This King’s Fund case study (funded by Aetna and the Aetna Foundation) investigates community virtual wards based in GP practices within South Devon and Torbay Clinical Commissioning Group (CCG). The community virtual wards were introduced by Devon Primary Care Trust in 2010 as a means of identifying proactively those patients at high risk of emergency admissions. A predictive risk tool has been devised to short-list patients most at risk and manage their care in the community through a multi-disciplinary approach.
“Predictive modelling is used to support proactive case management of patients by risk-stratifying a population and identifying patients with complex chronic needs who require multidisciplinary input. The Devon Predictive Model (DPM) combines primary and secondary care data to provide each GP practice with a list of its top 0.5 and 5 per cent of patients most at risk of an emergency admission in the next 12 months”.
Read more: South Devon and Torbay. The King’s Fund.
Sonola, L. Thiel, V. Goodwin, N. [and] Kodner, D.L. (2013). South Devon and Torbay: proactive case management using the community virtual ward and the Devon Predictive Model. London: The King’s Fund / Aetna and the Aetna Foundation, October 2013.