Health data flaws in the spotlight

IT problems and missing information mean system to measure patients’ progress offering inaccurate results

Adata collection system meant to measure patients’ progress through the health system from referral to discharge is producing inaccurate results because of issues including IT problems and missing information.

The National Patient Flow Programme (NPF), which began in 2014, has cost more than $16 million so far, the Ministry of Health says.

The NPF is meant to publish results quarterly but the ministry published results for the entire 2017 calendar year only in August this year because district health board (DHB) data across a number of measures is neither accurate nor up to date.

The data being collected was so poor that the planned quarterly publication due in February this year was cancelled and Health Minister David Clark briefed, according to information obtained by the Herald under the Official Information Act.

The NPF, billed as “new data collection to capture information from DHBs on each patient’s journey through secondary and tertiary services”, also does not cover the critical areas of mental health, maternity, emergency and acute admissions, public health and community nursing.

A briefing provided to Clark on the cancellation of February’s publication said that since October 2014, 66 million records had been processed but “data completeness and quality varies across DHBs due to DHB system variation and their ability to invest in data quality”.

The system failed completely for two weeks in November, resulting in a backlog of files to be input.

“NPF application performance remains poor and not all DHB data submissions have been able to be loaded without significant intervention and rework,” the briefing said.

The NPF is expected to improve patient flow through secondary and tertiary services by producing better data on demand, reasons for delays in patient access and gaps in care.

DHBs have been warned by the ministry that not implementing the NPF will result in “significant financial and reputational consequences”.

At this stage the data is being called “developmental” and the data published in August comes with advice not to compare DHBs because of “gaps and inconsistencies”.

Questions collated from monthly teleconferences with regional staff working on the NPF, as recently as July this year, show that the fouryear-old system is still not bedded in. Questions include:

● Are DHBs expected to retrospectively correct all data since the beginning of the project?

● Our DHB is still using remediation codes in some instances. Is this still acceptable?

● I’m not confident NPF is still considered a priority in my DHB.

● What communication does the ministry have planned with my DHB’s executive?

A ministry spokesman said: “The investment in the programme, over the four years of its development from July 2013, has been an average of $4.1m a year.” About half of that had been provided to DHBs and the rest within the ministry to develop the IT systems and infrastructure to support the programme, he said.

The NPF will eventually replace the National Booking Reporting System, which has been used since 2000 and is used mostly to monitor waiting times for elective services.

Canterbury Charity Hospital Trust chairman Phil Bagshaw, a surgeon, said there should be two pieces of data — what DHBs have done, and a regular national population survey on what isn’t done.

“It’s very simple actually”. Bagshaw said no one paid any attention to the NPF anyway.

“It’s not really in the interests of the ministry to for it to be collected is it? Then people would realise how much isn’t being done.”