1. Technology & innovation in health information systems - a lever for health system strengthening?
Peter Stephens, MA, PhD

2. Financial Sustainability
Technology enables the application of new research methodologies and reduces financial risk….efficiently
Clinical Excellence
Financial Sustainability
Strong Health System
Technology as a lever
Study power
Advanced methods
Concurrent, varied studies
Technology as a lever
Depth of analysis
Complexity of analysis
Financial risk reduction

3. 2,880 per hospital episodes over 3 years
Clinical Excellence
Technology as a lever
Use of antipsychotics in dementia
Finding undiagnosed patients with HCV (200 million records)
Precision (% identified correctly)
Sensitivity (% identified incorrectly)
Logistic Regression
Random Forest
Gradient Boosting Trees
Ensemble via GBT
New techniques 49 times more effective at identification
Audit
40 per hospital
consecutive patients
Technology
2,880 per hospital episodes over 3 years
Sample is 72 times as large
Stephens P (IQVIA) et al: European Geriatric Medicine, 2014
Doyle O (IQVIA) et al: Pharmaceutical Management Science Association, 2018

4. 3 26 250 Provider Focus Payor Focus Provider & Payor Focus
Technology as a lever
Financial Sustainability
Dubai Health Insurance (IQVIA)
PLICS systems promote payor and provider co-operation
4.5 million members
2800+ providers
70+ payors
insurance products
27.4 million electronic claims
250
transactions per second 3
seconds to approve 26
million combination checks
Fixed cost to fee ratio e.g. 10% +
Provider Focus
Relative Value Weights (e.g. Medicare)
Payor Focus
Activity Based Costing (Patient Level Based Costing Systems)
Provider & Payor Focus
Reduces payor and provider financial risk
IQVIA is largest PLICS supplier to NHS in UK with installations across Middle East

5. Strong Health System Technology as a lever Needs human expertise
At an Institutional level
Incomplete recording
Under-utilisation
Cost allocation differences
Under and over resourcing of centres
At a design level
Cost pooling design (failing to take account of case-mix)
But NHS RCI varies by almost two-fold
IQVIA cost analysis of HD centres, 2018

6. Questions
Peter Stephens, MA, PhD