Review finds monthly clinical performance reporting ‘not currently feasible’

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Review finds monthly clinical performance reporting ‘not currently feasible’

Sunday, 13 August 2023

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NEWS - eHealthNews.nz editor Rebecca McBeth

A review of Te Whatu Ora Health New Zealand's reporting of clinical performance metrics identifies data quality issues across the national data collections and says local data teams are overwhelmed and do not have capacity to meet increased demand.

The Clinical Data Review Report sheds light on a series of challenges that led to the publication of inaccurate data about New Zealand’s Emergency Departments in March 2023.

Te Whatu Ora has now resumed public reporting of 11 of 12 clinical performance metrics, but on a quarterly basis, rather than monthly.

The Emergency Department Admissions metric has been temporarily removed because the definition of a hospital admission from ED has been interpreted inconsistently.

Te Whatu Ora took over responsibility for health system performance reporting from Manatū Hauora Ministry of Health when it was created in July 2022.

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The National Collections and Reporting Group, which had been responsible for quarterly reporting, transferred from Manatū Hauora to the Te Whatu Ora data and digital directorate but some national collections’ subject matter expert analysts did not transfer and some left, “leading to a loss of knowledge and expertise in the national collections and performance reporting”, the review says.

Te Whatu Ora then decided to move to monthly reporting and an analyst team at Waitaha Canterbury was tasked with producing the reports.

“The team was reluctant to undertake this work as they did not have subject matter expertise and experience in the national data collections and reporting systems,” the review says.

Lack of a standard operating procedure meant well-established processes and procedures in place for ensuring the accuracy of the data prior to its publication were not followed.

The review finds that the timeframe to move to monthly reporting was unrealistic and “accuracy was compromised by a sense of urgency and wanting more frequent (monthly) public reporting.”

It also says that monthly reporting is not currently feasible and reporting the 12 indicators “does not provide the public with meaningful data” as “the indicators are not presented in ways that are informative for the public and easy to use”.

“There is insufficient National Collections subject matter expertise within Te Whatu Ora to support monthly reporting of the 12 performance measures to the public and to support robust quarterly reporting,” it states.

The Review also looked at the importance of Māori data sovereignty and Te Tiriti obligations, saying “the inherent rights and interests that Māori have in relation to the collection, ownership, and application of Māori data are not recognised in a clear reporting framework and in all performance reporting".

It offers a series of recommendations, including; building expertise in national data collections, implementing a robust quality assurance framework, and planning for automation of data processing to minimise manual handling.

“The events leading to this review have undermined the trust and confidence of staff, particularly analysts. Rebuilding this trust and confidence and acknowledging their skills and expertise is important,” the Review says.

Te Whatu Ora says it is now implementing the 28 recommendations.