mental health business architecture

© Redwing Business Intelligence Ltd 2002 - 2015 BI General

Mental Health Trusts

Business Architecture

Redwing Business Intelligence Architecture

Context

• 30% to 50% of Primary care workload is MH related (especially depression).

• Seventy to eighty percent of young men in prison/offenders have a MH condition.

• Patients with MH conditions who remain untreated suffer a 15-25 years’ reduction in their life expectancy and poorer quality of life.

• MH has the largest disease burden in the UK (22.8%) compared to CVD (16.2%) and cancer (15.9%)

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Source: King’s Fund

Architectural Framework

• Strategy: current and future activity - and local intelligence

• Patients’ - and carers’ - experiences and outcomes• Clinical quality: in particular, clinical outcome• Access / targets / KPIs• Finance: including income/expenditure and cash flow• Efficiency: including discharges and use of resources• Workforce: including workforce planning, violent

incidents and satisfaction

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Architectural Layers

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Technology (Specific Product)

Technology (Hardware, Networks, Infrastructure)

Application (Systems, Components, Services)

Data (Business Entities, Databases, Schemas)

Information System (Data and Application)

Business (Strategy, Priorities, Organisation)

Architectural Overview

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Board-defined Vision, Strategy, Goals, Objectives Board Governance: Monitoring, Tracking, Adjusting

Accessibility

Referral Protocols

Available Services

Patient

Crisis?

Comprehensive?Specific?

Simple?

Action Plan

Initial Presentation

Assessment

Care Plan

Care Coordination?Coordinated Care

Delivery of Care

Evaluation

Multiple Patient-Centric Integrated Care Pathways

Patient Administration System Business Intelligence SystemDatabase

Operational Reports

The Data WarehouseThe Data Warehouse

Dashboards, Scorecards,

etc.

Processes and Events

• Every enterprise has functional processes• Each functional process generates events of interest • For example, as part of the Assessment process, a

patient was admitted to a hospital as an in-patient• That’s an event of interest to the enterprise

(a.k.a. a Fact).• All Facts have data that can be analysed At the very

least, it can be counted. • The data warehouse is an automatic spin-off

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Example of PIs for a single area

• Engagement with partners e.g. social services, general practice, housing, home office:

– Progress against joint strategic objectives– % delayed discharges– % delayed admission for people on section of the Mental Health Act– % children in adult beds– % admissions with length of stay of less than one week– Out of area assessments and treatment– Continuing care placements– % stable patients seen in outpatient clinics (rather than primary care)– Balance of prescribing between primary and secondary care for atypical antidepressants, ADHD meds– Readmissions– 7-day follow ups– Gateway workers– Prison transfer waits

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Process Improvement

• Processes to be end-to-end defined• Ward staffing – as an example• Here are the goals:

– Understand and predict staffing levels

– Plan rostering

– Manage use of bank and agency staff

– Create automated workflow for bureau (bank and temporary staff) take-on . . . including training, know-the-patient, and help systems

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Quality and Performance

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Safety and Safeguarding (1)

• Insufficient just to record incidents

• Insufficient to investigate single incidents in isolation

• Need to show patterns of unsafe behaviours

• Need to differentiate types of incidents

• Need to understand trends

• Crucial input to risk management

• Essential component of good governance

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Safety and Safeguarding (2)

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Architectural Actions1.Understand the organisation2.Review internal documentation3.Identify key stakeholders4.Meet key stakeholders5.Identify current business systems6.Identify organisational priorities – provision of information to ensure

good governance, and to ensure patient safety. 7.Define the current business strategy, governance, and organisation8.Define the key business processes, including the events.9.Define the required future state10.Identify the steps required to move to the future state

1. in terms that make sense to the business, and 2. which can be then implemented technically.

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Architectural Deliverables

• Definition of current state– Business vision and strategy . . . including issues/challenges– Governance– Organisation– Processes

• Articulation of future state• Step change plan for the business, from here to

there• Articulation of technical implementation – the next

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Technical Architecture Spin-Off

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Summary

• Purpose of business architecture is to enable new and improved business and information systems to be put in place.

• Those systems must serve the Board’s vision

• And support monitoring and governance

• And always . . . first and foremost . . . serve the patient above all else

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Discussion

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Donna Kelly

donna@redwing-bi.com

0(781) 380-0181