“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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