Occasional Paper No. 24: Review of the National Sexual Health IT System (NaSH) in Scotland: the potential for sexual health research

McDaid, L. , Docherty, S. and Winter, A. (2013) Occasional Paper No. 24: Review of the National Sexual Health IT System (NaSH) in Scotland: the potential for sexual health research. Other. MRC/CSO Social and Public Health Sciences, Glasgow.

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Abstract

Background: Specialist sexual health settings present specific challenges to electronic record systems, including enhanced requirements from patients for discretion, anonymity, and rapid turn around. A number of international sexual health settings have pioneered bespoke electronic patient record (EPR) systems, and the National Sexual Health (NaSH) electronic clinical record system has been rolled out across specialist sexual health services in Scotland. The data collected could present a rich resource and here we discuss the key issues to address in the routine use of NaSH data for sexual health research. The intended audience for this report is primarily those in Scotland who are using, responsible for, or have the potential need to access, NaSH data, but the report will have wider relevance to those interested in sexual e-health.

Methods: Scoping review in three stages: a policy review of NaSH documentation; a review of EPR issues reported by an international selection of clinics known to be using computerized clinical systems; and a review of more general methodological issues related to the use of EPR.

Results: NaSH entails a data set with over 700,000 patients and more than 300,000 attendances recorded annually. Data include medical, family and sexual history, reproductive health and contraception, social and lifestyle factors, test requests/results, patient actions/recalls, prescriptions, symptoms, physical examination details, partner notification, and referrals. NaSH allows patientcentred choice of whether to use an anonymous identifier or CHI number, which could facilitate record linkage. Key issues in the use of the data are: data collection and completeness; storage and retrieval; and research governance. An anonymised data view has been created, but not all NHS boards complete all data fields, and even though minimum input criteria have been established, use of NaSH in real time has been problematic and variable. The data view only reflects current, visible data, and while episode-based data remain true, lifetime sexuality and smoking status, for example, can change over time, and the ‘original’ or preceding data are written over; precluding any longitudinal analysis. Similarly, longer term retention of NaSH data and availability to researchers out with the NHS are issues that have yet to be addressed.

Conclusions: Interrogating NaSH would enable research to make better use of existing sexual health data in Scotland, be cheaper than initiating large-scale surveys, and give access to high-risk populations, but would need to address conflict between the need for comprehensive and complete data for research purposes and the need for a routine clinical system to function in a routine way. Concerns over data collection, storage and retention should be considered within the context of the wider public health and research benefit.

Item Type:Research Reports or Papers (Other)
Status:Published
Glasgow Author(s) Enlighten ID:McDaid, Professor Lisa
Authors: McDaid, L., Docherty, S., and Winter, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Publisher:MRC/CSO Social and Public Health Sciences
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