Health and social care: data strategy

Technology and Infrastructure

We want to make sure that we have the technology and infrastructure in place to equip us to better collect, store and use data. This includes: structured data held within databases, unstructured data and information held in paper records, near real-time data from sensors and the Internet of Things.

Background

Our strategy ‘Care in the Digital Age’ sets out our vision, aims and objectives for how technology and infrastructure will evolve and integrate. We know we need to modernise some of the data infrastructure that is currently in use across health and social care to allow us to make the most of innovative technologies and ways of working. We will require the technology and infrastructure in place to best collect, store and use data, including unstructured data and information held in paper records.

At present, health and social care data is recorded and stored in multiple systems, and whilst there are some examples of good interoperability and shared access, more often than not, systems offer limited or no interoperability. This limits the number of people that can access the information. We want to work to the principle of capturing data once and using it many times. Having the right infrastructure will be critical to this.

Where we are now

Historically, our health and social care systems have been procured, developed and/or implemented separately from each other. There are, however, common core parts to many of our data systems. For example, within the NHS we currently make use of the Community Health Index (CHI) system, which holds the main demographic information about all patients. All Health Boards use this system as the basis for patient management, and a number of local authorities have successfully linked their management information system to the CHI system.

The current CHI system has been in use since the 1970s and is no longer sustainable or capable of supporting our future needs – including the needs of data-driven care. A programme of work to upgrade and modernise CHI is underway, so that services always know who an individual patient is and can match their information to their record. By modernising the CHI system, we will be better placed to support our data infrastructure, allowing better matching of data and enabling better data linkage across the health and social care sector.

As part of our overall approach to modernising our infrastructure, we have a number of key national developments already underway. This includes the development of National Digital Platform, and its associated National Clinical Data Store (which provided the foundation for consistent, and public, access to vaccine information). These are being developed in line with the overall ‘Cloud First’ policy, which emphasises a requirement to consider the use of public cloud services first, before other options, when introducing new services or updating existing ones – and we will develop a specific action plan for the use of Cloud technology across health and social care. The National Digital Platform and its related developments form a critical component of both providing staff with access to relevant information, whichever organisation they are from, and providing the public with access to their information.

There are multiple technical developments underway, all of which will be set out in a Technical Roadmap for Scotland, but some examples covering specific systems that are designed to use data in a better way include:

• Using data to improve patient care – we are implementing a Laboratory Information Management System (LIMS) to effectively manage laboratory data, ensuring operational efficiency. Data will be pulled together into a standardised format, resulting in improved data quality and making the data easier to find, use, and share.
• Using data to deliver more proactive care and support at home – we continue to progress a significant modernisation programme to transfer current analogue technologies used in social care, over to a digital infrastructure. This will affect in excess of 180,000 people in Scotland in receipt of these services, and have the potential to support greater data insights, health and care integration, and data sharing. The development of a shared Alarm Receiving Centre (ARC) provides the opportunity to improve the resilience of services, allowing for increased access to data between local authorities.
• Using data to support analysis and planning to improve outcomes – we are further developing and modernising our ‘Seer’ platform as part of the National Digital Platform, providing national health and social care insight, working hand in hand with the NCDS. This will bring together and manage national data assets in a secure and trustworthy computing environment, alongside the technologies required by analysts and innovators to generate new insights and ideas and improve outcomes.

Where we want to be

Ultimately, we want our technology to provide more rapid access to the right data at the right time, to support developments in innovative new approaches, and to support access for people to their own data. To achieve this, we will explore:

• Adopting innovative technologies – Scotland’s AI strategy sets out the vision for Scotland becoming a leader in the development and use of trustworthy, ethical, and inclusive AI. Health and social care services have vast data sets which AI technologies could potentially analyse and uncover patterns and insights that humans could not find on their own. Algorithms can be used to help professionals make better business and clinical decisions, generate additional capacity and ultimately improve the quality of health and social care services. Utilising AI can bring many benefits such as early detection of disease; it can also help with diagnosis and prediction of treatment effectiveness. As decision support tools such as The Right Decision Service mature, we will integrate them with innovative technologies such as AI to allow us to support health and social care professionals with validated evidence/guidance, create a learning health and social care system and reduce unwarranted variation, harm, and waste from inappropriate decisions. We will also seek to adopt other innovative technologies, such as Internet of Things sensors, that can be used to empower self-care and alert caregivers to deterioration in a person’s wellbeing. Data from these sensors can help build a whole system picture of how we can improve health and wellbeing in Scotland.
• Improving data quality across the health and social care – The Scottish Government and COSLA will encourage organisations to transform their data to improve outcomes. This will begin with assessing their data maturity and reflecting on how they can improve the quality, completeness and use of their data to achieve the ambitions of the Strategy. Improving data maturity will also be underpinned by introducing new technologies and infrastructure where needed. For example, in health, by adopting a national GP IT solution, alongside the introduction of SNOMED CT, we can begin to address the historical challenge in storing and accessing GP data. This improved technology will provide faster access to data and speed up some administrative tasks, leading to more consistent recording of health information and enable teams to work better together. In doing so, we will improve key data that is at the heart of many health and social care interactions, allowing us to deliver quality insights and deliver better outcomes.

To support this, we will work closely with planning and procurement colleagues to ensure that health and social care contracts contain the requirements necessary to drive forward the infrastructure required for care in the digital age.

In implementing our target technologies and infrastructures for the future, we must keep a focus on ensuring the safety of those we provide care for. We are committed to ensuring that safety and security of systems is embedded throughout health and social care, noting that all software classed as a medical device must be compliant with current UK regulations. This includes continuing to be alert to regulatory changes on software and AI as a medical device and engaging with partners. This will be achieved by monitoring the current change programme being run by The Medicines and Healthcare products Regulatory Agency and taking part in initiatives such as Multi-Agency Advisory Service for Artificial Intelligence (AI) and data-driven technologies.

As we introduce new infrastructure and technologies for the future, we must also be part of Scotland’s coordinated approach to making a just transition to net zero by 2045. The NHS has set out its plan to become a service which is both environmentally and socially sustainable. As local government have responsibility for social work and social care, these services will come under local authority plans to make a just transition to net zero by 2045. Across health and social care, we can make a positive contribution to achieving net zero by:

• Reducing the amount of duplicated data, and the use of legacy infrastructure used to host data in our health and social care sector.
• Capturing data in digital formats, as this reduces our use of paper. For example, by moving to digital prescribing and converting notes, consent forms, and appointment booking forms and letters to digital formats.
• Seeking to host data in data centres powered by green energy.

Our Commitments

We will embed a climate-considered approach to our management of health and social care data.

Who is it for?

Public
Professionals

Our Commitments

The Scottish Government, COSLA, and partners including the Scottish Innovation Centres will work collectively to ensure that health, social care and social work benefit from innovations based on IoT and AI.

Who is it for?

Public
Professionals

Our Commitments

We will ensure that clinical safety and security of our systems are embedded throughout, noting that all software classed as a medical device must be compliant with current UK regulations. This means ensuring we provide the public and professionals with the assurance they need that digital technologies are used to deliver care in a safe manner.

Who is it for?

Public
Professionals

Our Commitments

We will collect data once, and support appropriate access and use multiple times.

Who is it for?

Professionals

Our Commitments

We will promote a continuous improvement approach to improving the quality and completeness of data as well as making better use of the data we already have.

Who is it for?

Research & Innovation
Professionals