OCCUSIMSupporting eye care in a complex world

Pathway Communications Ltd

Eren Demir David Southern

Director

Pathway Communications Ltd

Associate Professor Hertfordshire University

Director

Pathway Communications Ltd

What OCCUSIM does

OCCUSIM models intravitreal pathway using computer software enabling the trust to see what will happen if they invest in new ways of doing things

Increase the number of patients treated

Help more patients get the treatment they desperately need

What OCCUSIM does

Forecast•Forecast hospital activity using a combination of hospital patient level data

Simulation

•The forecasts are entered into the simulation, which along with other key information about the service, creates a simulation of resources required for the next twelve months

Report

•Each quarter the process is updated so that Trusts always have a 12 month view ahead.

•Each quarter Trusts also receive an alternative scenario such as the impact of introduction of a new pathway or a new device

Forecasting – making sure your trust is

always aware of the challenges ahead

OCCUSIM takes the last 36 months of data

Using specialist software OCCUSIM splits the Trust data and HES data by age and forecasts each age groups individually

The forecasts are then imported into the Trust’s intravitreal service simulation

Simulation goes beyond forecasting

OCCUSIM takes key information about the Trust’s intravitreal service and creates a virtual copy of the service

It uses the Trust’s data to simulate the next twelve months activity one patient at a time

The information is collated each quarterly to provide the Trust’s unique report

Simulation – Scenario planning

What happens if…• If you change to treat and

extend pathway?• You adopt a new surgical

method?• You invest in a new device?

Each quarter OCCUSIM will run one of these or similar scenarios for the Trust.

The Trust can also run additional scenarios at any time.

Trusts can constantly improve their service by testing and

implementing changes that will enable them to treat more patients

Use OCCUSIM - Virtual clinicsExample based on real data - Hospital A• Hospital A has around 40,000 attendances a year

of which 10,000 use intravitreal services• According to Hospital A’s data they have 3,474

‘non discharged’ patients who have been in the service for the last 24 months

• Of these 3,474 patients 970 patients have not been treated for the last two years but have been followed up in the last six months

• We tested the virtual service by removing the 970 patients from the system and then increasing the number of new patients by 25%

Data flow chart: patients

INTRAVITREAL SERVICES(6,520 patient’s)

AMD(1,124)

DR(2,752)

LucentOP injections

(518)

Observations(606)

LucentOP (injections)

(99)

FU assessment(99)

Observations(2,459)

4%

Laser (194)

46%

FU assessment(518)

54%

FU assessment(155)

7%89%

MR(2,644)

LucentOP (injections)

(152)

FU assessment(152)

Observations(2,439)

5.7%

Laser (53)

FU assessment(53)

2.1%92.2%

42.3%

Y1(4)

Y2(3)

Y3(2.5)

Y1(4.8)

Y2(4)

Y3(3.6)

Y1(1.7)

Y2(1.6)

Y3(1.4)

17.2% 40.5%

Y1(3.5)

Y2(2.6)

Y3(2.6)

Y1(3.3)

Y2(3.1)

Y3(3.6)

Y1(1.6)

Y2(NA)

Y3(NA)

Y1(2.1)

Y2(2.3)

Y3(2)

Y1(1.4)

Y2(1.4)

Y3(1.2)

Y1(4)

Y2(2.8)

Y3(2.4)

Y1(3.7)

Y2(3.1)

Y3(2.5)

Y1(1.2)

Y2(NA)

Y3(NA)

Y1(2.8)

Y2(1.9)

Y3(1.3)

Y1(1.4)

Y2(1.4)

Y3(1.1)

Date range03/04/2013 – 31/03/2016

The Simulation

OCCUSIM - Virtual clinics

Monthly averagesCurrent Service

Virtual Clinic + 0% increase in new referrals

Virtual Clinic + 25% increase in new referrals

% increase

New attendances 113 113 141 25%Follow-ups 735 660 777 6%Consultant utilisation 74% 67% 78% 5%Nurse utilisation 60% 54% 68% 13%Consultation room utilisation 52% 47% 55% 6%Injection bed utilisation 30% 29% 33% 10%Number of Lucentis injections 172 171 187 9%Costing £159,962.77 £153,361.36 £186,895.79 17%Revenue £219,503.33 £209,720.93 £258,701.55 18%Surplus £59,540.56 £56,359.25 £71,805.76 21%

Increase in surplus £144,000 per year

Virtual clinic + treat and extend

Monthly averages Current ServiceVirtual Clinic + 0% increase in new attendances

Virtual Clinic + 25% increase in new attendances

% change

New attendances 119 119 147 23%Follow-ups 745 655 707 -5%Consultant utilisation 73% 65% 71% -2%Nurse utilisation 72% 65% 71% -2%Clinic room utilisation 54% 49% 53% -2%Injection bed utilisation 30% 30% 32% 8%Number of Lucentis injections 169 169 182 8%Costing £154,538.27 £156,761.27 £170,112.67 10%Revenue £211,345.74 £211,345.74 £231,487.73 10%Surplus £56,807.47 £54,584.47 £61,375.05 8%

2 x Nurse injectors + increase in DMO demand

Monthly averages Current ServiceTwo Nurse Injectors + no other change

Two nurse injectors + 5% increase in DMO arrivals/month

Two nurse injectors + 5% increase in DMO arrivals/month + 35% increase in use of Ozurdex for RVO and DMO (reduction in Lucentis and Eylea accordingly)

% change

New attendances 94 94 109 111 18%Follow-ups 1088 1092 1196 1132 4%Consultant utilisation 98% 78% 97% 90% -8%Nurse utilisation 59% 58% 68% 62% 5%Clinic room utilisation 75% 74% 79% 75% 0%Injection bed utilisation 45% 46% 52% 45% 0%Number of Lucentis injections 330 330 387 324 -2%Number of Eylea injections 272 272 306 280 3%Number of Ozurdex injections 9 9 11 45 400%Costing £517,028.72 £522,028.72 £599,864.00 £551,232.39 7%Revenue £639,549.50 £639,549.50 £736,363.07 £677,951.75 6%Surplus £122,520.78 £117,520.78 £136,499.07 £126,719.36 3%

Pathway Communications

Specialists in healthcare analytics and

patient pathway simulations

OCCUSIMSupporting eye care in a complex worldenquiries@pathwaycommunications.co.ukwww.pathwaycommunications.co.uk

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