Long term conditions; and social prescribing
For our penultimate post in Health Information Week we’ve discovered an older fully Open Access article from 2014 by Frank Sullivan commemorating a pioneer of the Scottish Health Informatics Programme, Dr John Bryden [1]. The article not only memorialises his work but provides a fascinating history of the development of the innovative Community Health Index (CHI) number allocated to all Scottish residents registered with a General Practitioner, and its uses in linked records to help doctors accurately trace diabetic patient treatment and outcomes.
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| Dr John Bryden Source: Sullivan 2014 |
His early work with the CHI in Scotland enabled data from multiple sources to be linked together in a deterministic manner rather than having to rely upon probabilistic methods.
A major success recorded of the introduction of the CHI and linked data infrastructure has been a reduction in the number of lower-limb amputations despite a substantial increase in the numbers of diabetics, due to to more appropriate and timely interventions.
The lecture highlights issues of safety and confidentiality and how they are managed through governance, e.g. researchers using linked data are required to undertake compulsory legal and ethical training. And Scottish data ‘safe havens’ have been developed that combine control measures in their physical environments, personnel, mechanisms and in projects. This has led to the emergence of an efficient platform that supports appropriate data sharing with new partners and collaborators.
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| Source: Sullivan 2014 |
Of course, it was not entirely accurate at first, and every Easter, we reported the resurrection rate for the first few years when people categorised as dead reappeared. After 5 years of feeding this information back to front-line staff, the problem ceased.
The author suggests patient data could be opened to patients themselves. In combination with personal biophysical data consumers increasingly gather with devices like Apple Watch and Fitbit, we can look forward to a future where Scots can confidently make better-informed decisions about their health, individually and in consultation with medical professionals.
The article can be read from the St Andrews Research Repository http://hdl.handle.net/10023/12803 and is freely available from the publisher https://doi.org/10.14236/jhi.v21i4.76.
1. Sullivan, F 2014, ‘The John Bryden memorial lecture: improving health with the community health index and developments in record linkage‘ Informatics in Primary Care, vol. 21, no. 4, pp. 156-160. https://doi.org/10.14236/jhi.v21i4.76