Wrightington, Wigan and Leigh NHS Foundation Trust has been distinguishing itself with its data work during the Covid-19 public health pandemic.
Mark Singleton, director of data analytics at the trust, recalls that the advent of the disease took the country and the health service by surprise. The trust’s clinical systems had not yet been updated so that the data connected with Covid cases could be captured efficiently.
However, it had a Qlik dashboard that was rapidly adapted so nurses could annotate the throughput of patients and their Covid status. Other Qlik apps were adapted to quickly capture pandemic-related matters such as how much oxygen was left and what mortuary capacity there was.
Singleton says the trust first engaged with Qlik in 2008. More autonomy for NHS foundation trusts entailed reporting on the profitability (or not) of each clinical service – service-level reporting and patient-level reporting.
Wrightington, Wigan and Leigh’s first non-financial use case was to track the standard “18 weeks” referral from GP to treatment target.
Since then, it has been building more and more QlikView applications – up to about 30 – and 50 applications in the more advanced QlikSense environment.
For Singleton, QlikView is like a desktop publishing package in comparison with QlikSense, which enables a user to “snap a dashboard to a grid”. He adds: “That makes the information more shareable. You can design once and run on a variety of formats, which means it’s better for mobile, too.”
Singleton has a broad role that spans data management and business intelligence (BI). “We’ve got everything from junior analysts providing the daily figures for the national portal that Number 10 [Downing Street] and so on present, through the data warehouse team that links and centralises information from 300 or so electronic systems, to analysts who are looking at the data, as well as information governance and data quality staff,” he says. “Poor data quality could lead to poor analytics and so poor decision making.”
There about 50 full-time employees in the data team.
“Poor data quality could lead to poor analytics and so poor decision making”
Mark Singleton, Wrightington, Wigan and Leigh NHS Foundation Trust
The data warehouse is built on Microsoft SQL, and there are plans to move that to the cloud, as the trust has already done with some analytics workloads.
“Big data was something of a buzzword a few years back,” says Singleton. “But for us now, it has come to fruition. The amount of data that we capture is such that we can’t keep processing it all on a nightly basis. So, we are having to look at leveraging cloud compute and real-time data change technology, such as Qlik’s Replicate [software].”
It was fortuitous, in view of the Covid-19 pandemic, that the trust recruited a data scientist in October 2019, he says. “She has been able to look, for example, at what central government statistics mean for Wigan, using Qlik but also [the programming language] R.”
The organisation is recruiting more data scientists, and is working with epidemiologists at Manchester University, as well has helping other Greater Manchester health organisations, says Singleton. “But we are just scraping the surface.”
He describes Qlik as a strategic technology partner for the trust’s data management effort. “It has helped us implement a single source of truth. We also like the way it raises the issue of data literacy. We want data to be designed to be understood by everyone.
“Ten years ago, we would answer a [user’s] question, but soon enough they’d come back with another.”
But in terms of clinical practice, too, this sort of BI software is proving its value more now, says Singleton. “Previously, it was all about paper or Excel,” he adds. “Paper and whiteboards are seen as the easiest way to manage the wards. But by using a whiteboard to log who’s getting discharged, and managing bed capacity, you lose data.
“There might be a complicating factor as to why someone due to be discharged is not – that’s lost when you wipe a whiteboard. Now, [with Qlik] we have an audit trail, and can then do the analysis, which can then be used to reduce delayed discharging.”
The system is not completely paper-free, he says, but the outpatients clinic is transitioning to electronic.
Singleton says the trust looked at alternatives to Qlik, but is “not yet convinced by [Microsoft] Power BI”, as part of Office 365, of which it is a user. It does, he says, consume data from the use of Tableau, a longstanding Qlik rival, by the Manchester Health and Social Care Partnership.
“I can’t praise highly enough what Qlik does for us,” he says, adding that the pandemic has accelerated the trust’s use of Qlik Cloud in a “pure” service mode. “That means the latest Qlik functionality is installed as soon as it is available,” he adds.