Overview

The team, led by Consultant Surgeon Professor Vishnu Chandrabalan at Lancashire Teaching Hospitals NHS Foundation Trust with support from CIO Stephen Dobson, is a significant player in utilising health data to improve healthcare experience and outcomes.

Images of Dr Stephen Dobson and Prof Vishnu Chandrabalan

Bringing together the trust’s 2.5 million electronic patient records (EPRs) has enabled them to create a new database for research and improve clinical and operational decision-making across the Trust.

The Challenge

Lancashire Teaching Hospitals NHS Foundation Trust (LTHTr) is a rural NHS trust and member of the UK Health Data Research Alliance, offering specialist secondary care and major trauma services for a diverse population of over 350,000 in Preston, Chorley and South Ribble and surrounding areas in North West England.

The region includes socio-economically disadvantaged neighbourhoods and minority ethnic groups that experience higher rates of ill health. As the trust embarks on digital transformation, they wanted to understand more about their populations, to ensure equitable access to care and improve health outcomes.

By gathering, linking, and analysing information about patients and their health, they could identify patients most at risk of becoming ill to intervene earlier.

The Solution

The team harmonised routinely collected clinical data for over 2.3 million patients, covering the entire care journey over the past 15 years, creating a new resource for research. This involved a complex and novel data transformation process, converting data from five source clinical systems into a single, globally-recognised common data model. 

Supported by a joint European Health Data and Evidence Network/HDR UK grant, the small but high-performing team developed the in-house resource using OMOP, a health data model that helps data and analytical tools work together. They have since become a founding member of the UK Observational Health Data Sciences and Informatics (OHDSI) node, which aims to bring out the value of health data through large-scale analytics. 

Transforming the data of our population. Inverted pyramid diagram that reads: top level 2.3 million records; second level 350,000 residents; third level 15 years of data; fourth level 5 systems which displays as a funnel into circle with caption 'one ODHSI OMOP common data model' This linking and analysing of routinely collected data has enabled them to both support research and address clinical needs across hospitals, in the region and beyond. Using OMOP has also allowed them to improve the pace of research to help meet patients’ needs as they change across time.

The team regularly invites feedback from researchers, clinicians, managers and engineers. They have also increased engagement with the public, particularly with under-represented voices, to promote transparency and ensure they are part of decisions around their data. 

In a commitment to open science, they are providing secure access to their data for new analysis, through their Secure Data Environment. They are also collaborating with King’s College London to build a large language model to allow researchers to ask freetext questions of the data.

Professor Vishnu Chandrabalan, Consultant Surgeon and Director of the Lancashire and South Cumbria Secure Data Environment (LSC SDE), said:

“We have engineered OMOP so it can be used not just for research but for operational use and direct care. Typically, data partners will run their OMOP data transformation every few months, annually, or as a one-off, whereas we refresh our data every day. This vastly expands the scope of our insights and opportunities with access to near real-time data conformed to a global standard.”

The Impact

In one year, the team has successfully integrated the EPRs and is already starting to see impact in key clinical areas. For example, they are able to monitor community blood tests to identify and alert GPs to patients with declining renal function; identify complications in patients with diabetes; and they are building a real-time dashboard of antibiotic prescribing to support antimicrobial stewardship across the trust.

They have also received international interest, with the team sharing their learnings with the global OHDSI community and Johns Hopkins Hospitals. The team’s adherence to FAIR principles and commitment to openness champions the reuse of health data and continuous learning within the health data research community.

Staff efficiency has also been improved as manual processes are being automated, such as for clinical audits. It can often take clinicians days to perform an audit, whereas the data trawl can now be completed automatically, freeing up clinician time.

The team are currently replicating their OMOP transformation journey at University Hospitals of Morecambe Bay in their OMOP journey with a plan to eventually map most health care data within LSC into OMOP over the next several years, as part of the Lancashire and South Cumbria Secure Data Environment program (federated partner of the Northwest SDE and part of the NHS SDE network £200 million programme). They are also leading a pan-Lancashire public empowerment movement to address social determinants of health.

Researchers can access the metadata of their database (called IDRIL-1) through the EHDEN portal (portal.ehden.eu/) and the data lineage for their data transformation at (omop-lsc.surge.sh/).

The LSC SDE is hosting a two-day event on 27-28 November 2024, offering comprehensive exploration of their state-of-the-art platform designed to propel health data research into new frontiers.