Dr Shaun O’Hanlon, chief medical officer at EMIS Group, explains how GP practices across the UK have been helping improve the nation’s health via anonymised data from their clinical systems
It is hard to believe in these data-driven times but, 15 years ago, the idea of utilising information from patients’ electronic health records for large-scale academic research was barely in its infancy. Back then it made sense to EMIS Health to find a way of making data held in its clinical systems work harder to improve patients’ health.
In 2002, we set up QResearch – a not-for-profit initiative research database with the University of Nottingham’s primary care division – and began some ground-breaking work. It is not an overstatement to say it has transformed the way we diagnose and treat chronic conditions.
The initiative was founded with us by Julia Hippisley-Cox who is a practicing GP and professor of clinical epidemiology and general practice at the university. Julia has grown QResearch into an internationally renowned clinical resource that uses anonymised patient data (donated free of charge) from 1,300 practices using EMIS Web. It now covers a historical patient population of more than 28 million. Her team has undertaken some ground-breaking medical research and created clinical tools that have changed clinical practice in the UK and beyond.
For me, three pieces of work have transformed care in general practice in different ways. In 2007, QResearch published a new risk calculator to identify people at risk of heart disease (QRISK), replacing the Framingham score which had been used for 30 years.
QRISK has been extensively evaluated and refined and is now the only tool in widespread use for calculating heart disease risk in the UK. The transformation of care has been absolute – the rate of death from heart disease has plummeted in the last 10 years.
In 2008, we published the first evidence highlighting that up to half a million patients with diabetes were going undiagnosed despite strong evidence of diabetes in their medical records. As a result, we implemented decision support algorithms in EMIS Web so that GPs can easily identify these patients and test them for diabetes immediately.
In 2011, we tackled the UK’s poor cancer survival rate. Recognising that many patients present to their GP up to six times before the referral is made, the QCancer algorithm, when integrated into EMIS Web, analyses both the patient’s record and data as the GP adds it into the record and flags when there is a combination of features that may indicate cancer. We are carefully watching diagnosis rates of cancer and there is certainly some evidence that referrals are being made earlier.
The power to improve health
EMIS Health practices are supporting many other important pieces of research with their data, including the Children of the 90s project which is charting the health of 14,500 families in the Bristol area to improve the health of future generations.
The power of the everyday health data at GPs’ fingertips cannot be over-estimated. Ethically mobilised, I am certain it will continue to help transform healthcare in the generations to come.