Data-driven care: why pharmacy needs to get involved

In the 20th century, oil was the commodity that made the world go around. In 2019, data is the new oil.

In a similar way, data needs prospecting, pipelines and storage, but it also needs to be converted into useful products. The five biggest global companies — Google, Amazon, Apple, Facebook and Microsoft — realise combined quarterly profits in excess of £20bn, largely because of their understanding and provision of data services and products.

Healthcare is no different. In 2017, the information technology company IBM estimated that global medical knowledge and data were doubling every three years, and that by 2020 they would double every 73 days. But the effective use of this huge resource remains largely untapped^[1]
.

In the UK, the NHS generates vast quantities of data, much of which remain unused or underused, despite the potential to drive better care. There are many reasons for poor use of data. One is poor interoperability; differing healthcare terminology can mean the same medicines are described in thousands of ways across the NHS. Lack of transparency between organisations is also a problem; information is obscured or not shared because it is seen as belonging to NHS trusts, contractors (GPs or community pharmacists) or other bodies, rather than being of benefit to the NHS. There are also gaps in education; current and developing healthcare professionals are not aware of the importance of informatics and the opportunities to use rich data reserves, even if they were available.

An opportunity for pharmacists

In evidence submitted to the Topol review^[2]
— a major review commissioned by the former secretary of state for health and social care, Jeremy Hunt, and published in February 2019 — a working group, led by chief pharmaceutical officer Keith Ridge, identified several types of data that could be better-used to improve care. These areas included prescribing information (including diagnosis and indications); product and supply information; outcomes from the patient’s use of the medicine; patient factors including concordance and any potential harms; and the costs and efficiency of supplied medicines.

The review reveals that pharmacists and pharmacy teams, as experts in medicines, have an opportunity to develop data skills. However, training in these skills is limited at undergraduate level, and in qualified pharmacists and technicians they are sadly limited to the enthusiastic and evangelical few^[3]
.

Pharmacy needs to reset its professional view on the use of data if it is to stay ahead of the game. We need to see changes in policy, education and training, and approaches to patient care with medicines.

The commitment to data-driven care is further echoed in the ‘Interim NHS People Plan’, published in June 2019, which states that our workforce will be supported and enabled by the latest technology and insights from real-world data^[4]
. Unless pharmacy is equipped and ready, it will not be able to create a culture in which digitally supported care is the norm, particularly when genomics and personalised medicine become more commonplace.

Pharmacists fit for the NHS of the future

Health Education England imagined what a future pharmacist would look like when it developed a fictional pharmacist named Owen, who illustrates the career trajectory of a typical pharmacist completing their preregistration training in 2019^[5]
. The profile highlighted the expectations and potential opportunities for pharmacists in today’s NHS. Owen goes on to specialise in diabetes and clinical informatics, and communicates with researchers across the globe to develop monitoring, alerting and engagement apps to support patients with diabetes.

The NHS in England is embracing the plans from NHSX — the new body driving digital change in the NHS — which include standards (including medication standards) that support interoperability and analytics. The intent is to reduce the burden on all clinicians and staff, so they can focus on patients and access clinical information wherever it is needed. This strategy will improve patient safety, productivity and use of digital technology across the NHS.

Pharmacy professionals must adapt to changing expectations and opportunities around medicines, and they must be supported by our professional leadership bodies — both the Royal Pharmaceutical Society and Association of Pharmacy Technicians UK — and also broader healthcare system organisations, such as the Faculty of Clinical Informatics and the Professional Records Standards Body.

With data’s potential to save time, improve care and boost pharmacists’ career prospects, surely it is time our profession got a grip with clinical informatics before other professionals beat us to it.

^[1]
The Health Foundation. Untapped potential: Investing in health and care data analytics. 2019. Available at: https://www.health.org.uk/publications/reports/untapped-potential-investing-in-health-and-care-data-analytics (accessed July 2019)

^[2]
NHS Health Education England. The Topol Review: Preparing the healthcare workforce to deliver the digital future. 2019. Available at: https://topol.hee.nhs.uk/ (accessed July 2019)

^[3]
 NHS England. Supporting early career pharmacy professionals in data-driven care: a guidance document for the profession. 2018. Available at: https://www.sps.nhs.uk/wp-content/uploads/2018/10/NHS-England-report-Supporting-early-career-pharmacy-professional-in-data-Final._-1.pdf (accessed July 2019)

^[4]
NHS Improvement. Interim NHS People Plan. 2019. Available at: https://improvement.nhs.uk/resources/interim-nhs-people-plan/ (accessed July 2019)

^[5]
NHS & Health Education England. Preparing the healthcare workforce to deliver the digital future: the additional personas. 2019. Available at: https://topol.hee.nhs.uk/wp-content/uploads/2019/05/Owen-the-Pharmacist-Topol-Persona.pdf (accessed July 2019)