Data can be difficult to access in the private healthcare sector but Healthcode’s Fiona Booth argues that we must all work together to make the most of this valuable asset.
Information has become one of the most important currencies in the modern world, transforming the way organisations operate and the way that consumers access goods and services.
Even in the healthcare sector, data is a prized asset. Professional services firm EY recently estimated the value of NHS patient records at nearly £10billion per year1.
It’s an astonishing sum, based on the data’s value to commercial organisations and its potential to unlock operational savings within the NHS, improve health outcomes and thereby benefit the UK economy. But as the EY report also makes clear, there would be significant costs involved in the “aggregation, cleaning, curating, hosting, analysing and protecting the transformation of these raw data records into a consolidated longitudinal patient-level dataset.”
In other words, simply accumulating and storing terabytes of unstructured data which lies buried within organisations is pointless. Information only has a real value if we can make sense of it and put it to a practical purpose. That means it has to be accurate, up-to-date, accessible, secure and shareable when appropriate. The costly failure of the Connecting for Health project shows that this is no easy task but it is encouraging that the NHS’s digital strategy is now based on developing common information standards and interoperable systems, rather than imposing one technology solution from the top.
Of course, recording and sharing information isn’t only a challenge for the NHS, it has become a matter of growing urgency within the private health sector too. This is something I have seen at first-hand in recent years as Head of the Association of Independent Healthcare Organisations (AIHO) and now at Healthcode.
It started with the publication of the CMA Report into private healthcare market in 2014 which demanded greater transparency about both charges and quality & outcomes data so patients could make informed decisions.
Another huge watershed moment was the scandal of the disgraced surgeon, Ian Paterson who was jailed in 2017 after carrying out unnecessary breast operations, causing serious reputational damage to the NHS and private hospitals where he practised and prompting calls for better sharing of information – and concerns – about consultants’ performance. An independent inquiry into the Paterson case, chaired by the Bishop of Norwich is due to report its findings towards the end of this year and is likely to include recommendations for improving consultant oversight.
Some progress is already being made. PHIN is currently working with NHS Digital on the ADAPt Programme (Acute Data Alignment Programme) which aims to ensure that data on privately funded healthcare is compatible with NHS systems and standards.
And this October, the Independent Healthcare Providers Network (IHPN) is due to launch its Medical Practitioners Assurance Framework (MPAF), originally referenced as their consultant oversight framework, developed under the leadership of Sir Bruce Keogh to improve clinical governance. IHPN’s chief executive, David Hare, has already said that this will require a single dataset about every consultant’s whole clinical practice which would then be available to all the hospitals where they work2.
Both these projects are significant because they put data front and centre. They require common data standards and compatible systems so that information that is currently held in one place can be collated, shared and analysed securely and efficiently. But to work they need different stakeholders to set aside any qualms and embrace the principle of data sharing in the interests of good clinical governance and patient safety.
The Private Practice Register (The PPR) shows what can be achieved. Healthcode originally launched The PPR back in 2016 to streamline the cumbersome PMI recognition process. The idea was that practitioners could create an online profile with all the information they need to apply to the PMIs of their choice in one go. Practitioners would then manage their own profile to ensure the information held about them was accurate (such as contact details), and showcase their qualifications, clinical expertise and experience to PMIs.
Fast-forward to 2019, and The PPR has evolved into a comprehensive directory and register of Consultants offering services in the independent sector, with more than 16,000 practitioner profiles on the system. And it is also being rolled out to hospitals who will be able to view the profiles of consultants with practising privileges, including details such as their scope of practice, indemnity cover and appraisal status. We expect that consultants will be able to use the system to apply for practising privileges and grow their private practice, while hospitals will have an important tool to help them with clinical governance and identifying concerns.
The PPR demonstrates that the technology exists to create an online platform on which data can be accessed and shared securely by users from different organisations in both the private and NHS sectors. It proves that different stakeholders will engage with an industry-wide data project when they can see the benefits. And it means that we already have a head start in establishing a consultant oversight network which enables effective clinical governance across all healthcare settings. I’m pleased to say that the IHPN has asked Healthcode to comment on its draft assurance framework and we are ready to work with it to explore how The PPR can support the goal of improving clinical governance by building on what exists, rather than creating unnecessary bureaucracy.
Overall, I am optimistic that consultants, hospitals and PMIs recognise that the sector has to show it is addressing the shortcomings highlighted by the Paterson case, in terms of effective communication and information sharing, if it is to regain public confidence.
And yet, there is still a long way to go before the industry is comfortable with data sharing. For example, thousands of consultants have yet to submit fee information to the PHIN online portal while PHIN’s report on the state of private data reporting in May3 revealed that 228 hospitals had made little or no progress in submitting data on adverse events and health outcomes. And we are yet to see real progress on other cross-sector initiatives that require the pooling of data such as centralised appointment booking.
When I joined Healthcode I was unaware of the wealth of data that the Company processes and holds securely on behalf of every private healthcare stakeholder in order to provide its online services. It’s been inspiring to see how technology can enable us to use data effectively, from automating time-consuming processes like billing, to secure messaging so that different organisations can connect and exchange information without compromising patient confidentiality.
At the start of this article, I made the point that the private healthcare sector could only realise the value of our data if we make use of it to deliver high quality care and services. At the moment, much of our data is like buried treasure but if we are willing to collaborate, we can be architects of our own fortune.
Fiona Booth is Head of Provider Programmes and Strategy at Healthcode
1How we can place a value on health care data, EY, 19 July 2019
2 Keep NHS and private sector in the loop and Both sectors need to share care data by David Hare, Chief Executive of IHPN, Independent Practitioner Today, May and June 2019 issues
3 PHIN outlines the state of private data reporting, PHIN, 30 May 2019 https://media.phin.org.uk/phin-outlines-the-state-of-private-data-reporting/
This article first appeared in the Independent Practitioner Today, October 2019