Brendan O’Brien, Chief Clinical Information Officer at the Health and Social Care Board offers insights into how data is being used to provide better healthcare in Northern Ireland.
“Ten years ago, most of us would not have heard of Clinical Information Officers. Now you can find us in every Trust in Northern Ireland,” says O’Brien. The data expert draws attention to the intricate network of trusts, practices and agencies tasked with providing healthcare to Northern Ireland’s population of over 1.8 million people. “Over 41 million prescription items are dispensed each year, with 1.5 million attendances at outpatient services recorded across 2016/17,” he says, “and 600,000 inpatient admissions in the same year – all of whom are managed by a workforce of over 70,000 staff.”
As O’Brien suggests, elderly patients in Northern Ireland are significant users of the NHS. Data collated through a combination of Open Data sources demonstrates that Northern Ireland has an aging population. “We can see that patients over the age of 65 typically suffer from more than one health condition. By the time you get to over 90, patients will typically suffer from four or more conditions. The data also demonstrates that age corresponds directly with healthcare spending,” explains O’Brien.
“Having so many agencies in the health service can create problems in how we synchronise, link and collect those varying datasets,” says O’Brien. “In the past, we had numerous ID systems for various services, including ED numbers, maternity numbers, etc. Now we have one Health Care Number which collates all this information and uniquely identifies each person and links all of these together,” he continues.
The digital transformation of the health service has been outlined in the eHealth and Care Strategy for Northern Ireland, which states several objectives including supporting people; sharing information, use of information and analytics, fostering innovation, modernising eHealth infrastructure and ensuring good governance. According to O’Brien, the introduction of a Health & Care Number Index has been a key element of this journey.
“Using GP data, we can see that regions such as North Down and West Belfast contrast greatly – if you are from an area such as West Belfast, you are less likely to live to a ripe old age. There are clearly inequalities here, and that’s what we are trying to change.”
“We used to have 19 trusts, which means we have nine legacy systems that we are currently using. We are currently phasing these out for a more efficient health service. Patient records can now be linked with information including lab tests, x-rays, referrals, appointments, discharge letters and more,” says O’Brien. “This has radically changed healthcare practice, and our new system has already picked up two awards for its significant improvement in data quality,” he adds.
The NI Electronic Care Record has revolutionised healthcare, according to O’Brien. “Electronic referrals have drastically sped up the process, and our colleagues can looks at referrals and triage those patients very quickly,” he explains. However, protecting such data is of paramount importance, he explains. “GPs are seen as data controllers for those datasets. They have professional and legal requirements under GDPR to protect that data. That is why we have introduced the GP Intelligence Platform, which brings together all codified information, whilst supporting the Bengoa reforms.”
Data science does not only find its use in the provision of direct care, according to O’Brien. He points towards a graph: “Using GP data, we can see that regions such as North Down and West Belfast contrast greatly – if you are from an area such as West Belfast, you are less likely to live to a ripe old age. There are clearly inequalities here, and that’s what we are trying to change,” he says. “We can measure comorbidities through our disease registers, allowing us to plan and allocate resources and services. The system is therefore immensely useful in detecting patterns,” he adds.
Healthcare related data is also valuable to people outside of the health service, including researchers. The Honest Broker Service has been created to grant both healthcare professionals and external researchers access to these datasets, with an approved area where people can access information in safe environments. This service, according to O’Brien, is essential in the age of GDPR.
“There is a growing understanding within the health service that using data innovatively can save lives”, concludes O’Brien, “and that is what we do.”