSO | 11 october 2012

4. Elements - data sources(extern versus intern; structured versus unstructured) - data model(presentation) - risk model(analysis) - business rules(analysing risks) - data warehouse(staging datasources) - reporting(dashboards/alerts) - analysis(ad hoc, mining) Purposes - initially:clean up the mess of Excel-files! - primary goal: support riskbased supervision (early detection) - additional I: support management reports (performance) - additional II:support strategic en tactical decisions (riskmanagement) How - by translating data into information, based on: - a set of business rules and - a datamodel reflecting our information requirements - a riskmodel for detection non-compliance, poor performance, potential risks Concept Data  Information  Knowledge  Arrangements  Action © 4 EPSO | 11 october 2012

5. 5 External sources (structured) 1.Annual quality of care reports: - hospitals (since 2007), safety since 2009 - mental health care (2010) - pharmarcies (2011, upcoming) - eldercare (2012, upcoming) - private clinics (2012, upcoming) - general practitioners (….) - …. 2.Mandatory annual reports Corporate Information (financie, HRM, etc.) 3.National registers: - medical registers (LMR) - production (diagnoses and treatments) 4.Other structured sources that meet our needs EPSO | 11 october 2012

6. 6 External sources (unstructured; not yet available) 1.Social media  topics, trends, signals, sentiments, fraud, reputation - Twitter - Facebook - Linkedin - …. 2.Crowdsourcing 3.Documents and files Advanced tools are needed: search, find, integrate analyse and interpret unstructured data and combine data with structured data. EPSO | 11 october 2012

7. 7 Internal sources (structured and unstructured; not yet available) 1.Complaints 2.Consumer or Provider Reports 3.Results from inspections 4.Filesystems Advanced tools are needed: define, measure, search, find, integrate analyse and interpret structured and unstructured data. Challanges: -connecting different data-sources -combining structured and unstructured data -different level of aggregation -ambiguos definitions of ‘providers’ -…. EPSO | 11 october 2012

8. 8 Riskmodel (business rules): Deviation - Non-compliance to regulations, fieldstandards etc. - Poor performance (10th percentiles) Trends  early warning - Continuing deviation (3 years or more) ! - Diverging trends - Unexpected trends (ipsative) - Forecasting (1 year) Reliability of measures Output: operational: - riskprofile and trends per provider (extern) - organizational risks (intern) strategic/tactical:- risks per care sector EPSO | 11 october 2012

9. 9 Facts Indicators Themes Aspects Finance Long term situation SolvabilityProfitability Short term situation Liquidity

10. 10 Future functionality What if-scenario’s -how many staff do we need for supervision when thresholds change Data mining (or backwards enginering) -have we missed important data? -are there underlying patterns that can explain incidents? -goals: - evidence based riskmodel - early warnings EPSO | 11 october 2012

11. 11 Better & more data Improve data-quality More frequent data Including results of supervision More data to cover information needs Social Media / Crowdsourcing Better connections (= uniform definition) Improving risk model  business case = better supervision Improve validity (systematic review) Fit for use Cover more risks Early warnings & predictions Integrated analyses  Risk Matrix Reporting ‘on the job’ (iPad), deliveries & alerts EPSO | 11 october 2012

12. 12 SHOWTIME! EPSO | 11 october 2012