1.Introduction to the system

2.System reports

Presentation Contents

1

ACG History

Minor - self-limited if treated appropriately

More severe - time-limited if treated appropriately

Generally chronic - remain incurable even with medical therapy

Structural problems - generally not curable even with adequate and appropriate intervention

Psychosocial conditions

The classification of patients based on the groupings was shown to accurately represent resource use and led to the development of the ACG system.

In the early 1980s paediatrician the late Barbara Starfield MD and her team, recognised that children using the most healthcare resources were not those with a single chronic illness, but rather were those with multiple, seemingly unrelated conditions.

To test their original hypothesis, illnesses found within paediatric populations were grouped into five discrete categories:

2

What:

Metrics/measures representing a persons level of healthcare resource use (this is the ACG).

Prediction of the use of healthcare resource for the following year. And the likelihood of high cost.

A concise and complete coded representation of a persons disease burden (EDCs).

Produces Models based on diagnosis codes (Dx) and prescription codes (Rx).

How

Risk profiling

Predictive modelling

ACG system tool overview

3

Raw Data

4

ADG (Adjusted Diagnostic Group)

Likely to Recur: Discrete

Likely to Recur: Discrete-Infections

Likely to Recur: Progressive

Chronic Medical: Stable

Chronic Medical: Unstable

Chronic Specialty: Stable-Orthopedic

Chronic Specialty: Stable-Ear,Nose,Throat

Example ADGs and ACGs

5

ACG (Adjusted Clinical Group)

4-5 Other ADG Combinations, Age 18 to 44, 1 Major ADGs

4-5 Other ADG Combinations, Age 18 to 44, 2+ Major ADGs

4-5 Other ADG Combinations, Age 45+, no Major ADGs

4-5 Other ADG Combinations, Age 45+, 1 Major ADGs

4-5 Other ADG Combinations, Age 45+, 2+ Major ADGs

6-9 Other ADG Combinations, Age 1 to 5, no Major ADGs

The system and the process of creating ADGs

6

Adjusted Clinical Groups (ACGs)

7

8

RUBs are aggregations of ACGs based on resource use

RUB variant depending on population of data

RUBs 1-5 each consume 20% of total resource

0 Non Users

1 Healthy

2 Low

3 Moderate

4 High

5 Very High

Resource Utilisation Bands (RUBs)

8

Case Management

Case Management Proactive health management strategies

to avoid increased health resources

Proactive health management strategies to avoid increased health resources

Short Term Interventions, Public Health and Prevention Strategies

Prevention and Public Health Strategies, Health Screening , Immunisation and Vaccination

Review that patients are not slipping through the net orthat they have left the practice

Complex Care 5

Chronic /Long Term Illness

3

4

2

1

0

Resource Utilisation BandsHigher the score the more health resource is used

At Risk moving towards higher

health use

Acute Self Limiting

Well

Non Users

Public HealthHealth Promotion

Practice NurseHealth Visitor

Community MatronDistrict Nurse,

Practice Nurse, Health Visitor

General PractitionerAllied Health Professional

Medicine ManagerPharmacist

Ambulance Service

Practice ManagerPractice Nurse

Health Promotion

General PractitionerHealth Promotion

Practice NurseHealth VisitorDistrict Nurse

Allied Health Professional

Example of Health Professional Intervention At Different Levels of ACG Resource Utilisation Bands

Creating EDCs and MEDCs

10

11

Creating Expanded Diagnosis Clusters (EDCs)And

Major Expanded Diagnostic Clusters (MEDCs)

11

The Predictive Modelling Process(ACG-PM)

12

Extraction process

Secure Network

GP System

GP System

...

Sollis ClaritySystem

SecondaryUses

Service

Clarity.PBCClarity.ACG

ReferenceData

...

Data Sources End Users

ACGGrouper

Apollo

Apollo

NHS Net (N3), no external access

Apollo

EncryptedData

Transfer

Users/Roles (AD)

13