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Table 4 Potential future developments in WSIC

From: How an electronic health record became a real-world research resource: comparison between London’s Whole Systems Integrated Care database and the Clinical Practice Research Datalink

Data gap

System sector

Current state and potential development

Private hospitals

Hospital

No plans yet

Private care homes

Social care

No plans yet

Private GPs

Primary care

Still very small sector, but potential very limited

Inpatient medications

Hospital

High-cost drugs already captured, but other drugs will need to come from pharmacy databases

Inpatient scans

Hospital

National Diagnostic Imaging Data set is newest part of HES* and captures such tests but, crucially, not their results, which would come from other hospital-specific systems

Inpatient lab test results

Hospital

No plans yet

Quality of life

all

This can potentially be recorded using Read codes in GP records

Patient activation measure

all

Already captured for around 5000 patients, and the number is growing

Over the counter medication use

Community care

None unless reported by patient and coded by GP

Medication adherence by the patient

all

Some Read codes exist for chronic diseases in primary care, usage unknown; some published algorithms exist for use with CPRD to estimate this

Patient-reported outcome measures (PROMs)

all

Captured nationally only for 4 procedures, linked to HES*

Real healthcare cost rather than price to the payer

Primary and secondary care

Not yet

Ambulance service

ambulance

London Ambulance Service database to be linked soon

NHS 111 telephone advice service

n/a

In discussion

ONS mortality data

all

Not yet but high priority

National clinical audits and registries

all

Could be linked via NHS number; CPRD link to several national audits e.g. cancer registry

  1. *HES Hospital Episodes Statistics (national hospital administrative database for England)