HSMR+ offers a leap forward in healthcare analytics

Author: Dr Lorna Barclay, Head of Statistics at Telstra Health UK

Analysing NHS data is becoming increasingly crucial for improving patient outcomes and making the healthcare system more equitable and efficient. The launch of HMSR+ marks a major advancement in this effort, demonstrating a strong commitment to innovation, precision, and the integration of state-of-the-art methodologies.

The development of HMSR+ is not just an update of its predecessor but rather a comprehensive review of what mortality benchmarking should look like in today’s context. The original model was established nearly 25 years ago, and the evolving needs of healthcare systems and the availability of more sophisticated data today necessitated a significant redevelopment.

The creation of HSMR+ was led by the Analytics team at Telstra Health UK and included a blend of customer feedback and the experiences of healthcare professionals and the Telstra Health Consultancy team who identified limitations of the existing model, as well as an independent review conducted by Professor Simon Jones, Population Health Expert at NYU Grossman School of Medicine. Over the years, drawbacks of certain variables like the Charlson Comorbidity Index and deprivation indices have become apparent, which, while once effective, no longer provided the most accurate insights in today’s complex healthcare environment. Recognising these limitations, the team at Telstra Health UK set out to develop a model that would better reflect the realities of modern healthcare.

One of the most significant challenges was integrating the impact of COVID-19. The pandemic drastically altered mortality data and healthcare dynamics, making it essential to include COVID-19 as a variable in the new model. Instead of excluding COVID-19 data, HMSR+ retains this data, ensuring the model remains relevant and robust even in the face of unprecedented health crises.

The advancements in HMSR+ are far-reaching. Among the most notable is the shift from the Charlson Comorbidity Index to the Elixhauser Comorbidity Index, which expands the range of conditions considered from 17 to 32. This change allows for a more nuanced understanding of patient health and risk factors. Additionally, the introduction of the Dr Foster Global Frailty Index provides a critical tool for assessing the complexity and vulnerability of elderly patients, a growing demographic in healthcare as our advances in healthcare lead to an increasingly ageing population.

Another critical update is the replacement of the Carstairs deprivation index with the Index of Multiple Deprivation (IMD). This shift allows for a more comprehensive and up-to-date measure of deprivation, which is crucial for addressing health inequalities. The IMD, specific to England, offers a more detailed and accurate reflection of socio-economic factors that influence health outcomes.

As part of the transition to HSMR+, palliative care has been excluded from the model to address potential inconsistencies and biases, resulting in more accurate and equitable performance benchmarking across hospitals.

Looking ahead, HMSR+ is poised to play a vital role in shaping the future of healthcare analytics. It has been designed not just as an update but also to provide a deeper understanding of the evolving needs of healthcare systems. With regular updates planned every three years, HMSR+ will continuously adapt and evolve to new data and emerging health trends, ensuring that it remains a gold standard in healthcare benchmarking.

At Telstra Health, we believe HSMR+ has a bright future in the NHS. The model’s potential to influence international best practices cannot be understated. By integrating the latest methodologies and engaging with global experts like Professor Simon Jones, HMSR+ is set to establish new benchmarks in healthcare analytics, driving improvements not just in the UK but potentially worldwide.

The development of HMSR+ was a collaborative effort, involving extensive engagement with healthcare providers and industry experts. The process was not just about updating a model but about listening to the needs and insights of those on the front lines of healthcare. Workshops, board meetings, and individual consultations with NHS trusts and clinical coders ensured that HMSR+ was shaped by those who would use it most.

This collaborative approach continues post-launch, with Telstra Health UK offering robust support to ensure that healthcare providers can reap the benefits of the new methodology. From detailed data outputs to impact analysis and training, we are committed to providing the resources needed to make the transition to HMSR+ as smooth and beneficial as possible.

HMSR+ is more than just a revised benchmarking model; it reflects our commitment to delivering accurate and relevant models in all that we develop at Telstra Health.

Read more on the Health Service Journal here.