A new online prescribing platform which enables the speedy analysis of prescriptions across the country for the first time has the potential to save the NHS millions of pounds, while ensuring that patients are given the best medication for their conditions.
Until now data relating to patient prescriptions by General Practitioners has been published on a monthly basis by the Health and Social Care Information Centre (HSCIC). The dataset amounts to 100GB and there are around four million rows for each file, making it very time consuming and challenging to access and analyse.
The platform has been established to make the significant amount of prescription data much more accessible and usable for the benefit of the healthcare community and patients. With support from the West of England Academic Health Science Network, it has been co-developed by Anna Powell-Smith, a computer programmer specialising in data analysis and visualisation; and Ben Goldacre, doctor, author, and Senior Clinical Research Fellow at the Centre for Evidence Based Medicine in the Department of Primary Care Health Sciences in the University of Oxford.
“CCGs and practices can now easily compare themselves with others, and this can trigger ideas for projects to improve patient care and reduce waste. They can also ensure that medications, which should be used for certain conditions as stipulated by NICE guidelines, are being prescribed and less effective medicines are not.”
OpenPrescribing.net is available online for all to use, free of charge. Target users include clinicians, Clinical Commissioning Groups, patients, the policy community, the media and researchers. It enables users to turn complex data into simple graphs at a touch of a button, to reveal how much of any drug has been prescribed at both CCG and the GP practice level
Its significant potential lies in its ability to spot patterns and major variations in prescriptions that can indicate opportunities to enhance patient safety through medications that are being commonly prescribed, as well as bringing about much needed cost savings by using less costly but equivalent medicines, which are shown to be popular in some areas of the country but not others.
The platform has already revealed a number of variations across all CCGs. For example, the use of branded statins relative to the more cost-effective generic versions varied eleven-fold between the highest and lowest prescribers. Within one CCG this difference was in excess of 40 fold between practices. Similarly, across CCGs there is a 45-fold variation in the amount of newer oral anticoagulants prescribed compared with the use of warfarin – the traditional treatment.
Said Ben Goldacre: “This platform makes complex data easily accessible. You can drill right down to the prescribing behaviour of individual GP practices, and all in the space of seconds. OpenPrescribing.net can help identify where there are variations and specific trends which could present opportunities for huge cost savings, or better prescribing. However it is important to be cautious in interpreting the data, and we have provided advice around this issue on the site itself. We’ve been delighted to have the assistance of the West of England AHSN in making this service freely available to everyone in the country, and we look forward to increasing the functionality of OpenPrescribing and delivering similar products on other datasets.”
Added Peter Brindle, Commissioning Evidence-Informed Care Lead at the West of England AHSN: “Ever increasing pressures on our healthcare system has led to a major drive for innovation in how the health services go about their daily business and to underpin new models of healthcare delivery with evidence.
“This is exactly what we have set out to do with OpenPrescribing and the potential of this approach is vast. CCGs and practices can now easily compare themselves with others, and this can trigger ideas for projects to improve patient care and reduce waste. They can also ensure that medications, which should be used for certain conditions as stipulated by NICE guidelines, are being prescribed and less effective medicines are not.
“Furthermore patients can use the platform to see how widely the medications they are taking are being prescribed by their practice and how that compares with other practices.
Data into action
Commented Anna Powell Smith: “Currently anyone wanting to query the prescription data from the HSCIC must load it into their own data tools first, which takes time and technical knowledge.
“It also only offers aggregate views so users cannot query individual practices and drugs. We want to get the data into action with this platform and encourage users to spot trends, develop hypotheses and test interventions.”
OpenPrescribing has been launched initially as a beta version so as to gain initial feedback from clinicians, CCGs and patients.
Posted on December 3, 2015