Prof Mahmood Adil, Medical Director, ISD Scotland and Health Protection Scotland Pharma Pricing & Market Access Congress 2017 22 February 2017 London

1. Scottish Health Intelligence –
Creating Value for the world
Prof Mahmood Adil
DCH, MPH, CertHEcon, DipHInformatics, MHSM, FRCP (Edin), FFPH, DipIoD
Medical Director
Information Services Division (ISD) Scotland
&
Health Protection Scotland

2. £12B
Population 5M
Single health care provider
14 Territorial Boards
38 Hospitals, 1020 General Practices
High rates of morbidity of common complex
disease
Collaboration – Aberdeen, Edinburgh, Dundee,
Glasgow, St Andrews
Unique patient identifier

3. Chronic Diseases + Elderly Population
+ New Technologies/drugs
+ Waste & Variation
• £20 billion by 2015
• £30 billion by 2020

4. Value
Improved outcomes (quality)
= divided by
Resources utilised (cost + waste + variation)
Maximising health outcomes for every pound spent

5. Health Intelligence
Our Strength in Scotland
Data Create Value

6. Best data in the world?
Scotland has some of the best health
service data in the world which combines:
- high quality data
- consistency
- coverage (national and local) and
- the ability to link data to allow patient
based analysis and follow up.

7. A&E
Maternity
BIRTH
DEATH
Child health surveillance
Immunisation
GP consultations
Outpatients Hospital Admissions
Mental Health
Prescribing Screening
Continuing care census
Cancer registry
Dental inspection
Scottish birth record Substance misuse
Clinical audits
http://www.isdscotland.org/About-ISD/About-Our-Statistics/ISD-Statement-of-Administrative-Sources-v2.0-Mar2012.pdf
Most of our data sets offer 100% coverage

8. Community Health Index (CHI) No
Date of Birth Sex Check
07 10 64 02 5 0

9. A&E Outpatients
Inpatients
Day cases
Deaths
Prescribing
Age/gender
CHI
Linked File
SPARRA
Social Care
SIMD
Linked Health and
Social care data
individual service
user level
Integrated Data
£

10. • Hospital Medicines Utilisation Database (HMUD)
• PIS & PRISM
• Hospital Electronic Prescribing & Medicines
Administration (HEPMA)
• Scottish Primary Care Information Resource
(SPIRE)
Driving value:
prescribing and drugs utilisation

11. Hospital Drug Supply
14 Boards:
Independent
stock control
systems
Identified
as drug
utilisation
Supply to clinical areas
as ward stock
Supply to specific
patients (but costed to
clinical area)
Monthly
import
to data
warehouse
Data from different
pharmacy systems
mapped to standard
drug reference file
(dm+d)
HMUD

13. HMUD Use
• Identify high level medicines expenditure and tracking
change, allowing comparison between Scottish average
and Boards etc.
• Monitor uptake and usage of new and high cost
medicines
• Track impact of change projects on prescribing
• Identify unnecessary variation & opportunities for quality
or efficiency improvement

14. PIS & PRISMS
hold information on all prescriptions written by
Scottish prescribers and dispensed in the
community

15. Prescription events and data
flows
Prescription
written
ePrescribed
data set
95% of ALL Rx
100% CHI
Within 48 hours
Dispensed &
collected
eDispensed
data set
83% of ALL Rx
100% CHI
14 days
Prescription
payment
Reimbursed
data set
100% of Rx
97% CHI
2-3 months

16. HEPMA Hospital Electronic
Prescribing & Medicines Administration
• Has record of prescribing and drug
administration (and non-administration)
• HEPMA systems now in place in 3 Boards and
plan for wider roll out
• Massive potential in intelligent use of different sources
of data

17. SPIRE (Scottish Primary Care
Information Resource)
• Single national system to extract data
from GP clinical IT systems in Scotland
• To help GPs, the NHS in Scotland and
researchers to learn from information
held at GP practices and so improve
outcome and value

18. Why infection?
Why now?

19. The Scottish Infection Intelligence Platform (IIP)
Improving patient outcomes and reducing harm from infection
through innovative data integration to support clinicians within
the NHS in Scotland
Key datasets:
• ECOSS-microbiology
• HMUD-medication use in
hospital
• PIS-primary care prescribing
• SMR-hospital activity and
deaths
• SSIRS-surgical site infections

20. Uniqueness & Strengths
• Scotland has databases of medicines
usage in primary and secondary care.
• Primary care data can be linked to
patients rather than prescriptions
• Reporting on medicines use can be
combined with data from other
national databases e.g. population,
occupied bed days etc.

21. Applied Intelligence
• How many people are being treated?
• What are the characteristics of those
people?
• What have they been treated with before?
• What else are they being treated with?

22. Applied Intelligence
Information
Optimisation
Hindsight
Insight
Foresight
Descriptive
Analytics
Diagnostic
Analytics
Predictive
Analytics
Prescriptive
Analytics
What
happened?
Why did
it happen?
What will
happen?
How can we
make it happen?
Analytic Value Escalator
Descriptive
Analytics
Diagnostic
Analytics
Predictive
Analytics
Prescriptive
Analytics

23. Descriptive
Analytics
Diagnostic
Analytics
Predictive
Analytics
Prescriptive
Analytics
Saving Lives through Data Analytics
Big Data – Volume, Velocity, Variety
Safe Data Sharing Architect
Where do we have opportunities to
collaborate and make a difference together?

24. • Electronic Data Research & Innovation
Services (eDRIS)
• Patient Benefits & Privacy Panel (PBPP)
Working together to create value

25. mahmood.adil@nhs.net
Thank you
@mahmoodadil