Evaluating Evercare nurses and data guided case management
Although not part of the Roland evaluation report (1), North Tees PCT
worked with United Healthcare to develop sustainable planning and
commissioning systems. As the tenth PCT involved in the pilot programme,
we have been working with UHC in the development of HealthNumerics,
tailoring US approaches to data management and analysis to meet PCT
commissioning needs. So far, use of these systems has not been tested in
conjuction with nurse-led case management.
The HealthNumerics tool allows managers to utilise healthcare data to
make commissioning decisions based on activity patterns and trends.
Combining healthcare and population data, the analyses that can be
performed go a considerable way towards supporting evidence based
commissioning within a PCT. Having a thorough understanding of patterns
of use across the PCT area, across electoral wards and neighbourhoods as
well as within the traditional health boundaries, gives greater knowledge
of local issues. By having a greater understanding of equity and need
rather than simply basing case mangement on the number of unplanned
admissions, our PCT has increased confidence to develop relevant and
effective case management. We acknowledge that NHS information systems did
not allow this in the Evercare nursing pilots (2).
Integrating the HealthNumerics information with data from the disease
registers kept in primary care and hospital benchmarking data, may allow
the targeting of case management approaches towards areas where both the
cost and quality of care might be improved. In order to understand the
complex utilisation patterns we use funnel plots to help us visualise the
variation (3).
Perhaps the next step ought to be to test the combination of case
management of patients who intensively use hospital services with the use
of sophisticated data systems. These systems can guide allocation of
patients to case management in primary care and assist with monitoring the
impact on hospital utilisation.
1. Roland M, Dusheiko M, Gravelle H, Parker S. BMJ 2005; 330: 289-
292
2. Smith R. BMJ Rapid Responses. Feb 5
3. Spiegelhalter D. Funnel plots for institutional comparison.
Quality and Safety in Health Care 2002;11:390-1
Competing interests:
Both authors are employees of North Tees Primary Care Trust and have worked on the DH funded project with United Healthcare
Competing interests:
No competing interests
08 February 2005
Anthony P Roberts
Head of Clinical Effectiveness
Alison Roe
North Tees PCT, Thornaby, Stockton on Tees TS17 6SF
Rapid Response:
Evaluating Evercare nurses and data guided case management
Although not part of the Roland evaluation report (1), North Tees PCT
worked with United Healthcare to develop sustainable planning and
commissioning systems. As the tenth PCT involved in the pilot programme,
we have been working with UHC in the development of HealthNumerics,
tailoring US approaches to data management and analysis to meet PCT
commissioning needs. So far, use of these systems has not been tested in
conjuction with nurse-led case management.
The HealthNumerics tool allows managers to utilise healthcare data to
make commissioning decisions based on activity patterns and trends.
Combining healthcare and population data, the analyses that can be
performed go a considerable way towards supporting evidence based
commissioning within a PCT. Having a thorough understanding of patterns
of use across the PCT area, across electoral wards and neighbourhoods as
well as within the traditional health boundaries, gives greater knowledge
of local issues. By having a greater understanding of equity and need
rather than simply basing case mangement on the number of unplanned
admissions, our PCT has increased confidence to develop relevant and
effective case management. We acknowledge that NHS information systems did
not allow this in the Evercare nursing pilots (2).
Integrating the HealthNumerics information with data from the disease
registers kept in primary care and hospital benchmarking data, may allow
the targeting of case management approaches towards areas where both the
cost and quality of care might be improved. In order to understand the
complex utilisation patterns we use funnel plots to help us visualise the
variation (3).
Perhaps the next step ought to be to test the combination of case
management of patients who intensively use hospital services with the use
of sophisticated data systems. These systems can guide allocation of
patients to case management in primary care and assist with monitoring the
impact on hospital utilisation.
1. Roland M, Dusheiko M, Gravelle H, Parker S. BMJ 2005; 330: 289-
292
2. Smith R. BMJ Rapid Responses. Feb 5
3. Spiegelhalter D. Funnel plots for institutional comparison.
Quality and Safety in Health Care 2002;11:390-1
Competing interests:
Both authors are employees of North Tees Primary Care Trust and have worked on the DH funded project with United Healthcare
Competing interests: No competing interests