PSI Digital Health & Monitoring Helpdesk

Background: Two in-depth discussions have taken place with the foundation, and the result is that they would like for us to measure, but not to report on, provider potential. They would like to see evidence of this data being used for programmatic decision making, should they ever come to visit your platform. The calculation is based upon a template created by Cambodia, which was explained to the foundation and which they accepted. Ideally, they would like to see the provider’s potential take into account the universe of need and the provision of the other providers in the region, but we have indicated that this is not possible at this time. Finally, the foundation was interested in seeing evidence that our providers are increasing their average insertions over time.

Programmatic Utility: Given the diversity of average IUD insertion rates throughout our networks, the idea of calculating an individual provider’s potential is one method of improving the goals we set for our providers in a consistent, logical manner. The potential can be used to benchmark providers, and determine if we are improving a provider’s ability to provide IUD services. Finally, data on provider insertion will be used to determine if providers are on an upward trajectory regarding insertions per month, as described below.

Methodology to determine provider potential

Required Data

1. Provider name/unique ID
2. # of IUD clients for last 3 months
3. # of total FP clients for last 3 months

Calculation Explanation

1. Calculate the ratio of provider IUD to FP clients in the last 3 months
2. Apply decision rule to the individual private provider’s IUD/FP ratio
   • If ratio  <1%, mark provider as dormant
   • If 1%<=ratio<=35%, mark provider as low-performer
   • If 35%<=ratio<=65%, mark provider as middle performer
   • If 65%<=ratio<=100%, mark provider as high performer
     
     

     Potential By Formula (IUD/FP Ratio)
     Class	From %	To %	Increase By
     D	0%	1%	0%
     L	2%	35%	50%
     M	36%	65%	30%
     H	66%	100%	10%
     Total

     
     
     
     
     
     
     
     
     
     
     
     
3. Multiply provider’s previous quarter IUD insertions by a factor, indicating how much they should be increasing their regular volume by, as follows:
   • Dormant = dropped
   • Low-performer = (3month total)* 1.5
   • Middle performer = (3month total) * 1.3
   • High performer  = (3month total) * 1.1
4. Round up to the nearest whole number to get a quarterly potential
5. Examine results to determine if a provider’s potential should be adjusted
   • If the provider’s quarterly potential is less than 3, consider adjusting this to be a minimum of 3 per month (9 per quarter), in line with the definition of active provider. (See example of provider 2 –Dr. Beryl)
   • If the provider has not inserted any IUDs in the previous quarter, consider dropping the provider from the network.
6. Assess whether or not provider reaches their cumulative potential each quarter
   • Cumulative potential is equivalent to the sum of potential for each preceding quarter that year. For example, if the potential for Dr. Alberto=29 per quarter, at the end of quarter 2, Dr. Alberto’s cumulative potential is 2*29=58.
   • See instructions below for methodology to assess proportion of providers meeting potential.
7. Recalculate provider potential for the following year.
   
   

   ID	Name	Year joined	Sept-Nov 2011 (prev 3 months)
   			Client IUD Visits	Total FP Visits	Ratio	Provider class	Provider potential (Quarterly)	Provider potential (with rounding)
   1	Dr. Alberto	2009	22	41	54%	M	28.60	29
   2	Dr. Beryl	2012	1	7	14%	L	1.50	9
   3	Dr. Chris	2011	8	37	22%	L	12.00	12
   4	Dr. Debby	2012	6	67	9%	L	9.00	9
   5	Dr. Ernesto	2009	41	53	77%	H	45.10	46
   6	Dr. Florence	2011	15	51	29%	L	22.50	23
   7	Dr. Gordon	2010	9	19	47%	M	11.70	12
   8	Dr. Helene	2012	4	43	9%	L	6.00	9
   9	Dr. Isaac	2011	26	93	28%	L	39.00	39
   10	Dr. Joyce	2009	14	21	67%	H	15.40	16

   
   

Methodology to assess proportion of providers meeting potential:

1. This indicator is to be assessed and reported on each quarter.  The indicator will be assessed cumulatively. Instructions and an example for calculating the proportion of providers meeting cumulative potential is provided below.
2. Over the course of one calendar year, the proportion of providers in the network meeting potential will be assessed 4 times.
3. Each quarter, sum the total number of IUDs inserted over the course of the calendar year for each provider.
4. Compare this number with the individual provider’s potential multiplied by the quarter. If P=potential, then in quarter 3, the cumulative potential for that provider = P*3.
5. The provider has met his cumulative potential for that quarter if the cumulative sum of IUDs inserted meets or exceeds the cumulative potential.
6. Sum the total number of providers in the network meeting their potential each quarter, and divide by the total number of providers in the network to determine the proportion meeting potential.

The example provided below is for calculations at the end of quarter 1 and quarter 2. The number of IUDs inserted by the provider each month is not shown – only the quarterly total. The potential was calculated in the table above – note that the providers are the same.

If the total network only includes 10 providers, then the table below shows the percentage of providers meeting cumulative potential each quarter.