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Presentation Contents. Introduction to the system System reports. - PowerPoint PPT PresentationTRANSCRIPT
1.Introduction to the system
2.System reports
Presentation Contents
1
ACG History
Minor - self-limited if treated appropriately
More severe - time-limited if treated appropriately
Generally chronic - remain incurable even with medical therapy
Structural problems - generally not curable even with adequate and appropriate intervention
Psychosocial conditions
The classification of patients based on the groupings was shown to accurately represent resource use and led to the development of the ACG system.
In the early 1980s paediatrician the late Barbara Starfield MD and her team, recognised that children using the most healthcare resources were not those with a single chronic illness, but rather were those with multiple, seemingly unrelated conditions.
To test their original hypothesis, illnesses found within paediatric populations were grouped into five discrete categories:
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What:
Metrics/measures representing a persons level of healthcare resource use (this is the ACG).
Prediction of the use of healthcare resource for the following year. And the likelihood of high cost.
A concise and complete coded representation of a persons disease burden (EDCs).
Produces Models based on diagnosis codes (Dx) and prescription codes (Rx).
How
Risk profiling
Predictive modelling
ACG system tool overview
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Raw Data
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ADG (Adjusted Diagnostic Group)
Likely to Recur: Discrete
Likely to Recur: Discrete-Infections
Likely to Recur: Progressive
Chronic Medical: Stable
Chronic Medical: Unstable
Chronic Specialty: Stable-Orthopedic
Chronic Specialty: Stable-Ear,Nose,Throat
Example ADGs and ACGs
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ACG (Adjusted Clinical Group)
4-5 Other ADG Combinations, Age 18 to 44, 1 Major ADGs
4-5 Other ADG Combinations, Age 18 to 44, 2+ Major ADGs
4-5 Other ADG Combinations, Age 45+, no Major ADGs
4-5 Other ADG Combinations, Age 45+, 1 Major ADGs
4-5 Other ADG Combinations, Age 45+, 2+ Major ADGs
6-9 Other ADG Combinations, Age 1 to 5, no Major ADGs
The system and the process of creating ADGs
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Adjusted Clinical Groups (ACGs)
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RUBs are aggregations of ACGs based on resource use
RUB variant depending on population of data
RUBs 1-5 each consume 20% of total resource
0 Non Users
1 Healthy
2 Low
3 Moderate
4 High
5 Very High
Resource Utilisation Bands (RUBs)
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Case Management
Case Management Proactive health management strategies
to avoid increased health resources
Proactive health management strategies to avoid increased health resources
Short Term Interventions, Public Health and Prevention Strategies
Prevention and Public Health Strategies, Health Screening , Immunisation and Vaccination
Review that patients are not slipping through the net orthat they have left the practice
Complex Care 5
Chronic /Long Term Illness
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4
2
1
0
Resource Utilisation BandsHigher the score the more health resource is used
At Risk moving towards higher
health use
Acute Self Limiting
Well
Non Users
Public HealthHealth Promotion
Practice NurseHealth Visitor
Community MatronDistrict Nurse,
Practice Nurse, Health Visitor
General PractitionerAllied Health Professional
Medicine ManagerPharmacist
Ambulance Service
Practice ManagerPractice Nurse
Health Promotion
General PractitionerHealth Promotion
Practice NurseHealth VisitorDistrict Nurse
Allied Health Professional
Example of Health Professional Intervention At Different Levels of ACG Resource Utilisation Bands
Creating EDCs and MEDCs
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Creating Expanded Diagnosis Clusters (EDCs)And
Major Expanded Diagnostic Clusters (MEDCs)
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The Predictive Modelling Process(ACG-PM)
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Extraction process
Secure Network
GP System
GP System
...
Sollis ClaritySystem
SecondaryUses
Service
Clarity.PBCClarity.ACG
ReferenceData
...
Data Sources End Users
ACGGrouper
Apollo
Apollo
NHS Net (N3), no external access
Apollo
EncryptedData
Transfer
Users/Roles (AD)
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