U.K. Agency Hopes Integration Tools Boost Quality of Health Data

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January 30, 2006 (Computerworld) -- The U.K.'s National Health Service (NHS) Cancer Registry, which monitors the health of cancer patients from diagnosis through treatment, is testing new integration tools that it hopes will boost the quality and availability of patient data.
In November, two of the country's eight regional cancer registries began a pilot program using tools from InterSystems Corp. in Cambridge, Mass., to integrate, validate and manage information from hundreds of data sources.
The test is scheduled to be completed in three months. If the testing goes well, the technology will be used agencywide as part of an effort to assess the outcomes of cancer treatments, study the effects of environmental and social factors on cancer risk, and evaluate cancer prevention and screening programs.
The regional Merseyside and Cheshire Registry and the Thames Cancer Registry are testing the InterSystems Ensemble tool suite, which includes an integration server, an application server, an object database and a unified development and management environment, said Chris Carrigan, the U.K.'s national coordinator for cancer registration.
Multiple Data Sources
The regional operations want the tools to automatically link data feeds from multiple sources to their registries and to the NHS centralized registry. Automating the feeds would decrease the need for manual input and thus significantly improve the quality of the data, Carrigan said. "The number of sources of data from which we would need to [create a patient history] could be hundreds," he said. "It is virtually impossible to do high-quality, high-volume cancer registrations by hand."
Replacing manual processes will also help keep the registries more up to date, Carrigan said. There is currently an 18-month lag between the time a patient's cancer treatment begins and when information about it becomes available in the registry, he said.
Using the integration technology, "every data record that comes in electronically to the [regional] data registry will be automatically linked to NHS to check and authenticate who the person is and to augment other data in the registry," Carrigan said.
The NHS also expects that an Ensemble-based system will allow health officials to apply standardized business rules to the categorization of data. The current process, based on human decision-making, can lead to discrepancies in how data is categorized and analyzed.
"I can never tell whether it is a right or wrong decision, because [the data is analyzed] in someone's head," Carrigan said. "With the [new] system, I can control and visualize the business rules that are happening within the registries."
The pilot project is expected to allow registries to more easily support the influx of data expected as the country rolls out the NHS National Program for IT, which will create a single electronic record of care for all U.K. citizens. That program could result in a 100% increase in health care data over the next several years, Carrigan said.
Scott Tiazkun, an analyst at IDC, said the challenges of the new U.K. system mirror the massive integration requirements for the U.S. national health information network proposed by the Bush administration. That system is intended to allow health care providers easily share patient data.
"The technology around middleware and tools that will be able to provide the links between all these disparate data sources will be crucial in making local databases be able to talk to regional databases," Tiazkun said.

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