In my role as a clinical researcher, I believe that has the potential to improve patient experience, allow us to deliver services more efficiently and have a positive effect on population health, but to do it successfully is not straight forward.
So, what tools can help us to take a more integrated approach to patient care? Could advances in utilising health data provide the silver bullet we have been waiting for?
By improving relationships, processes and pathways between primary, secondary and social care, we can positively impact those with chronic disease by getting patients treated more quickly. Importantly, at a time when resources are stretched, an effective integrated approach can also reduce the burden on secondary care and waiting lists by limiting unnecessary referrals.
Data enabled trials make research possible
The brings together multidisciplinary teams to provide integrated, ºÚÁϳԹÏÍø-based care in an area of social deprivation in East Birmingham.
Our research project based here looked specifically at integrating care for Chronic Obstructive Pulmonary Disorder (COPD) patients. The feasibility of the project hinged on the use of data collected from routine health records. We had 18 GP surgeries participating in the trial and, owing to the location and the size of the practices, most did not have research nurses embedded in their teams.
Without a research nurse it’s hard for practices to take part in research as no one else has the time or expertise to be involved, indeed we know that 85% of these practices had not been involved with research before. Conducting a data enabled trial made it possible for us to learn about how best to support this ºÚÁϳԹÏÍø to deliver more effective, more joined up care for their COPD patients.
The findings supported the need for health policies to integrate respiratory specialists into GP practices, with positive impacts for patients through better coordinated services, streamlined processes, reduced wait times and more effective communication between providers. The practices we worked were so impressed with the results that they have clubbed together to pay for specialist time to allow the integrated journeys we set up to continue.
We have demonstrated how health data can both make research feasible and also help services come together more effectively.
But while projects like the one in Washwood Heath demonstrate that successes are possible, the idea of a fully integrated health system, where all the data that would help both researchers and health practitioners is available at their fingertips, still seems somewhat of a utopia.
We still face practical and logistical challenges of joining data for integrated care, such as systems that don’t speak to each other.
Challenges and opportunities
Data security must be high priority and taking into account patient concerns about how their data is used. Through our integrated care project, we made use of a secure data environment to ensure that all of the care providers working together in the project could access each other’s data safely and responsibly.
In order to overcome these challenges, we need to speak publicly about the potential benefits of making use of health data and we need more investment to align systems so that they work together. This is an investment in care systems of the future, to be able unlock the full potential of health data.
Indeed, we can go further than linking up primary, secondary and social care and bring in data from other sectors.
If we can find ways to do this, both ethically and practically, then there is scope to bring in data from housing or education for example, giving a fuller picture of the lives of the individuals we are treating. There is also a wealth of data being collected personally, using privately purchased smart watches and other wearable devices, which on one hand holds exciting potential and on the other raises questions about reliability and security.
Technology is also evolving to allow us to pull richer information from health records more easily. Rather than only being able to collate data from tick boxes, fields and categories, large language models and natural language processing techniques can be employed to dig through the free text boxes on health records, meaning researchers can use computers to read the words in large volumes of medical records and pull-out themes. This opens opportunities for researchers to use information previously inaccessible at scale. Codes will only ever be able to give us part of the puzzle but this new way of looking at records will give us a much more rounded view of patients’ lives.
A step into the future
It's exciting to think where health data could take us next.
Especially since here in Birmingham, we have amazing data scientists, working with us through , who can really understand the technicalities of matching data from different systems.
It feels like a step into the future for my own research area of integrated care and my colleagues across the welcome forward-thinking approaches to improving the complex health and social care landscape with open arms. We look forward to further collaboration and new insights on how different research disciplines can learn from one another when .
