Like all air ambulance services, the team at The Great North Air Ambulance Service (GNAAS) deal with life and death situations on a regular basis. In situations like these the power of data can really make a difference in ensuring the charity’s paramedics and doctors are as prepared as possible to make every second count.
Clinical data is also important from a quality assurance and reporting point of view. These reports can be for clinical governance reviews or for producing statistics which can be used to aid fundraising for air ambulance charities.
GNAAS have always been industry innovators and they understand the power of data and the value it brings to their operation. Since 2016 they have been using ARCEMS which is a single platform which records and manages patient records and compliance. They wanted to harness the data collected over the years in ARCEMS and really examine it and make the data work for them.
To help them achieve this, GNAAS are in the process of setting up Microsoft Power BI dashboards that utilise the collected data from ARCEMS. Clive James, Head of IT at GNAAS explains, “We use interventions and drugs which have names which are specific to us e.g. an RSI which has eight different attributes, so we built the data warehouse as our repository to make it easier to access the data. We take the data that’s in the back-end of ARCEMS and pull it together into a data set which is then fully queryable.”
This set up allows users with a lot less detailed knowledge of the data be able to run a variety of queries and reports.
Anonymised data is also accessed by the GNAAS marketing team in order to pull statistics together which help promote the work that the team is doing and help fundraising efforts.
At present GNAAS are working on two dashboards. The first is the Operational Dashboard which is about the operational timings e.g. how long it takes the crew to get airborne, to reach the incident, to administer critical interventions to a patient, to get to hospital and then clear the hospital. “This is then broken down by type of incident, by date range, by which hospital they went to and by certain interventions,” said Clive.
The second is the Clinical Dashboard (currently in development) which gives more information about specific medical interventions, drugs and the impact they have. Clive said, “We’re hoping this will give us an insight into scenarios like if we give X drug at a particular time or we do things in a certain sequence does it increase the chances of patient survival by X%. The crew then look at things like this in the data as incremental changes have an impact on patient outcomes.”
From a medic’s point of view, this level of data will be extremely useful for how they do their day-to-day job as well as for reviewing cases. Tim West a HEMS Paramedic at GNAAS gave an example, “We use Tranexamic acid (TXA) and we know from a quality assurance point of view that for every fifteen minutes that you delay giving it to a patient following an injury there is a 10% drop in survival rate. So one of the things we’re pushing as an organisation is to administer that within fifteen minutes of arrival on scene if it hasn’t already been done. So we’ll use Power BI to retrospectively look at that data and the cases that fall outside of those parameters will then be analysed in more detail.”
Another example is that the data in these dashboards will also be used to predict certain outcomes for interventions like intubating a patient. Tim said the team will, “Look at the combination of clinician, the environment, the patient, the patient’s weight and pull it all together to see if there’s a common pattern so we can predict when we’re going to have a difficult airway in the future.”
Enhancing Patient Care
Improving patient care sits at the heart of this project. The interrogation of data will ultimately lead to even better prepared and trained paramedics, as Tim explains, “One of the things we will be using Power BI for is to look down at an individual clinician level. The individual clinician dashboards will be able to instantly pull up information to show that a certain intervention like a cannulation hasn’t been done enough to hit competency so they can go brush up on them or it could show that they’ve done eight in six months so competency has been fulfilled.”
“This is all around quality assurance and being able to use the data that’s held in ARCEMS to reflect as a clinician on your practice and see everything including your on scene times. This lets the organisation see if there’s a training need.”
GNAAS don’t plan on stopping once these two dashboards are live with plans for further development underway as Power BI opens up exciting avenues to explore in the future.
Tim said, “Power BI can be used to build a query that fits a research study we are planning on running in the next twelve months. It will allow us to design a system that captures all the data we want and monitor the data capture during the process. The best studies are those that analyse weekly how the data capture is going and tweak accordingly. If we proposed a piece of research that was looking at one treatment set versus another we would be expected to monitor the ongoing information and analyse it in real-time which we can do using Power BI.”
There are also plans to collaborate with the North East Ambulance Service (NEAS) and share anonymised data which would be mutually beneficial to both organisations but this is currently on hold due to the on-going pandemic. Another area of collaboration they are exploring is to utilise the relationship Air Ambulance UK have with NHS Digital which gives them access to NHS data. This would then enable GNAAS to see what happened to a patient after they were handed over to the receiving hospital.
The Great North Air Ambulance Service are a registered charity and receive revenue from sales of ARCEMS which helps them to continue to provide a helicopter emergency service for the North of England, serving North Yorkshire, the North-East, Cumbria and Scottish borders.