Real Time Monitoring (RTM)

Enabling providers and commissioners to benchmark and monitor clinical outcomes.

Real Time Monitoring (RTM) is a web-based solution that monitors and identifies potential process, clinical and coding problems around key indicators of clinical quality and effectiveness. It is used by around 70% of providers and a growing number of commissioners to drive improvements in the quality of data and care.

RTM enables providers to measure,compare and understand their performance, monitor activity using statistical process control charts (CUSUM) and drill down to patient-level data for detailed investigations. RTM enables commissioners to commission for quality, benchmark the performance of providers and monitor local CQUIN standards.Through its intuitive user interface and a range of graphical representations, from charts to funnel plots, RTM highlights areas of high or low performance. RTM offers:

• The ability to monitor the quality of patient outcomes, around key indicators such as mortality (HSMRs, ‘deaths after surgery’ and deaths in high and low-risk conditions), length of stay, day case rates and 28-day readmissions.
• Intelligent analysis from an automated report function that highlights potential clinical issues as soon as they occur, eg changes in patient outcomes, case-mixes or coding quality.
• Statistical alerts using both CUSUM and relative risk to highlight areas of concern.
• Automatic letters and CUSUM charts that trigger an alert to the medical director and Care Quality Commission when there is significant divergence in expected clinical outcomes.

“Dr Foster’s RTM enables me to quickly understand and act on warning signs across every specialty and department and also recognise the areas where we’re doing well.” - Ruth Holland, Associate Director of Performance and Information, South London Healthcare NHS Trust

The RTM difference

RTM is the only quality benchmarking solution that provides:

• High quality risk adjustment and benchmarking to ensure like-for-like comparison.
• Extensive drill-down functionality that allows users to interrogate the data, including drill-down to patient records.
• Unrivalled national, regional and peer benchmarking delivered through the national Secondary Uses Service (SUS) data-set.
• The ability to view data by consultant team and link this back to the patient.
• Access to service line indicators that measure performance and outcomes across the stroke and orthopaedic pathways.

Developed with clinicians for clinicians

RTM has been developed through in-depth consultation with our customers and development work with leading academic centres. RTM incorporates methodologies from Hospital Standardised Mortality Ratios (HSMRs) designed by Professor Sir Brian Jarman and Dr Paul Aylin at the Dr Foster Unit at Imperial College London. The ‘deaths after surgery’ indicator, first published in the UK in the 2010 Hospital Guide, was developed alongside Imperial College London and King’s College London.

RTM in pictures

Benefits to providers

• Obtain both a trust-wide view and the ability to drill down to specialty and patient level, to quickly identify areas of concern and inform clinical audit.
• Benchmark performance against comparable providers nationally, regionally and at a peer group level.
• Externally assess standardised mortality rates, a key recommendation of the Francis report (Mid Staffordshire inquiry, February 2010).
• Manage the dual demands of quality and efficiency through a range of metrics, including length of stay, day case rates and readmissions.
• Identify avoidable readmissions – for patients readmitted to your hospital or any other hospital in England.
• Inform your performance improvement programmes, including HSMR reduction, Enhanced Recovery and care bundles.

Benefits to commissioners

• Monitor and benchmark the quality of local provider services across a comprehensive range of indicators, including mortality, productivity, outcomes, patient safety and service line.
• Compare your providers’ outcomes and productivity with peer trusts across England (based on performance, location or case-mix) to quickly identify outlying performance.
• Commission for quality and monitor local CQUIN standards.
• Facilitate joined-up working across the health economy.

The Dr Foster difference

Dr Foster Intelligence is the leading provider of health information in the UK. Our solutions enable the NHS to use information more effectively in order to provide better and more efficient patient care. Our analytical tools are used by nearly 80% of acute trusts and around 40% of PCTs. Our unique access to the Secondary Uses Service (SUS) data, combined with our understanding of the NHS and experience in analytics, enables us to provide insight to NHS organisations that can support and underpin all areas of performance measurement and improvement. Download the RTM factsheet.