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We have the technology...
...we need the projects
Routine data + Health Outcomes Group
Simon de Lusignan
St. George’s – University of London
www.clininf.eu/projects/ahsn.html
Presented to: AHSN
Opportunity
We have the most complete health data in the world
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We have the capacity & capability To measure health outcomes along complex care pathways Link data without knowing patients’ identities
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Growth in A&E use provides an opportunity Pilots so far of interventions:
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Before
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In A&E
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After...
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Maybe a need for more robust evaluation?
www.clininf.eu/projects/ahsn.html
Readily available routine health data
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Among the best primary care data in the world!
CONDUIT study internationally recognised output
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Secondary care data Standard format available through “SUS” Most cases and major outcomes managed within NHS
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“Ad hoc” clinic data Other non-SUS clinical data (e.g. Diabetic clinic)
www.clininf.eu/projects/ahsn.html
Capacity & capability:
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Capacity: Current largest study: QICKD trial Cluster randomised trial of quality improvement interventions in chronic kidney disease (CKD)
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1.3 million patients – 137 practices in a 3 year study
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Over 6,000 variables
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Largest ever study 2.4 million patients
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Capability: Evaluation of impact of introducing IAPT in pilot sites
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Pseudonymise & link data from hospital – GPs – IAPT clinic
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(IAPT clinics have no NHS number)
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Case-control study: IAPT less hospital utilisation
www.clininf.eu/projects/ahsn.html
Data linkage capability:
www.clininf.eu/projects/ahsn.html
Health outcomes group – general approach to evaluation
Intervention Health Care Problem Outcome
www.clininf.eu/projects/ahsn.html
Workshop No1: Pilot interventions to control admissions Intervention
-Pre -During -Post Growth in A+E admission
Outcome
Relentless rise???
Do we know if they work?
www.clininf.eu/projects/ahsn.html
Summary
Excellent local data...
Unique population & potential collaborators
Capacity and capability to harness that data to measure the impact of new interventions
A&E may be the right place to start?
www.clininf.eu/projects/ahsn.html
....Thanks for listening
Simon de Lusignan Email: [email protected]
www.clininf.eu/projects/ahsn.html