The problem

Regular integrated care system (ICS) cost benchmarking needs to happen at a level that provides insight into the drivers of variation, because otherwise we will miss opportunities to identify and collaborate on service improvements at a system level.

The challenge

How might we share detailed costing data in a timely way so that ICS level opportunities can be identified, deriving further benefits from costing information?

The outputs

The teams have developed an interactive Power BI dashboard that can be accessed by ICS provider Trusts. The dashboard combines the quarterly ICS costing models and displays the following:

• total service cost at a system level, which can be broken down by point of delivery and HRG
• service level overview – total cost and average costs for each provider. Activity information, including the highest volume
• cost opportunities – areas of the greatest cost opportunity for each provider, when compared to the ICS average
• drill down to breakdown the cost opportunity by cost driver (national activity level), to allow for comparison across providers and identification of outlier areas, e.g., ward care costs, imaging at department level, etc.
• length of stay (LoS) opportunity – areas with the greatest length of stay opportunity for each provider when compared to the ICS average
• drill down to breakdown the LoS opportunity by activity volumes and costs
• inpatient cost drivers – compares procedure and anesthetic times, number of patient contacts, etc.
• clinical support opportunities – comparisons of pharmacy, radiology, and pathology costs and usage
• comparison of critical care costs.

The outcomes

The great thing about doing this work in-house is the flexibility it brings in terms of developing how you want your dashboard to look and what information you want to share. You can quickly turn around suggestions and developments, keeping users engaged. Combining data in this way has allowed us to review variation as a system and work to improve data quality. Coming towards the end of the review phase of our project, we are progressing to sharing the information with clinical and operational teams. We intend to use the information to reduce unwarranted variation and improve patient pathways, taking a system-level approach.