Support for OpenPrescribing from GPs, commissioners and the world!

In December the new online prescribing platform, co-developed by Anna Powell-Smith and Ben Goldacre with support and funding from the West of England AHSN, was launched publicly to an overwhelming positive response.

OpenPrescribing.net enables the speedy analysis of prescriptions across the country for the first time and has the potential to save the NHS millions of pounds, while ensuring that patients are given the best medication for their conditions.

The new platform generated significant interest, receiving nearly 95,000 hits during December. Twitter was flooded with conversations about OpenPrescribing, with this one being the most shared. In all there have been 431 tweets and 1,691 reactions, reaching a potential audience of around 46 million people.

Since the launch, an equivalent site for Welsh prescribing data using open source code from OpenPrescribing.net has been developed, while the Scottish government has also confirmed it will release their data which means an equivalent Scottish site could be available later this year.

A GP’s perspective

According to GP Peter Jenkins, every month prescriptions are issued for 450,000 individual drugs across the Wiltshire region, where he is based, equating to five million a year. This huge volume results in a very large amount of data being recorded and made available, but it is not always easy to interpret, making it a challenge to distinguish patterns in prescribing.

Peter Jenkins, Bristol CCG
GP Peter Jenkins

Dr Jenkins, who is also Clinical Chair at NHS Wiltshire Clinical Commissioning Group, says: “Data intelligence provides a method to review our own prescribing and benchmark it against our colleagues locally and nationally. It is obviously only related to prescribing and needs to be taken in context with other aspects of patient care, but it provides a tool to enable further review and improvements where appropriate.

“I am aware that GPs have previously used information that was available from the NHS Business Services Authority (PPD) in the form of a quarterly prescribing report for each practice. This became unavailable a couple of years ago and the only way we’ve been able to access this kind of information up to now is to request it from our medicines management team.”

He added: “The OpenPrescribing platform will allow GPs to use prescription information to review practice prescribing performance and compare it to other practices locally, or even nationally. We will be able to identify areas for potential audit, and perhaps improvements in practice, if it is not according to local or national guidance.

“The platform makes data easily accessible on mobile devices, such as an iPad, as well as on a computer, and can be accessed from anywhere, not just an NHS computer. It is very user friendly and you can manipulate the graphs to expand the details you want to see. Being able to view graphs is always more meaningful than tables of data and the option to review the progress over a period of time is very helpful.”

A commissioner’s perspective

Jon Hayhurst is Head of Medicines Management at Bristol CCG, which has ongoing programmes of work that involve collaboration between GPs, with the aim of making prescribing safer, more effective and more sustainable. Jon says: “A number of IT interfaces currently allow people like me to access the rich prescribing data that we get from our GPs – ePACT.net or the Information Services Portal to name two. These are great for those of us that regularly view such data, but can be impenetrable for those that don’t.

GP Jon Hayhurst
Jon Hayhurst, Bristol CCG

“We will be encouraging our local clinicians and other partners to use the OpenPrescribing platform to see variation in prescribing for themselves and encourage them to have a play around with it. Benchmarking data is a great driver for change and quality improvement, and also a way to show people how great their performance is.

“From a medicines management perspective, its greatest benefit will be the accessibility. With almost Google-like simplicity, OpenPrescribing gives everyone the ability to explore prescribing data.

“I also feel that that it could positively change the relationship between commissioners and clinicians: from one where clinicians see the data that commissioners choose to show them to one where they can see whatever data they choose, and then discuss this with commissioners in a proactive way.”

Only the beginning

Peter Brindle, Commissioning Evidence-Informed Care Lead at the West of England AHSN, says :”We are really pleased that OpenPrescribing has been so well received by Clinical Commissioning Groups and others, however this is only the beginning. OpenPrescribing will have greater functionality added to it over the coming months making it an even more effective tool to help practices understand their own prescribing.  The major area of activity will be to work with other Academic Health Science Networks and their practices so that OpenPrescribing is used to maximum effect.”

Find out more

More information about OpenPrescribing is available here and you are encouraged to ‘play’ with the data at OpenPrescribing.net

New OpenPrescribing platform aims to save the NHS millions of pounds and improve patient safety

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.

Highlighting variations

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.”

Easy comparisons

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.