By John Thornton | 1 January 2012
Automation can speed up paper, online and telephone enquiries and make decision-making quicker and more accurate. In some cases, it can save lives
Policy automation is becoming widely used in the public and private sectors – so what exactly is it?
All organisations rely on ‘policies’ to make things happen, to ensure consistency and to prevent undesirable outcomes. While these are relatively easy to write, they are usually much harder to implement – as this depends on developing ‘rules’ and ensuring ‘compliance’. However, technology is really good at using rules to make decisions and guide people quickly through complex decision-making processes.
Policy automation therefore provides a powerful means of improving decision making, speeding up processes and dramatically reducing costs, especially as more functions are accessed and managed online.
It uses what are called ‘rules engines’ to generate actions and follow-ups based on the information received. Rules can usually be entered in everyday business language, enabling them to be defined and maintained without recourse to IT specialists. These potentially enable large numbers of routine enquiries and decisions to be handled automatically, creating more time for the enquiries and decisions that are less routine. The technology is currently mainly used for things such as the automatic calculation of benefit entitlements, scheduling appointments and signposting to relevant information.
It can also be used for more complex decision-making such as responding to health risk assessments completed by patients online. A family history of heart disease could trigger an appointment for blood and blood pressure tests, as well as a link to further relevant information about diet and exercise.
Policy automation allows health professionals to construct and deploy auditable rules and ‘decision trees’ to ensure that patients are accurately and consistently treated at every stage in the patient journey. This means that information such as eligibility for a form of treatment or the rationale for an individual decision can be quickly determined and incorporated into the patient’s record.
In a paper submitted to the public inquiry into the failings at the Mid Staffordshire NHS Trust, the University Hospitals Birmingham NHS Foundation Trust showed how better information management, analytics and rules engines can be combined to improve patient care. For more than a decade, the Birmingham trust has seen information technology as central to actively managing and improving quality of care. This includes collecting and interrogating, on a continuous basis, a very large amount of clinical and operational data. It says that error reduction starts at the point carers make decisions or initiate actions. Real-time clinical decision support is therefore the central plank of its error management strategy.
Decision support is provided by tiered, context-specific warnings to users at the point at which actions (such as a new prescription) are initiated, or by the system initiating context-specific actions. These can be related to any data, combination of data, or rate of change of data within the system. The rule base used to generate these warnings currently holds more than 16,000 separate rules, most of which are specialty specific and managed by the specialty clinicians.
The UHB report highlights a reduction in mortality rates of 16.9% for patients admitted as emergencies and undergoing a procedure. It also shows that if this approach was adopted across the NHS, it would equate to 16,000 deaths avoided nationally. It concludes that it would not be possible to achieve this level of hospital-wide error reduction without using electronic systems. It would not, for instance, be possible for the UHB medical director’s team to analyse 1,200 paper drug charts, even if they were legible, to spot and redress ‘omitted doses of medication’ in the time achieved by the technology.
Could policy automation help your organisation?
John Thornton is a director of e-ssential Resources, and an independent adviser and writer on business transformation, financial management and innovation
Automation can speed up paper, online and telephone enquiries and make decision-making quicker and more accurate. In some cases, it can save lives
Policy automation is becoming widely used in the public and private sectors – so what exactly is it? All organisations rely on ‘policies’ to make things happen, to ensure consistency and to prevent undesirable outcomes. While these are relatively easy to write, they are usually much harder to implement – as this depends on developing ‘rules’ and ensuring ‘compliance’. However, technology is really good at using rules to make decisions and guide people quickly through complex decision-making processes.
Policy automation therefore provides a powerful means of improving decision making, speeding up processes and dramatically reducing costs, especially as more functions are accessed and managed online.
It uses what are called ‘rules engines’ to generate actions and follow-ups based on the information received. Rules can usually be entered in everyday business language, enabling them to be defined and maintained without recourse to IT specialists. These potentially enable large numbers of routine enquiries and decisions to be handled automatically, creating more time for the enquiries and decisions that are less routine. The technology is currently mainly used for things such as the automatic calculation of benefit entitlements, scheduling appointments and signposting to relevant information.
It can also be used for more complex decision-making such as responding to health risk assessments completed by patients online. A family history of heart disease could trigger an appointment for blood and blood pressure tests, as well as a link to further relevant information about diet and exercise.
Policy automation allows health professionals to construct and deploy auditable rules and ‘decision trees’ to ensure that patients are accurately and consistently treated at every stage in the patient journey. This means that information such as eligibility for a form of treatment or the rationale for an individual decision can be quickly determined and incorporated into the patient’s record.
In a paper submitted to the public inquiry into the failings at the Mid Staffordshire NHS Trust, the University Hospitals Birmingham NHS Foundation Trust showed how better information management, analytics and rules engines can be combined to improve patient care. For more than a decade, the Birmingham trust has seen information technology as central to actively managing and improving quality of care. This includes collecting and interrogating, on a continuous basis, a very large amount of clinical and operational data. It says that error reduction starts at the point carers make decisions or initiate actions. Real-time clinical decision support is therefore the central plank of its error management strategy.
Decision support is provided by tiered, context-specific warnings to users at the point at which actions (such as a new prescription) are initiated, or by the system initiating context-specific actions. These can be related to any data, combination of data, or rate of change of data within the system. The rule base used to generate these warnings currently holds more than 16,000 separate rules, most of which are specialty specific and managed by the specialty clinicians.
The UHB report highlights a reduction in mortality rates of 16.9% for patients admitted as emergencies and undergoing a procedure. It also shows that if this approach was adopted across the NHS, it would equate to 16,000 deaths avoided nationally. It concludes that it would not be possible to achieve this level of hospital-wide error reduction without using electronic systems. It would not, for instance, be possible for the UHB medical director’s team to analyse 1,200 paper drug charts, even if they were legible, to spot and redress ‘omitted doses of medication’ in the time achieved by the technology.
Could policy automation help your organisation?
John Thornton is a director of e-ssential Resources, and an independent adviser and writer on business transformation, financial management and innovation
