Risk Stratification

IDC35
Version1.0.1
Type Capability
StatusEffective
Effective Date 

Full or Partial Capability status. For this Capability, Solutions are required to meet a minimum of one MUST EPIC and associated acceptance criteria but not all MUST EPICs (where there are multiple MUST EPICS) to achieve Partial Capability Status, or; to meet all MUST EPICs and their associated acceptance criteria to achieve Full Capability Status.

Description

Risk Stratification tools are specifically designed to identify those individuals who are at high risk of experiencing a future adverse event, such as readmission to hospital or unplanned hospital admission, or an acute event such as a heart attack.  Risk Stratification often takes into account multiple risk factors and morbidities and their inter dependency, rather than just concentrating on one criterion (e.g. high blood pressure). 

A Risk Stratification Capability will allow risk calculations to be performed for individual patients using algorithms that can be run against Patient data (known algorithms can be used such as QRISK®2, QDiabetes®, QFracture®, QCancer®, QAdmissions®) to proactively identify a Patient's risk level (e.g. of an unplanned admission). If the high-risk individuals can be identified early and offered better support and preventive care then it may be possible to improve their health outcomes and their experiences of care while, at the same time, making net savings for the health service as a whole by averting complications and avoiding hospital admissions.


Outcomes

GPs
  • Able to proactively identify at-risk Patients
Patients
  • Patients identified as at risk may receive preventative care


MUST Epics - Epics and acceptance criteria will be evaluated during the Capability Assessment Stage of Onboarding

C35E1- run Risk Stratification algorithms

As a Service Provider

I want to identify whether a Patient is at risk

So that I can prioritise the management of their care

Acceptance criterion 1: Service Provider can run Risk Stratification algorithms 

Given the Service Provider is using a Risk Stratification Tool

When they want to identify whether a Patient is at high risk of developing certain outcomes or diseases

Then they can run Risk Stratification algorithms against that Patient's data

And a risk level can be calculated

And the results can be saved

Acceptance criterion 2: tools based on nationally or industry recognised algorithms

Given the Service Provider is using a Risk Stratification Tool

When there is a nationally or industry recognised algorithm for the Risk Stratification Tool

Then the Risk Stratification Tool uses the nationally or industry recognised algorithm

Acceptance criterion 3: view Risk Stratification Tool algorithm details

Given the Service Provider is using a Risk Stratification Tool

When the Service Provider chooses to view details about the algorithm used by the tool

Then the algorithm details can be viewed

And the source is displayed


Capability Specific Standards

Suppliers will have to attain compliance with these Standards during the compliance stage before they can be live on a framework with this Capability:

None


Other Applicable Standards

Suppliers will have to attain compliance with these Standards during the compliance stage before they can be live on a framework with this Capability:


Items on the Roadmap which impact or relate to this Capability

Suppliers will not be assessed or assured on these Roadmap Items as part of Onboarding