This interview was first published in HTN jointly with Sam Elliott and Rob Findlay

HTN caught up with the team at Insource to discuss the company’s data platform and what it can offer to NHS trusts.

As reported by HTN, Insource announced the acquisition of Gooroo earlier this year. The company, which specialises in advanced capacity planning with particular expertise in elective waiting times and non-elective bed occupancy, was added to boost Insource’s portfolio and its offering of Elective Care Recovery data management solutions to both the NHS and private UK healthcare providers.

At the time, Sam Elliott, CEO at Insource, said: “We are delighted to welcome Gooroo into Insource at such a critical time for Elective Care Recovery in the NHS. With the impetus of digitisation during COVID, now is the time to make significant strides in data management across the service.

“Data unification and standardisation are essential if the NHS is to be able to integrate, manage and utilise data in any meaningful way. With this new acquisition, Insource is ideally placed to help not only with elective care but also in the planned NHS restructuring around ICSs [Integrated Care Systems].”

Rob Findlay, Founder of Gooroo, added: “Good quality, accurate and timely data is vital to the NHS and the need for accurate planning and comprehensive reporting is only going to get bigger. Together we bring powerful planning to front-line managers and enable them to measure ongoing performance against evolving waiting time targets.”

Five months on from the announcement, we spoke to Sam and Rob to find out all about the new partnership, their mission statement, future plans, the UK Government’s data strategy and the importance of clean and consistent data. Here’s what they had to say.

A powerful solution and strategic partnership

Rob Findlay continued: In April, Insource acquired Gooroo, and me, and we fit really well together. What Insource has is a powerful data platform, that consolidates, standardises, validates, and unifies operational data from across the hospital, and what Gooroo has is powerful capacity planning software, which relies on that clean data.

This links to the government’s data strategy because what the NHS (and myself) tend to do is focus on all the exciting things that we can do with data, to manage the NHS more safely and efficiently. But when you come to try and do it, you find that it’s hard to get the data to feed your analytics in a readily available, clean and consistent form, and that’s what the Insource technology solves. iIt does what the government strategy says, it separates the data from the applications.

Sam: I’ve been in healthcare for more years than I’d like to remember. I started by helping the NHS manage their medical and non-medical equipment asset base, which was as confusing then as it is today. I moved around the healthcare sector and worked, geographically, all over the world, with large global companies and small start-ups, in US, Australian, Asia Pacific, Asian, African and Middle East markets. All the time I was privileged to be in these roles, it gave me a growing understanding and an empathy towards patient care and outcomes.

I’ve known Insource for about 16 years now. I joined them about 15 months ago. During this period, I have gained so much more knowledge of the benefits that can be derived from having good and meaningful data and how, if provided correctly, it can ultimately and massively improve a patient’s journey and overall outcome. The more that I talk with people like Rob, the more I’m beginning to understand that data is critical to providing the right outcomes for patients.

What having clean, unified, up-to-date data can mean for a hospital

Rob: As a patient, what you find if you use the health service, is that the clinicians are fantastic but the hand-offs between them aren’t always quite so great. When you’re referred from the GP to the hospital, there may be incomplete data and when you go to A&E you might tell your story to five different people.

The hospital has a patient administration system (PAS), which runs most of the hospital. But even then, it’s got an outpatient module, an inpatient module, and separate systems for theatres, radiology etc. You’ve got this proliferation of using different systems of different ages, and different data standards. Even if you have the same system in two different hospitals, they’ll use them differently.

What the Insource data platform does is takes all these different sources and consolidates, standardises, validates and unifies the data, so that you can throw them into the same bucket, and they all look alike. This is what we call our Unified Data Layer (UDL). This means you can interrogate them all in the same way and tell what journey the patient is taking through the hospital, so all those hand-offs are correctly picked up.

This is important if you’re a company that’s building a clever app that makes wisdom out of data. You’ll only have to build it once because you won’t have to worry about data coming through in the wrong format. It means you have clean, up-to-date data with the pathways linked together, so that all the intelligence that sits on top of it can function. This powerful data platform isn’t the sexy end of it, this is the plumbing.

Sam: At the moment, a lot of the analysts are working with data that’s two to three months old. And now there’s thousands of people on those waiting lists and hospitals are finding it very difficult to make those journeys better and more efficient. The immense frustrations for both the NHS and from the patients are now being aired more openly and across multiple sectors within the healthcare provision.

The data is too old, it’s not allowing the users of this data to perform and show its true potential value and plan for better outcomes, in better planning and care delivery.

How can this benefit ICSs?

Rob: These problems get magnified when you start looking at an ICS level, or at a regional or national level. What you find when you look at waiting times is different pressures. There is scope for one part of the system to help other parts of the system. But how do you do that? This is a very difficult data problem because you must stitch the data together.

We’ve spoken about how hard it is to stitch data together in one hospital. Now imagine you’ve got lots of hospital sites across an ICS, lots of ICSs in a region, and lots of regions in a country. Using conventional approaches, analysts sitting down and hand-coding the connections, this is an almost impossible job. But, with the Insource platform having unified the data in all those places, all that data can just be pulled together.

The first thing I’d tell the ICSs is to recognise that they have a data problem, which they need to solve first. They need unified data from all the IT systems across the ICS, so that they’ve got that complete, up-to-date, and consistent view. Having done that, they then have the freedom to think about how to solve the problem.

If we take just one issue, the post-COVID elective backlog, they need to understand whether they will have capacity to treat elective patients. One reason they may not, is if they are running out of beds. They need an understanding of that, and whether splitting elective work off onto a cold site will solve the problem or have other consequences. They need to work out how big the challenge is across the ICS and establish whether they can do this with extra capacity or whether they need to increase the size of the elective NHS on a long-term basis. I would suggest this is quite likely to be the cheaper approach.

Then they need to do it, they need to be able to devolve that problem successfully to local managers, so that people are working in consistent ways. This problem is too big to firefight in a conventional way. You need clear and consistent processes that people at all levels of the service can follow, day-in, day-out, so that on the frontline the right clinician is treating the right patient, at the right time.

A further ingredient is that waiting times are a function of not just how long the queue is but also what order you treat the patients in. Urgent patients must come first and you need to make sure the way you are booking patients is safe, fair, and efficient. If your data quality is poor, you’ll be tripped up all the time, you’ll be contacting patients who aren’t waiting, who have moved, or have sadly passed away.

Sam: ICSs have inherited all the problems that have been building up over the last five or 10 years, and they are supposed to have the capabilities to solve all these issues, But supplier companies that are currently trying to help the NHS with these problems are still dealing with the same data problem that the NHS is dealing with, they only have access to old [SUS] data that is two to three months out of date. It’s not fresh, it’s not accurate, it’s not daily.

I have recently spent time talking with existing and potential partners within our network. They have been aware of the data issue for some time but have not been able to overcome the issue of the old data facing them. At Insource we have been able to share our expertise in providing good, constructive and clean data on a timely basis. The consensus continues to grow and develop into a clear understanding that Insource can overcome many of the inherent problems surrounding the use of old disparate data. There appears to be a very willing appetite where we will collaboratively work to deliver better results, greater accuracy, and improved outcomes right across the ICS and beyond.

What do the next 12 months look like for Insource?

Sam: We are currently on a pathway of education and sharing our data experience gained over the last 20 years. Data has been historically viewed as vehicle to provide reports on past activity. However, it is now being seen as the vehicle to improve outcomes delivery and as the basis for accurate future planning. We at Insource are committed to providing the best data solutions to help healthcare realise the real value of clean, usable, and functional data.

Rob: Insource, way back in the day, was a consultancy. They were finding that they were spending a lot of time wrangling data. That was the germ of the Insource data platform. To solve it they built the platform, which is now very mature. What it has enabled us to do is to work very quickly and correctly, when dealing with different data sources. This is what makes it possible to be nimble, we’ve got advanced technology, so when new problems arise, we can go in and say: ‘We’ve got solutions and partners with solutions, and we can turn them on in a matter of weeks.’

Building on what Sam said, what we’re doing is helping the NHS to move away from ad-hoc management and solving the problems of today, this week or this month, and more into a position of having consistent processes that everybody at all levels can follow, for the benefit of patients. And also, to tell when things are veering off-track and make the appropriate course corrections. It’s a safer and more resilient approach, and less exhausting. People in the NHS are exhausted after COVID, it’s been quite a ride for the last 18 months. We want to provide them with more predictability and more stability, so that they can manage the tremendous backlog.

To find out more about the Insource data platform and offerings for NHS trusts and ICSs, visit www.insource.co.uk