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Graphnet's CareCentric shared record software facilitates pioneering research study.

15th December 2014

Graphnet’s CareCentric software is at the heart of a ground-breaking research study into the effectiveness and safety of a new treatment for a chronic lung disease and asthma. 

Graphnet’s shared care record software is being used to pull together patient data from right across the Salford health economy.  Called the Salford Lung Study, the research project uses this valuable data to test the effectiveness of a drug when it is used in everyday practice in a randomised control trial.

It is the world’s first pre-licence ‘pragmatic’ randomised controlled trial in asthma and chronic obstructive pulmonary disease (COPD), and aims to randomise almost 7,000 patients, each of whom have individually signed up to participate. [1]       

Graphnet’s customer is the NorthWest eHealth (NWEH), a not-for-profit organisation formed by a partnership between the University of Manchester, Salford Royal Foundation Trust and Salford CCG.  NWEH was set up in 2008 to develop links between academia and the NHS in the area of health informatics and develop new research using anonymised patient records to support improving healthcare.  The research is sponsored by the pharmaceutical company GlaxoSmithKline (GSK).

The Salford Lung Study is based on a deployment of CareCentric known locally as the Salford Integrated Record.  This captures linked data in real time from Salford Royal Hospital and the surrounding 58 primary care practices. 

The study is now being extended and NWeH receives feeds from nine GP practices in Manchester, 17 in Trafford and three in Stockport.  Where the individual patient has given consent, the data collected from these CareCentric solutions is securely transmitted to Salford for inclusion in the study.

Additional data feeds have been implemented to capture data from out of hours services, all 55 community pharmacies, health services outside of Salford and deaths. 

This provides a unique depth of information, allowing researchers to assess whether patients are actually taking their medication, for example, based on the number of prescriptions delivered to the pharmacy and the number of prescriptions actually dispensed to the patient.

Dr John New, consultant physician at Salford Royal and NWeH director of the Salford Lung Study, said there were a number of infrastructure and clinical features which made Salford a unique environment for this type of research project.  “The population is relatively static and is served by a single hospital, Salford Royal.  On top of this, the scope of the CareCentric electronic health record is such that it captures linked data in real time on all people accessing primary and secondary care services in Salford. 

“The significance is that it allows us to conduct a randomised control trial that is not in an idealised setting but which gives us ‘real world’ information about a drug’s effectiveness in routine primary care. Because the information is collected in real time, it is free from interviewer or recall bias.”

NWeH has brought together clinicians, researchers, epidemiologists, project managers and IT specialists to develop a methodology and governance framework for the project. 

The records for patients participating in the research study are carefully controlled and managed under strict data-sharing agreements, supported by explicit consent from the patients themselves.

NWeH systems and security policies have been reviewed by the National Information Governance Board, and its integrated quality and information security management system is certified against ISO 9001 and 27001 quality and information security standards.

A fully validated electronic Case Report Form (eCRF) ensures prompt safety monitoring and reporting of adverse events as well as the collection of research data for the study.

Brian Waters, chief executive of Graphnet, commented: “There are two important benefits to the use of shared records – helping the patient at the point of care, and providing data from the wider health community to support important research work. 

“This project led by Salford does both, and shows the real power of collaborative working across multiple NHS organisations.”

The first results of the COPD trial are due  in 2016. Recruitment to theasthma study is ongoing. 

[1] John P NewNawar Diar BakerlyDavid LeatherAshley Woodcock . Obtaining real-world evidence: the Salford Lung Study. Published 6 March 2014 in Thorax (BMJ and the British Thoracic Society).

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