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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 gapSystem sectorCurrent state and potential development
Private hospitalsHospitalNo plans yet
Private care homesSocial careNo plans yet
Private GPsPrimary careStill very small sector, but potential very limited
Inpatient medicationsHospitalHigh-cost drugs already captured, but other drugs will need to come from pharmacy databases
Inpatient scansHospitalNational 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 resultsHospitalNo plans yet
Quality of lifeallThis can potentially be recorded using Read codes in GP records
Patient activation measureallAlready captured for around 5000 patients, and the number is growing
Over the counter medication useCommunity careNone unless reported by patient and coded by GP
Medication adherence by the patientallSome 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)allCaptured nationally only for 4 procedures, linked to HES*
Real healthcare cost rather than price to the payerPrimary and secondary careNot yet
Ambulance serviceambulanceLondon Ambulance Service database to be linked soon
NHS 111 telephone advice servicen/aIn discussion
ONS mortality dataallNot yet but high priority
National clinical audits and registriesallCould 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)