Improving the health of the nation through data insights

“The UK’s vac­ci­na­tion pro­gramme is a fan­tas­tic exam­ple of how data sci­ence can deliv­er high-qual­i­ty pro­grammes,” says Dr Shaun O’Hanlon, chief med­ical offi­cer at EMIS, the tech­nol­o­gy com­pa­ny that pio­neered the use of patient clin­i­cal records to improve out­comes.

“Analy­sis of data under­pinned risk pro­fil­ing, shield­ing patients, logis­tics and deliv­er­ing the vac­cine. The programme’s suc­cess wasn’t a fluke, it was how you use data to dri­ve health ser­vice changes.”

Rebuilding health services

Because of the pan­dem­ic, NHS wait­ing lists are grow­ing and look set to get larg­er and longer. But find­ing the patients most at risk and pri­ori­tis­ing resources can have a pos­i­tive impact on the back­log, as can recal­i­brat­ing health ser­vices so patients are iden­ti­fied and diag­nosed ear­li­er, direct­ed to care path­ways and then mon­i­tored, says O’Hanlon.

Analy­sis of patient data col­lect­ed secure­ly with the appro­pri­ate GDPR-relat­ed approvals from pri­ma­ry care set­tings, offers the bright­est hope for the NHS to deal with the back­log caused by the pan­dem­ic and the ris­ing demand for ser­vices from an age­ing demo­graph­ic liv­ing with mul­ti­ple comor­bidi­ties.

It also pro­vides real world evi­dence from patient records that makes it eas­i­er for ser­vices to be tai­lored to clin­i­cal needs and for research pro­grammes to devel­op effec­tive treat­ments.
“Our health ser­vices are going to be increas­ing­ly dri­ven by analysing data and focus­ing resources on those most at risk. It won’t take away the human ele­ment of health­care; it will make the human ele­ment more focused,” adds O’Hanlon, a for­mer GP who joined EMIS Group in 2000, and is part of a team that has helped the com­pa­ny become the UK’s lead­ing sup­pli­er of health­care soft­ware.

“Data analy­sis will enable us to deliv­er bet­ter, more tar­get­ed care and empow­er patients to become more involved in their health. It will help the NHS bet­ter plan, have bet­ter deliv­ery and bet­ter val­i­da­tion of what it is doing right.”

This prin­ci­ple is cen­tral to the health­care system’s abil­i­ty to cre­ate a sus­tain­able future and is being iden­ti­fied as the dri­ving force behind the growth in life sci­ences in the UK.

Privacy by design

“Mod­ern ana­lyt­ics sys­tems need to be built with data secu­ri­ty as a core foun­da­tion com­po­nent – before we do any­thing else data needs to be pro­tect­ed and secure,” explains O’Hanlon. “Our sys­tems have been built with pri­va­cy by design, ensur­ing that there are strong con­trols on access to any item of data, respect­ing data con­troller per­mis­sions, patient con­sent and GDPR.

“This gives cus­tomers a strong foun­da­tion to start to make clever use of secure­ly pro­tect­ed data.”

Improving patient outcomes

The rich­ness of the pri­ma­ry care records will help GPs and pri­ma­ry care net­works iden­ti­fy patients in poten­tial at-risk groups and sched­ule checks to pick up dis­ease con­di­tions ear­li­er than wait­ing for them to self-report. It also helps meet the social care chal­lenge of build­ing path­ways and net­works to sup­port peo­ple as they recov­er from or live with a chron­ic con­di­tion.

“Ear­ly iden­ti­fi­ca­tion of con­di­tions such as can­cer, obe­si­ty and demen­tia can improve sur­vival rates. You can do that with the rich­est source of data, which is gen­er­al­ly pri­ma­ry care records but you can also include phar­ma­cy data, hos­pi­tal atten­dance data, social care and socio eco­nom­ic data, and analyse at-risk pop­u­la­tions,” O’Hanlon says.

EMIS-pow­ered data has been fun­da­men­tal to a range of recent research pro­grammes that have gen­er­at­ed rev­e­la­to­ry detail about long Covid, deep vein throm­bo­sis and blood thin­ning med­ica­tion — stud­ies con­duct­ed via QRe­search, a data­base of more than 35 mil­lion anonymised health records derived from GP prac­tices.

Using this data­base, researchers at the Uni­ver­si­ty of Oxford and the New and Emerg­ing Res­pi­ra­to­ry Virus Threats Advi­so­ry Group (NERVTAG) devel­oped a pop­u­la­tion-wide risk assess­ment mod­el called QCovid.

Award-win­ning QCovid was used by NHS Dig­i­tal to pre­dict on a pop­u­la­tion basis whether adults with a com­bi­na­tion of risk fac­tors may be at more seri­ous risk from Covid-19 and should be pri­ori­tised for vac­ci­na­tion.

As a result, in Feb­ru­ary 1.5 mil­lion high-risk indi­vid­u­als were iden­ti­fied, added to the Shield­ed Patient List as a pre­cau­tion­ary mea­sure and pri­ori­tised for ear­li­er vac­ci­na­tion. The research also played a vital role in rais­ing pub­lic aware­ness of key Covid-19 risk fac­tors.

Shar­ing data will also enable the pub­lic to engage more deeply with their health and achieve bet­ter out­comes and fos­ter a more col­lab­o­ra­tive doc­tor-patient rela­tion­ship. It also pow­ers col­lab­o­ra­tions across indus­try, the NHS and tech­nol­o­gy. EMIS has more than 100 part­ner organ­i­sa­tions as part of a health­care ecosys­tem and is com­mit­ted to work­ing with life sci­ences and research to deliv­er the government’s vision out­lined in the ‘Sav­ing and improv­ing lives: the future of UK clin­i­cal research deliv­ery’ pol­i­cy paper launched in July 2021.

“This knowl­edge has led to changes that have ben­e­fit­ed patients imme­di­ate­ly,” O’Hanlon adds.
“This approach pro­vides real evi­dence that is vital to bet­ter health­care,” he says. “The NHS needs this so it can analyse its per­for­mance and make changes with con­fi­dence.

“Data will con­tin­ue to dri­ve pos­i­tive change across all aspects of health and the prospects are excit­ing.”

A collaborative approach

EMIS has a her­itage of col­lab­o­ra­tion to advance research. As well as QRe­search, it is a key part­ner in the Open­SAFE­LY plat­form, a col­lab­o­ra­tion head­ed up by Dr Ben Goldacre MBE that was set up to dri­ve knowl­edge about Covid-19.

NHS Eng­land researchers using Open­SAFE­LY are ben­e­fit­ting from a secure research envi­ron­ment with­in the cloud-based EMIS‑X Ana­lyt­ics suite which allows the records of all EMIS’ 4,000 Eng­lish GP prac­tices to be searched as one.

The researchers, who are based at the Uni­ver­si­ty of Oxford and the Lon­don School of Trop­i­cal Hygiene and Med­i­cine, recent­ly pub­lished a clin­i­cal paper which revealed that Long Covid was being under-diag­nosed.

“This is the first in a wave of research projects to ben­e­fit from the new­ly-extend­ed Open­SAFE­LY plat­form,” says Goldacre, direc­tor of the Data­L­ab at the Uni­ver­si­ty of Oxford, who leads the project.

“We are huge­ly grate­ful to EMIS for its months of hard work to enable us to reach this land­mark posi­tion, with researchers now able to access the health records of 96% of the UK pop­u­la­tion, under COPI (con­trol of patient infor­ma­tion) leg­is­la­tion, with all of the pri­va­cy and trans­paren­cy fea­tures of Open­SAFE­LY.”

“Good data on Covid is cru­cial for research and, though the imme­di­ate threat from the pan­dem­ic is now reced­ing, there is much more work to be done to ben­e­fit pub­lic health and med­ical knowl­edge as we move for­ward.”

O’Hanlon added: “As the UK’s lead­ing provider of health­care soft­ware, EMIS is proud to sup­port NHS Eng­land and Open­SAFE­LY through this col­lab­o­ra­tion. 

“By enabling secure access to the pri­ma­ry care records of 35 mil­lion patients in Eng­land, and link­ing those to a num­ber of oth­er nation­al datasets plus data from oth­er sys­tem sup­pli­ers, researchers are now able to run analy­sis across almost the whole of the Eng­lish pop­u­la­tion at source.”

EMIS Group, which was formed 30 years ago by two GPs in York­shire, spe­cialis­es in devel­op­ing IT sys­tems that now sup­port 10,000 organ­i­sa­tions across the full spec­trum of health­care, includ­ing 5,200 phar­ma­cies, 4,500 GP prac­tices and 80% of NHS acute trusts.

Its award-win­ning QRe­search not-for-prof­it col­lab­o­ra­tion with the Uni­ver­si­ty of Oxford uses GP approved anonymised his­tor­i­cal records from around 45 mil­lion patients to inform research pro­grammes and clin­i­cal prac­tice.

It has also devel­oped a secure, cloud-based ana­lyt­ics plat­form that offers a pow­er­ful resource to researchers seek­ing to improve health and care.

For more infor­ma­tion please vis­it emishealth.com/sectors/research

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Pro­mot­ed by EMIS