Overview
Getting data in near real time offers profound benefits for everything from clinical decisions about individual patients to resource management across entire hospitals. A multidisciplinary team from University College London Hospitals (UCLH) spent two years developing the Experimental Medicine Application Platform (EMAP) platform to make fuller, faster, more effective use of data in electronic health records (EHRs).
The COVID pandemic saw them demonstrate the quality of the platform and the team. Using the EMAP infrastructure they rapidly created a bed management tool that helped take pressure off north London intensive care units (ICUs). Now the team has facilitated a series of grants to take their work into new areas including better antibiotic stewardship.
Outstanding achievements
When COVID cases surged the EMAP team, co-led by UCLH critical care consultant Dr Steve Harris, responded with a bed management tool that reported in near real time. This allowed staff to be allocated where they were most needed and kept transfer beds available at all times. The tool supported the treatment of 434 critically ill patients (including retrieving 162 patients to the UCHL surge centre) from overstretched units across north London.
The team
Dr Harris says the team “is not a traditional academic lab group or academic team”. Its work is born from a long-term commitment to make better and more practical use of the enormous amounts of information collected by the NHS. Its objective is always to innovate in ways that will benefit the clinician at the bedside.
He said:
“We don’t just want an EHR, we want a system which enables digital health technology interventions, which allows your machine learning or AI to actually do something at the bedside to directly improve patient care or support the processes around that care.”
According to Dr Harris the team and its work exemplify how modern data science needs to adapt for healthcare – putting an emphasis on safe, reliable, tested, transparent and usable.
Key characteristics of the EMAP team include its diversity, including not just software engineers and clinicians but a healthcare designer and a behavioural scientist – who played an invaluable role in looking at how users actually relate to dashboards. Members also get to understand each other’s worlds with engineers spending time on the critical care unit and clinicians receiving data science and software design training. Underpinning all this is that they are all embedded within the NHS and understand its culture, needs and practices.
Next steps
EMAP now supports three NHSX awards using the platform to look at antibiotic stewardship, managing anti-microbial resistance, identify patients with heart failure patients, and provide ward-level forecasts of bed demand.
Open science
EMAP has been built using free and open source software (FOSS). Where possible permissive licenses have been attached to software.
HDR UK affiliation
HDR UK London and HDR UK Catalyst Informatics Consult Award team
Acknowledgments
EMAP development was supported by University College Hospital London Charity, and the National Institute for Health Research University College London Hospitals Biomedical Research Centre.
Contact
Dr Harris s.harris8@nhs.net.
