Customer Success Stories
Belgian government uses SAS to ensure quality patient care
As required by the federal administration, every six months hospitals in Belgium have to report each patient admission by uploading information on the patient (hospital, patient data, diagnosis, treatments, etc.) to PortaHealth, the portal of the FPS Public Health. "Here we meticulously check the quality of all the incoming data", says Roeland Geebelen, Head of the Business Intelligence Unit at FPS Public Health. "An absolute must because afterwards the data will be used for many other purposes such as the federal financing of the hospitals, international reports from OECD and EUROSTAT, epidemiological studies, etc. Over the past twenty years or so, we have been developing dedicated applications based on SAS, focused on three major aspects of quality control: technical controls, analytics and audits".
Check, analyse, audit
Once the data have been submitted via PortaHealth, they are subjected to a series of technical checks. If no technical errors are found, business controls are initiated on items like medical or administrative data, each time generating SAS PDF-reports to allow the hospitals to check the quality of their data - all done automatically, without any manual intervention. The whole process is monitored by a purposely built SAS program that reads every log and sends an e-mail if it spots an error. SAS ETL procedures then transfer the data from the database to the SAS environment where the analysts start querying the database for patterns, using analytics techniques.
"There were several reasons why we went for SAS", Roeland Geebelen explains. "First of all because of its extensive analytical features and the fact that SAS was able to effortlessly handle all sorts of data formats. Also for its data management qualities, for the way the software could manipulate huge volumes of data". It is hard to overestimate those volumes, he says. "On average, every year 3.3 million people get admitted to Belgian hospitals which, in SAS, represents 15 GB per year or some 300 GB since we started using SAS back in 1990. And that's just the data in SAS, if you include the metadata and the extensive data dictionaries, you end up with vastly larger volumes in the relational databases. As for the users: in total about one hundred people at the FPS Public Health use SAS on a regular basis. Most of them are Report Consumers, but there's also some thirty analysts to mine the data".
One of the major assignments of the FPS Public Health is building reports per hospital to improve the safety of the patients. Using an internationally defined set of healthcare definitions from the AHRQ, the Agency for Healthcare Research and Quality, the department "Quality and Safety" of the FPS analyses 18 patient safety indicators over a period of 8 years as the basis of the reports. Each hospital only gets its own dedicated report that results in a number of recommendations for improving patient safety and quality care.
Nearly five years ago, the federal government initiated a project called "Co-ordination of Quality and Patient Safety" to encourage hospitals to promote patient safety and quality care in a systematic and structured way. One of the major elements of the project relates to Patient Safety Indicators, the warning lights on the dashboard that tell you that something is wrong and immediate action is needed. It does require the level of patient safety in a hospital to be measured on a permanent, continuous basis.
But how do you find out if the hospitals are actually working on improving patient safety and quality care? "That's where SAS comes in", says project lead Hilde Peleman. "All the participating hospitals have to file a report every year, a standard document developed by our Quality and Safety team. Those reports are analysed with the help of SAS software and the aggregated results are fed back to the hospitals by means of an annual publication. To further improve the effectiveness of the solution, the federal government is now initiating a second multi-year project focused on providing all those involved with high quality data for defining valid and reliable Patient Safety Indicators, enabling effective enhancement of the care processes. It is obvious to all of us at the FPS Public Health that the use of SAS Analytics is crucial here in generating reliable data as the basis for that new multi-year project".
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About the FPS
The Federal Public Service (FPS) Health, Food Chain Safety and Environment was set up in 2001. The FPS is charged with developing a transparent, dynamic and scientifically based policy that takes care of people's health, provides a safe food chain and a better environment for everyone, both today and in the future. For research into policy-supporting matters and advice, the FPS has close ties with several scientific institutions such as the VAR (Veterinary and Agrochemical Research Centre), the IPH (Scientific Institute of Public Health), and the SHC (Superior Health Council). There are four directorates general or DGs: Health Care Facilities Organisation, Primary Health Care & Crisis Management, Animals, Plants and Foodstuffs, and Environment.
“ "To check if the hospitals are actually working on improving patient safety and quality care, each one has to file a report every year, a standard document developed by our Quality and Safety team. Those reports are then analysed with the help of SAS and the aggregated results are fed back to the hospitals for corrective action" ”
Head of the Business Intelligence Unit at fps Public Health