Predictive Health Intelligence has launched a new liver disease case-finding pathway at the newly opened Bridgwater Community Diagnostic Centre (CDC), using existing NHS blood test results to identify people who may be at risk of liver disease and metabolic ill health.
“Chronic liver disease has traditionally fallen rather awkwardly between primary and secondary care,” Dr Tim Jobson, NHS consultant gastroenterologist and Medical Director of Predictive Health Intelligence, told Building Better Healthcare.
When the opportunity arose to develop new preventative pathways through the CDC programme, while the CDC itself was still being developed, it felt like a very natural fit.
The £17.8m Bridgwater CDC, completed by Actiform in partnership with Ergéa UK, opened to the public on 18 August.
The programme, being delivered with Somerset NHS Foundation Trust, will use Predictive Health Intelligence’s hepatoSIGHT (registered trademakr) technology to identify people attending the CDC who may benefit from further investigation.
Up to 9,000 people will be invited for additional checks through the pathway, with the CDC providing the diagnostic capacity and community-based setting for further investigation.
Jobson said the aim was to use the CDC for more than diagnostic testing, instead linking its capacity to earlier identification of disease.
“A CDC should be more than somewhere where we send patients for tests. It gives us an opportunity to find disease earlier and design genuinely preventative pathways around that diagnostic capacity,” he said.
Using existing NHS data to find patients earlier
The new pathway will use information already held within NHS records to identify people who may be heading towards serious liver disease.
It builds on earlier work in Somerset involving around 700 people, with hundreds subsequently receiving treatment, monitoring or follow-up.
Jobson said the approach was prompted by the difficulty of identifying patients before liver disease becomes advanced.
“Liver disease is a particularly good example of why a more proactive approach is needed. Deaths from liver disease have quadrupled over the past 50 years, while many people can have the condition for years without experiencing obvious symptoms,” he said.
By the time someone feels unwell and reaches a liver specialist, the disease can already be advanced and our opportunities to intervene are much narrower.
He said previous experience of treating patients with advanced liver disease showed that warning signs were often present in their medical records well before they reached specialist care.
“The problem was not that the NHS lacked the information, the problem was that we lacked a systematic way of finding those signals and acting on them,” Jobson said.
The technology will help clinicians use information the NHS already holds to identify people who may be heading towards serious liver disease while there is still an opportunity to do something about it.
The initiative forms part of Somerset’s wider CDC programme and is intended to test a model that could potentially be replicated at other centres across the NHS.
Jobson said the ambition was for the model to extend beyond Somerset.
If we can demonstrate that in Somerset, there is no reason why the same model could not be adopted by other CDCs across the NHS.
