Patients and the WebBetter NHS services with linked data

Frank SullivanNHSTayside Prof. of R&D in Primary Care Health Informatics Centre Dundee

Dundee

Edinburgh

Outline of talk

• How are health data linked in Scotland?

• What services does that enable?

• Do patients benefit

• Making access easier

• Multi-agent systems

64% of adults access the Internet

Adults who have used the Internet in the 3 months prior to interview in October 2005 (GB )National Statistics Omnibus Survey 2005

How often, if at all, do you personally use the internet?

Health Use Internet

• Have used for this purpose– Health-related information 34%

• Is there anything which you havepersonally never used the internet to do but which you would like to?– Get medical information/advice 7%

MORI 2005

Data, Data everywhere

OpticiansOpticiansHospitalHospital

SMRSMR

GPGP

PAMSPAMS

Lab Lab DataData

PharmacyPharmacyEye vanEye van

InvestigationsInvestigations

ScreeningScreening

Community Health Number

DOBDOB SexSex CheckCheck

07 10 6407 10 64 02 02 55 00

Serial No

Linking Data for Seamless Care

CHNoCHNoHospitalHospital

Eye VanEye Van

PharmacyPharmacy

Lab Lab DataData

OpticiansOpticians

InvestigationsInvestigations ScreeningScreening

PAMSPAMS

Remote Interrogation Remote Interrogation GENIE GENIE Generic

Import and Export

GP Clinical SystemsGP Clinical SystemsData In Data In Standard Standard FormatFormat

Erroneous DataErroneous Data

‘‘Clean’ DataClean’ Data Previous ExportPrevious Export

====

Regional repositoryRegional repository Data For ExportData For Export

Currently operational in Tayside, Glasgow and Lothian

76 General Practices76 General Practices1000 Networked PCs1000 Networked PCs

NHS TaysideNHS TaysideI & CT DepartmentI & CT Department

Acute Trust SitesAcute Trust SitesHealth Board SitesHealth Board Sites

Primary Care Primary Care Trust SitesTrust Sites

3 Hospitals3 Hospitals3000 Clients3000 Clients

5 Sites5 Sites300 Clients300 Clients

20 Hospitals20 Hospitals700 Clients700 Clients

NHSNetNHSNet

The InternetThe Internet

FirewallFirewall

Local AuthorityLocal Authority

Perth & KinrossPerth & KinrossAngusAngusDundeeDundeeNorth-East FifeNorth-East FifeOther TrustsOther Trusts

& Boards& Boards

SchlumbergerSemaSchlumbergerSemaMainframe ServicesMainframe Services

FirewallFirewall

NHSTayside ICT DepartmentNHSTayside ICT Department

Communications InfrastructureCommunications Infrastructure

Web Services

• a standard means of interoperating between different software applications, running on a variety of platforms and/or frameworks.

Patient Summary for clinicians

Summary for patients

• NHSTayside IT for managed clinical networks– DARTS– HEARTS

Available results reduce visits

How easy or difficult is it for you to get access to the internet?

Health Use Internet

• Have used for this purpose– Health-related information 34%

• Is there anything which you havepersonally never used the internet to do but which you would like to?– Get medical information/advice 7%

MORI 2005

Seniors Seeking Health Information Need Help Crossing "Digital Divide"

Use of Internet

0

10

20

30

40

50

60

70

80

50-64 65-74 75+

age group

%

Voelker R JAMA. 2005;293:1310-1312.

Multi-agent Systems in Development

• Patients’ electronic rights represented and protected by their agents

• Agents interacting on behalf of patients with electronic systems including web services, databases, and agents representing other individuals, organisations and functions.

patientagent

collator

Web service:Trials list

audit +regs

trialsData?

Data?

History

Anonymised

Access?LogsSuitable?

Trials

GPsurgery

hospital

other stakeholders…

Ferguson T, Inverting the power Pyramid, Consumer Health informatics, Healthcare Forum, 1995

Record linked data and the web enables the Information Revolution in health care