QlikView in Public Health Care

Experiences Landstinget Blekinge

Leif Fransson
Department of Planning and Statistics and - prior - Department of Clinical Physiology

5/15/2007

Landstinget Blekinge in the South of Sweden.

Blekinge 150.501 inhabitants uses 3.4 bilj SEK (0.36 bilj ) ~5000 employees ~4200 computers

5/15/2007

Health Care
Primary Health Care (GPs): ~205.000 visits/year Non Institutional Care:~160.000 visits/year Institutional Care: ~25.000 visits/year Psych. Care: ~66.000 visits/year Dental Care: ~61.000 treatments/year

5/15/2007

QlikView & Health Care

Blekinge Hospital, use QlikView to gain increased visibility into its operations to: Shorten waiting times for patients dramatically by monitoring inflow/outflow patterns - finding bottlenecks Increase operational efficiencies by benchmarking against other hospitals Improve treatment recommendations by analyzing survival expectancy data Reduce medical costs by 5% or $1.1 million by analyzing prescription patterns Economy: deliver annual budget surplus by assessing economic indicators Comply with government regulations by delivering key patient metrics

5/15/2007

Some Statements and Keywords

Keywords creating a Data Warehouse: When, Where and How (Time, Organization and Treatments/Examinations) Some words about using QlikView and Qlikview Server: Low costs in the end (you create solutions yourself without any consulting firm !) Easy to learn and due to that, short take off (if youre familiar with the data) Ad hoc - the opposite of static cubes Easy and fast screening of large amounts of data Handling multiple data sources ( Excel, text files, data bases) Creating statistical reports and distribution on internal or external web Easy analysing of data from high to low level (drill down to details) Improving Health Information, Insight and Knowledge
5/15/2007

State of the Art in Blekinge

One data source (Data Warehouse) - one tool (QlikView with Qlikview server) - for everyone this is decided by County Council Management (very important!) Presenting all the statistics on the internal web site, covering Production Economics Drugs - consumption (Defined Daily Doses, DDD) and costs Personnel Other reports (e.g. survival studies or surveys of different kinds and much more)

5/15/2007

Our Experience using QlikView

A broad knowledge gives rise and triggers to: participation operational efficiency improve quality ideas acceptance

QlikView on the web

easy to learn easy to build and maintain easy to use ad hoc no costs for consulting Leading to effects such as: Reduced costs Increased efficiency Motivated employees

5/15/2007

Examples
Flow Economy Drugs Statistical methods

5/15/2007

Examples - Admission Notes

Inflow of admission notes INFLOW Percent OUTFLOW

5/15/2007

Examples - Bottlenecks
Delays could depend on Administration (blue) Care unit (red) Patient (green) Medical reasons (yellow)
Details

5/15/2007

Examples - Trends
Trends and seasonal fluctuations

Orthopaedic surgeon Knees.

Orthopaedic surgeon Hips

5/15/2007

Examples - Political Edicts

Political Edict 90 + 90 days

5/15/2007

Examples - Economy
Overview: Managing Director (designed by himself )

5/15/2007

Examples - Economy
Overview- Managing Director Administrations

5/15/2007

Examples - Drugs expenses.

Moving Average Administrations The trends of increasing costs of drugs was stopped due to the fact that we started to show this graph on our internal web. That started a discussion of how to reduce costs. Reduction nearly 10 millions SEK in 1 year (1.06 million Euro ).

Pharmacy

5/15/2007

Examples - Drugs expenses.

Local Committee for Drug Management
By visualizing the drug prescriptions - using QlikView and Qlikview server - we gain a very deep and broad knowledge of how drugs are prescribed. Results: better aim at our goal - decreasing costs without jeopardizing the medical effect.

The committee creates and maintains a list of recommended drugs

5/15/2007

Examples - Drugs expenses.

Local Committee for Drug Management

Difference in cost : If by the list the costs = 1.55 SEK/DDD otherwise 6.03 SEK/DDD 5/15/2007

Examples - Drugs expenses.

Municipal Differences
Difference in prescriptions between municipals due to characteristics of the inhabitants but mostly due to the doctor

5/15/2007

Examples - Survival
Kaplan-Meier Survival Analysis, Students t-test

Surgery: Yes

Surgery: No

Surgery, Median: 306 days

No surgery, Median: 96.5 days

5/15/2007

Examples - Survival (K-M)

Stadium IA,IB With Helicobacts

Stadium III,IV

Without Helicobacts

5/15/2007

Examples - ANOVA, t-test, CI, adjusting for age and more Stroke

All methods are verified by SPSS

5/15/2007

Examples - ANOVA, t-test, CI, adjusting for age and more Health Score & Drugs
Health score Nbr of Drugs

5/15/2007

Examples - Surveys
Public Health, influenced by age: medical, mental and social health

5/15/2007

Examples - Surveys
Public Health, influenced by location: confidence limits (95%)

If < 25 yo

5/15/2007

Examples - Benchmarking
Differences in health between countys Number of visits vs expenses

5/15/2007

Summary.
A broad knowledge gives rise to: participation understanding ideas

QlikView on the web easy to learn easy to build/maintain easy to use ad hoc no costs for consulting

Leading to effects such as: Reduced costs Increased effiency Motivated employees New knowledge

Thank You for Listening.

5/15/2007