1. "Quality Issues: Collection, Coding, Metadata - some NHS experiences" Philip Johnston NHS Scotland, Information Services Division

2. Quality Issues: Collection, Coding, Metadata - some NHS experiences about Information Services Division (ISD) about ISD data ISD processes, and some examples some statistics on quality

3. about ISD part of National Services Scotland, and NHS 40+ years old around 650 staff across Scotland Scotland's national organisation for health information, statistics and IT services 17 work programmes – eg waiting times, mental health

4. about ISD data around 60 data sets, evolving variety of data providers – eg: hospitals, NHS boards, GP practices, voluntary sector, private sector per year: ~60 publications, ~3000 information requests, ~500 Parliamentary Questions Part of National Statistics Scotland has some of the best health service data in the world

5. ISD data : some context some uses: clinical governance, planning, epidemiology, performance management, setting policy some stakeholders: NHSScotland, Scottish Executive, Scottish Parliament, local authorities, Audit Scotland, GRO, researchers, media, public, political parties some influences: health policy, devolution, National Statistics, Freedom of Information, data protection, patient involvement, IT developments (eg web), media awareness

6. ISD data : SMR01, an example dataset patient/episode -based acute inpatients / day cases ~100 data items, including clinical codes (ICD, OPCS) ~1.2m records/year

7. SMR01 data collection electronic, secure (encrypted) varying timetables for submission data for ~1000 locations, from ~17 IT systems ~100 validation files, with ~3m records ~1500 error/query checks

8. SMR01 quality : accuracy Accuracy of coding of main condition, 2000- 02, by hospital

9. SMR01 quality : timeliness

10. SMR01 quality : other measures validity completeness fitness for purpose relevance coherence comparability data sign off

11. SMR01 quality – some factors conflicting local/national priorities IT system issues (eg purpose / specification / delivery) timeliness vs accuracy quality of source data (eg case notes) training and definitions changes in service delivery

12. SMR01 : example of accuracy versus timeliness

13. SMR01 : some metadata definition? Data Dictionary (web-based; ~1500 items), including definitions and recording manuals statistics on quality of data data audit controls Change Control process health warnings on outputs statistical imputation / suppression

14. other data collection : some examples census of Allied Health Professionals (non-NHSnet; developmental) Scottish Birth Record (national repository) the future, eg: clinical datasets, electronic health record, SNOMED, data warehouses

15. Quality Issues: Collection, Coding, Metadata - some NHS experiences – in summary range of complex, interdependent factors affect data quality ISD applies considerable resource to data quality ISD ability to measure data quality, and to understand influences, is essential and is much valued by users