The NHS is once again asking for a share of big data. Speaking today at a conference in London, Peter Bradley, director of health intelligence at Public Health England, said that improvements in public health can only happen with better access to information – and especially personal information.
The more data public health services can gather and analyse from doctors and patients, he said, the more insight researchers will get into conditions, and the better the NHS can prevent illnesses.
"We want to make sure we use data in all its forms," said Bradley. "As we move towards personalised approaches, we can create even more information with citizen-generated data, such as data coming from smartphones, for example."
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One potential future innovation, he explained, would be to digitise the NHS health check – a check-up designed for adults in England between 40 and 74 years old, to spot early signs of stroke, kidney disease, dementia or type 2 diabetes.
Bradley presented an imaginary digital version of the check-up, showing patients being prompted by their NHS app to undertake the check-up directly on their phones.
To complete the check-up, the user would answer questions about their weight, lifestyle and family history, and input blood-pressure results from a pharmacy test.
If the patient's results show low-risk, the app would then come up with tips to maintain their health. For example, it could suggest more exercise, and introduce an app to track the user's progress, including weight and heart-rate monitoring.
The data generated from tracking the patient's activity would be shared with their GP, with regular evaluation of their health to recognise a risk and provide additional support and face-to-face consultation if necessary.
"Information is available from many platforms," said Bradley, "and we want to link this new data for more insights. But to move forward, we will need to collaborate with academics and with the commercial sector, because we cannot do this on our own."
As an example of work already underway, Bradley mentioned the emergence of Health Data Research (HDR) UK, an alliance between public sector organisations and research institutes created last year to make information held by NHS bodies more useful for healthcare professionals.
Earlier this year, HDR controversially created seven "data hubs" where pharma firms including Novartis and Janssen will have access to information about millions of NHS patients' medical histories to boost the search for cures to diseases such as cancer and asthma.
The NHS has tried teaming up with private companies in the past, with mixed results.
In 2014 a scheme dubbed Care.data launched to let GPs share their patients' data with the Health and Social Care Information Centre (HSCIC), which could then pass those details to businesses in exchange for financial compensation.
The goal was to understand which healthcare bodies performed best, improve the NHS's predictive modelling, identify healthcare trends or measure which treatments worked best in certain circumstances.
Two years later, the scheme was abandoned for lack of public trust, after a report from the National Data Guardian emerged recommending better safeguards for the sharing of patient data.
Then, in 2017, the NHS provided the personal data of about 1.6 million patients to Google DeepMind as part of a trial to test an alert and diagnosis system for kidney injury.
But an ICO investigation found that in doing so, the NHS had failed to comply with the Data Protection Act, and that patients had not been adequately informed that their personal information would be used as part of the test.
This has not discouraged the public health services. "Data-driven and individualised approaches are the way to go to prevent health problems," said Bradley at the conference.
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He also acknowledged, however, that the virtuous cycle of public health will only happen once patients trust the way their data is handled and protected.
"The technology is very exciting but we need to focus on whether what we do really helps the public," he said. "We have to be clear about information governance and legislation. There needs to be a debate about this before it happens."
He told skeptics that Public Health England is working "closely" with National Data Guardian, an independent body created in 2014 to protect patients' confidential information, as well as "other groups", to secure the privacy of citizens' data.
Bradley added that, contrary to preconceptions, patients are generally willing to share their data, and especially if it is done locally.
"We find that when we talk to patients, there is enormous enthusiasm from certain groups to share data – they just need to understand why they are sharing it."
In light of recent events, though, it seems that more efforts are needed to rebuild public trust before smartphone-based health check-ups become a reality.