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How data can improve the way stroke patients use medicines

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By vfiore
27 March 2018

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East Kent Hospitals and health providers across the county are working together to link data so that drug compliance can be tracked in real-time for people who have experienced a stroke.

East Kent Hospitals and health providers across the county are working together to link data so that drug compliance can be tracked in real-time for people who have experienced a stroke.

Around half of those patients do not take all their prescribed drugs each day. This will be for a host of reasons that include concerns about the effects of some of the individual drugs (often having read a newspaper article about supposed detrimental effects) or a perceived change in their needs because they have changed their diet or lifestyle. Or simply having problems remembering to take drugs, or perhaps physical issues making it difficult to take them.

The on-going relationship with the stroke patient is key. At the time of the stroke there is very close contact and intervention with the acute physician but after discharge their only contact might be a brief meeting in an outpatient setting. While at discharge from acute care a community team – and often the Stroke Association – are informed, there is not always a set of efficient relationships between all potential advice and care providers. This could include acute, community, social care, charity, pharmacy and GP for example.

The University of Kent has developed the Kemist research programme, to look at opportunities to improve drug compliance. Central to its success is a new data platform, which allows the sharing of patient data between different organisations so that care can be better tracked and coordinated. This is being developed by a company, called Beautiful Information, set up by the hospital trust and the academic health science network for Kent, Surrey and Sussex. 

Historically different care providers hold patient data in different systems. Coordination between different teams has an over-reliance on manual intervention; put simply lots of people phoning and writing to each other with no access to a shared view of the patient.

The technology Beautiful Information developed is known as a Patient Tracking List (PTL) and provides a ‘virtual whiteboard’ of patients that can be discussed in real-time through a secure connection. The data about each person includes their medical history and their on-going compliance with their drug regime. It can consume data feeds from any number of different systems so that a timeline can be developed for each patient.  

In stroke, the acute physician does not have enough patient contact in order to ensure medicines compliance. The pharmacist, and the Stroke Association volunteer, have a much closer day to day relationship with the patient, helping them manage repeat prescriptions and putting them in touch with local resources to support their physical and mental wellbeing.

Information governance has traditionally been a barrier to linking data to improve patient outcomes. However, we have been able to test this new model, developing innovative data-sharing systems so that all those involved in stroke rehabilitation can communicate electronically, sharing real-time data. Better data sharing of this kind will improve drug compliance by providing continual calls to action between the patient and the healthcare professional that currently do not exist.

Kent and Medway STP stroke lead Dr David Hargoves, of East Kent Hospitals, says: ‘Until now, at the discharge stage for a patient, the acute trust loses close contact with the stroke sufferer and we are not able to keep a watching brief on them. We hope that the development of these new systems will make it possible for us to monitor our patients better, remotely.’

A key advantage is that this system uses existing data, so it does not involve costly IT purchases. In future, we hope to develop ways for the patient to send and view their own data.

Dr Marc Farr is Founder of Beautiful Information, Director of Information, East Kent Hospitals NHSFT and Shared Health Analytics Lead, Kent and Medway STP

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