Journal of Medical Systems

, Volume 36, Issue 2, pp 621–630 | Cite as

A Decision Support Tool for Health Service Re-design

  • Eren DemirEmail author
  • Salma Chahed
  • Thierry Chaussalet
  • Sam Toffa
  • Farid Fouladinajed
Original Paper


Many of the outpatient services are currently only available in hospitals, however there are plans to provide some of these services alongside with General Practitioners. Consequently, General Practitioners could soon be based at polyclinics. These changes have caused a number of concerns to Hounslow Primary Care Trust (PCT). For example, which of the outpatient services are to be shifted from the hospital to the polyclinic? What are the current and expected future demands for these services? To tackle some of these concerns, the first phase of this project explores the set of specialties that are frequently visited in a sequence (using sequential association rules). The second phase develops an Excel based spreadsheet tool to compute the current and expected future demands for the selected specialties. From the sequential association rule algorithm, endocrinology and ophthalmology were found to be highly associated (i.e. frequently visited in a sequence), which means that these two specialties could easily be shifted from the hospital environment to the polyclinic. We illustrated the Excel based spreadsheet tool for endocrinology and ophthalmology, however, the model is generic enough to cope with other specialties, provided that the data are available.


Service re-design Sequential association rule Demand and capacity Decision support tool 


  1. 1.
    National Health Service England, (accessed 18 August 2009).
  2. 2.
    Ham, C., The 2009 budget and the NHS. Br. Med. J. 338:1024–1025, 2009.CrossRefGoogle Scholar
  3. 3.
    Nguyen, J. M., Six, P., Antoniolib, D., Glemain, P., Potel, G., Lombrail, P., and Le Beux, P., A simple method to optimize hospital bed capacity. Int. J. Med. Inform. 74:39–49, 2005.CrossRefGoogle Scholar
  4. 4.
  5. 5.
  6. 6.
    NHS Hounslow, Annual Public Health Report 2008/2009,, 2009.
  7. 7.
    Hand, D. J., Mannila, H., and Smyth, P., Principles of data mining. MIT Press, p. 1, 2001.Google Scholar
  8. 8.
    Lavrac, A., Selected techniques for data mining in medicine. Artif. Intell. Med. 16:3–23, 1999.CrossRefGoogle Scholar
  9. 9.
    Obenshain, M. K., Application of data mining techniques to healthcare data. Infect. Control Hosp. Epidemiol. 25:690–695, 2004.CrossRefGoogle Scholar
  10. 10.
    Lavrac, N., Bohanec, M., Pur, A., Cestnik, B., Debeljak, M., and Kobler, A., Data mining and visualization for decision support and modelling of public health-care resources. J. Biomed. Inform. 40:438–447, 2007.CrossRefGoogle Scholar
  11. 11.
    Y. Shan, D. Jeacocke, DW Murray, A. Sutinen. Mining medical specialist billing patterns for health service management. In: Roddick, J. F., Li, J., Christen, P., and Kennedy, P. J., (Eds.), Proceedings of Seventh Australasia Data Mining Conference (AusDM 2008). Glenelg, South Australia. CRPIT, 87. ACS. pp. 105–110.Google Scholar
  12. 12.
    Dogaru, R., Zaharie, D., Lungeanu, D., Bernad, E., and Bari, M., A framework for mining association rules in data on perinatal care, The 8th International Conference on Technical Informatics (CONTI’2008), Timisoara, Romania.Google Scholar
  13. 13.
    Agrawal, R., and Srikant, R., Mining sequential patterns. In proceedings of the 11th International Conference on Data Engineering, Taipei, Taiwan, March 1995 (ICDE’95).Google Scholar
  14. 14.
    Han, H. K., Kim, H. S., and Sohn, S. Y., Sequential association rules for forecasting failure patterns of aircrafts in Korean airforce. Expert Syst. Appl. 36:1129–1133, 2009.CrossRefGoogle Scholar
  15. 15.
    Thierry, D., Yongmei, C., Gilles, C., and Patrice, D., Analysis of hospitalised patient flows using data-mining. Stud. Health Technol. Inform. 95:263–268, 2003.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Eren Demir
    • 1
    Email author
  • Salma Chahed
    • 1
  • Thierry Chaussalet
    • 1
  • Sam Toffa
    • 1
  • Farid Fouladinajed
    • 2
  1. 1.Department of Information Systems and ComputingUniversity of WestminsterLondonUK
  2. 2.MiddlesexUK

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