Posted by: Hadrian Moss17 September 2014
The news that NHS England is looking at expanding care.data extractions to include ‘sensitive’ patient information should have come as no surprise. After all, if NHS England is going to extract some patient data, why not extract all of it?
Big Data is a new industry that runs off the back of the NHS, and viewed by many as a revelation in healthcare provision. There is an opportunity for healthcare providers to use complex analytical tools to identify both high-risk patients who may need more support and also to determine the most cost-efficient care pathway or treatment for a particular group of patients.
And in the NHS, where we all have to tighten our belts, discovering which are the most cost-efficient treatments can’t necessarily be a bad thing, can it? I worry it could create a problem.
Traditionally, GPs have been reimbursed based upon volumes of treatment and big data could enable payment by outcome instead - after all, how do QOF payments work?
But your practice income could be under even greater threat.
Those shoulders injections you keep doing on an item of service basis could literally change overnight to a payment by results model, meaning the ones that don’t get better will attract no payment. It’s not a good position to be in when you have no control over the outcome of a procedure, but have already spent time and resources providing it.
Selling patient data introduces many threats, both to clinicians and patients.
Apart from risks to providers of healthcare, there is also the risk of sensitive patient data falling into the wrong hands, or being misrepresented by an organisation with access to it. On 18 August, it was reported that over 4.5 million American health records have been ‘hacked’ and confidential data was extracted. How good will be the safeguards provided by NHS England, who I’m assuming will delegate the task of data storage to a third party (and probably the lowest bidder)?
Oh well. At least if my patients’ data is hacked, somebody will actually look at the useless QOF boxes I’ve ticked.
Dr Hadrian Moss is a GP in Kettering, Northamptonshire. You can tweet him at @DrHMoss.