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How interactive mapping software is being used by New Zealand's Health Quality & Safety Commission


New Zealand's Health Quality & Safety Commission (HQSC) was set up to ensure all New Zealanders get the best health and disability care within available resources. Its role is wide ranging and includes: providing advice to the Minister of Health on how quality and safety in health and disability support services may be improved; leading and coordinating improvements in safety and quality in health care; identifying key health and safety indicators (such as events resulting in injury or death) to inform and monitor improvements in safety and quality and reporting on safety and quality, including performance against national indicators.

Catherine Gerard is a Senior Analyst in Health Quality and Evaluation at HQSC. She works with Richard Hamblin on the New Zealand Atlas of Healthcare Variation and also on developing quality and safety measures.

Getting started

In New Zealand, the Ministry of Health is responsible for national health and disability data collections. A range of data are collected, the subjects covered including: hospital events, pharmaceuticals, maternity services, laboratory tests, mental health events and cancer registrations.

HQSC combines these different data to identify variation in selected topic areas and analyses this for presentation to a wide range of stakeholders (such as primary and secondary care clinicians, health managers, planners, funders and researchers). The aim is to start a national debate as to why this might be. HQSC chose InstantAtlas as the most promising online mapping software to provide a web-based presentation tool to highlight the variation.

"The idea was to present the data in an interactive way for users," says Catherine. "Historically the way national data have been presented has not always made it easy to understand."

Meeting the need

The Atlas of Healthcare Variation now displays easy-to-use maps, graphs, tables and commentaries that highlight variations by geographic area in the provision and use of specific health services and health outcomes.

HQSC Cardiovascular Atlas

The Atlas is designed to prompt questions about why variation exists rather than directly making judgements about what the 'ideal' result or level of activity may be. This debate may then lead to improvements in health care services. The subject areas in the Atlas are chosen by a group of clinical experts and consumers, based on a range of criteria such as burden of disease, the potential to modify any identified variation, the opportunity to reduce inequalities and alignment to existing quality improvement initiatives and national work programmes.

Catherine says "Getting clinicians involved was always part of our approach, and the Atlas has given them an insight into current practice," she says. "It is a good way of presenting national data interactively and of getting people engaged by helping them grasp the content quickly."

Future Developments

The HQSC is considering the way it presents regional variation. "In some of our data there is limited geographic variation but at the same time there is consistent variation between groups. It is important to show this whilst not over-emphasising the regional variation," says Catherine. "We will continue to develop new atlases over the next couple of years. Our plan is to keep adding domains and refining what we have already done."

Key benefits

  • The Atlas of Healthcare Variation is helping the HQSC highlight variation in healthcare provision at a regional level
  • Visual presentation of data has been helpful for a range of users
  • It is also helping to stimulate questions and debate about the health care needed at this level
  • The interactive presentation helps users quickly understand large amounts of data
  • The atlas has provided a focus for a work programme that will continue to provoke debate about healthcare provision

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