The vision thing: Lincolnshire looks to the future with Business Intelligence

Lincolnshire Partnership NHS Foundation Trust called in Microsoft when it wanted to transform its use of information. Now, it is deploying some of the company’s newest Business Intelligence tools to deliver information to front-line staff in ways that make sense to them. Daloni Carlisle reports.

In the summer of 2007, the senior management team at Lincolnshire Partnership NHS Foundation Trust was inching its way towards a big decision about its information systems.

The mental health trust, which provides services across the county, was experiencing the information challenges that many trusts are facing: it needed to monitor performance and produce reports but had capacity constraints and was trying to extract and analyse data from multiple systems.

Just as importantly, it had an ambition to deliver high quality information to its front line staff. “We need to be able to get up to date, accurate information back to the teams and frontline managers so they can improve patient care,” says John Murray, programme manager for corporate systems.

To add to the pressure, the trust had applied for foundation trust status (now granted) and its managers needed to demonstrate they could manage risk effectively through access to complete, timely and accurate information.

“Our information strategy showed we needed integrated information but we did not have an integrated system... so we looked at introducing integrated data.”“Our information strategy showed we needed integrated information but we did not have an integrated system,” says Mr Murray. “So we looked at introducing integrated data.”

Envisioning the future

In November 2007, the trust invited Microsoft business manager, Tim Gee, to help them create a vision for how Microsoft’s technologies could be applied to its specific needs. This kind of “envisioning event” is proving to be a useful way of introducing new concepts.

“The great thing about these demonstrations is that they show the art of the possible,” says Mr Gee. On show were some of Microsoft’s newest Business Intelligence tools. These allow users to manipulate and interrogate data in entirely intuitive ways; instantly creating graphs and charts that allow them to ask “what if…” and to see how changing parameters can affect outcomes.

Mr Gee helped the team to understand how they could extract data from existing systems such as the patient administration system (PAS), HR, finance and clinical systems, and place it in a data warehouse. From there, it could be extracted, analysed and presented to users via an intranet with a front-end reporting and analytics interface.

Finding a partner and laying the groundwork

The trust was also shown how it could build security around the data using an Active Directory structure to automate access according to need. “So for example, if we produce information about the whole organisation, an individual manager or clinician will still only be able to see the detailed information relevant to them,” explains Mr Murray.

The trust was excited but took matters slowly; such a major change would require a large-scale project with senior management buy-in and significant amounts of middle management and clinical engagement. The groundwork was laid over the winter by developing a business plan and an invitation to tender. In March 2008, the trust appointed Microsoft partner, 21C, to carry out the work.

Sales director Daniel Wakefield explains why 21C were the right people for the job. “We’ve done it before,” he says simply. “We understood the organisation better than anybody else because we have done the same project elsewhere.”

Between March and June 2008, the project got underway in earnest. In went a SQL server as the data warehouse, SharePoint to provide the security, and PerformancePoint to carry out the data handling.

Making data meaningful

By July, the trust was about three quarters of the way through implementation. In addition to providing standard operating reports, the initial focus was on developing dashboards for key performance indicators that show at a glance how a department or service is measuring up.

“We can use traffic lights or put in line graphs or bar charts - whatever makes that information meaningful or stand out.”

“We have taken a production line process to delivery,” says Mr Wakefield. “We involved the service very early in the design and outputs. We have used an iterative approach of taking a performance metric, developing the code to extract the data and understand the logic that is applied by the information teams to the data.

“We code the logic, automate the process, then put a presentation layer on top and release over the intranet. We can use traffic lights or put in line graphs or bar charts - whatever makes that information meaningful. And by clicking on the graphical presentation, users can drill down to see the detailed data that underpins any of the performance metrics.”

It takes between four and five days to develop a dashboard from data in the warehouse, says Mr Murray. So far, heads of service and general managers of directorates have access. In time, it will be rolled out to middle managers and frontline clinicians as well. “The ambition is for a dashboard on every desktop,” explains Mr Wakefield.

The next steps

The next stage will be to develop operational reporting beneath the dashboards, so that team leaders and team co-ordinators can look at what is happening in their areas, analyse caseloads and activity, and spot anomalies. 
This approach will help the trust to deliver service line reporting and service line management - and the projects are closely linked. The structures agreed through the service line management project are what are being used to populate the structures in SharePoint and the data warehouse.

The results are beginning to filter through. Mr Wakefield recalls a meeting with a senior director who was at first sceptical about the project, but had become an enthusiast. “She did a presentation at which she said she had relied on teams of people to give her information. Now she was able to do it herself, simply by clicking through the data on the screen,” he says.

The trust is now preparing an entry for an e-government award scheme. Meanwhile, Mr Murray is quietly getting on with his job and keeping an eye on value for money. He makes a point that will be dear to the heart of many an NHS manager.

“It costs money to maintain your network and the machines on desktops,” he says. “We have a significant and unavoidable cost here, but we were not realising maximum benefits from that powerful infrastructure. Developing reports directly in the back end systems is expensive and of limited use.

“We have now developed the vital component joining desktop computers to the core information systems. This enables the trust to capture data from any source, process it, and produce first rate reporting with analytical tools to interrogate the data. We have completed the circle and begun to leverage that infrastructure.”

About the author: Daloni Carlisle is an experienced freelance journalist and lecturer. She specialises in writing about health and management, but also has an active interest in international development.

Want to know more? Read our Business Intelligence: demonstrated article

If you'd like to discuss how Business Intelligence can help your trust, email Tim Gee or call him on 0118 909 3513.