Better care through better use of data in GP-patient partnerships.

In 1988 Julian Tudor Hart prescribed ‘A new kind of doctor’, calling for data-intensive, community-responsive primary care.1 He argued for a realignment of primary care with the needs of populations rather than individuals; and for greater emphasis on prevention.1 These principles are largely ingrained in modern UK general practice: clinical commissioning groups (CCGs), the Quality and Outcomes Framework (QOF), and audit all require primary care to consider information about practice populations; and disease prevention is routine practice. The new era of ‘big data’ is likely to escalate further such approaches but may also change the conversation of primary care between patients, practitioners, and the public. Systematic collection, collation, and analysis of data were core to Hart’s manifesto. Today’s primary care has more advanced tools at its disposal. Electronic health records are the foundations on which we build alerts and reminders to guide decisions at the point of care. Electronic templates help capture key data on conditions and care pathways. These data can be extracted across IT systems for research (for example, the Clinical Practice Research Datalink [CPRD], The Health Improvement Network [THIN], QResearch, and ResearchOne in the UK; the NIVEL Primary Care Database in the Netherlands; or SIDIAP in Spain), and across populations to support service development (for example, audit, www.openprescribing.net) and incentivise activity (for example, QOF in the UK, the Primary Health Organization [PHO] Performance Programme in New Zealand, or Practice Incentives Program [PIP] in Australia). Traditionally, large-scale data extracts of NHS care records have been seen as the way to realise the more systematic primary care that Hart envisioned. Extracted records may be combined with other data at a national level such as hospital admissions and discharges from claims data, or official government statistics such as death registrations. More detailed information at regional level, however, is …