Easing Winter Pressures with Risk Stratification

It’s that time of year again. The nights are drawing in and there’s a chill in the air. And we all know how cold winter weather exacerbates respiratory conditions and vascular diseases, putting more people at risk of emergency hospital admissions and piling the pressure on A&E departments. Chronic obstructive pulmonary disease (COPD) and asthma are two conditions that can worsen during winter, particularly for the elderly.

According to the NHS England white paper ‘Understanding Winter Pressures’, of all the people who present at A&E, those aged 75 and over have a greater than 80% chance of emergency admission. And it is those requiring emergency admission who spend the most time in A&E.

It asserts that demand for A&E space and beds for emergency admissions can only be managed by better self-care, monitoring, early recognition of illness, and response, such as urgent access to medication and timely primary or community care.

Of course, COPD and asthma are chronic conditions not confined just to the elderly, and we should widen the sphere of focus to include all age groups when looking to manage patients with those conditions.

So what can commissioners and clinicians do to help reduce pressure on A&E departments? You’ll be familiar with the Avoiding Unplanned Admissions DES, but how can you target those patients with the conditions that we know increase the risk of emergency admissions during winter, such as COPD?

This is where risk stratification and predictive modelling can have a real impact. No doubt you’ll be familiar with those terms as well. You might have a risk stratification system. You might even use it.

Well, you should.

Sollis recently worked with a CCG to help them focus on those patients with COPD to monitor, review and intervene where necessary before winter sets in, to help reduce winter pressures. The key is identifying the at-risk patients in specific cohorts, and putting care programmes or interventions in place to reduce the likelihood of an A&E attendance followed by a spell in hospital.

Sollis has incorporated the Adjusted Clinical Groups® (ACG®) System, developed by the Johns Hopkins University, into Clarity Patients to create one of the most advanced risk stratification systems available in the UK. It takes data from across the healthcare system to create integrated patient care records that are risk stratified by the ACG System.

Clarity Patients enables you to actively target those patients most at risk – in this case – of emergency admission due to those seasonally aggravated conditions such as chronic asthma or COPD. These at-risk patients can also be automatically added to care programmes or registers for review.

“The problem appears in A&E, the solutions are mostly upstream and downstream.”1

Targeting and treating patients whose conditions can be managed upstream of A&E is made possible with the right data, presented in the right way at the right time. That’s what we do.

1 Understanding Winter Pressures; NHS England, October 2014.