Data Science on a budget in the NHS

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# Data Science on a budget

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__Chris Mainey__
Senior Data Scientist 
University Hospitals Birmingham 
NHS Foundation Trust
 
[chris.mainey@uhb.nhs.uk](mailto:chris.mainey@uhb.nhs.uk) 
 <a href="https://twitter.com/chrismainey?s=09" style="line-height:2;">@chrismainey</a>
]

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<img src= "https://chrismainey.github.io/EARL_2019_presentation/assets/logo.png" width=50% height=50%>
 
<img src= "https://chrismainey.github.io/EARL_2019_presentation/assets/HI.png" width=62% height=62%>
 
<img src= "https://www.uhb.nhs.uk/Images/uhb-logo-2017.png" width=58% height=58% style="border:10px solid #FFFFFF;">

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# NHS Overview

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__UK's large, public-funded, healthcare system__

+ Primary (GP), secondary (hospitals), tertiary (regional), community and mental health services.
+ Although there's much co-operation, network of separate, competing, organisations
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<img src="https://www.aintreehospital.nhs.uk/media/2121/full-group-wsbwc.jpg?mode=pad&rnd=131116722910000000" width=100%>

Image: Aintree Hospitals: https://www.aintreehospital.nhs.uk/news-events/?page=41&media=3098
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__Data Science work can be found in lots of areas:__
+ Trust BI and information teams
+ Finance and planning teams
+ Clinical research, sometimes in partnership
+ Clinical sciences, e.g. imaging, genomic
+ Interested individuals

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# Univesity Hospitals Birmingham NHS FT

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+ One of the largest Trust's in UK
+ QE, Heartlands, Good Hope, Solihull
+ Regional specialist services centre
+ Strong clinical research, partnerships with HDR-UK, Turing Institute, Microsoft etc.
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+ Large, merged, informatics department
+ SQL Server-based analysis and dashboards, .
+ Spotfire, .NET websites, with bits of R, Stata, SAS, PowerBI and D3.
+ Funding is tight and hard to justify new projects.
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# Healthcare Evaluation Data (HED)

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- Online hospital benchmarking system
- Statistical models and analysis tools
- Activity, Mortality, Re-admissions, Length-of-Stay, Market-share etc.
- Built by Informatics team at University Hospitals Birmingham NHS Foundation Trust
- Used by ~60 NHS and other organisations
- Training and support, including `R`
 
- __Using national NHS data, including HES, ONS mortality, central returns, NRLS and others__
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<img src="https://chrismainey.github.io/EARL_2019_presentation/assets/HED_system.png" width=110%>
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# What is our work like?

+ Building models on national hospital data, mortality, readmissions, LOS etc.

+ Not 'big data', but large, relational data (~60 million pa, 100+ data items)

+ We had used SAS for many years, but it's expensive.

+ I had PhD work funded, and chose to use `R`, led to devleoping new methods.

+ Working to 'productions' our modelling process in `R`, improve automation etc.

+ Adopted tools like Git and building R packages, looking at Docker etc., but not 'supported.'

+ I have to justify increase in profit, or saving on time spent to frame what we do.

+ I run R training courses and R-usergroup to promote it.
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# Set up

+ Bog-standard Windows desktop.

+ Fight for more RAM, although over charged!

+ Important to note, cloud providers are not yet fully trusted.

+ Desktop machines are constrained in RAM, disk and CPU, so we learnt to be efficient.

+ Couldn't get funding for RStudio professional or other solutions, so eventually set up our own.

+ Acquired a piece of a 'development' server and put Linux VM on it, now run Open Source RStudio server.

+ Again, not supported by our Trust, but we have to manage locally.

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# Take aways

+ There is plenty of Data Science in the NHS!

+ You often have to fight for it.

+ Need to sell the benefits to anyone who might be able to fund.

+ Even without funding, there is loads you can do.

+ Demonstrate benefits and take people along with you to make your case!

+ Engage with the community, e.g. NHS-R community, Twitter, third sector

+ Be an Evangelist!  Train others, publish blogs/articles, be a mentor.

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# Thanks for your time!

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 <a href="mailto:chris.mainey@uhb.nhs.uk;" style="line-height:2;"> chris.mainey@uhb.nhs.uk </a>
 
 <a href="http://www.hed.nhs.uk" style="line-height:2;">http://www.hed.nhs.uk</a>
 
 <a href="https://twitter.com/chrismainey?s=09" style="line-height:2;">@chrismainey</a>
 
 <a href="https://github.com/chrismainey)" style="line-height:2;">chrismainey</a>
 
 <a href="http://www.mainard.co.uk" style="line-height:2;">http://www.mainard.co.uk</a>
 
 <a href="https://nhsrcommunity.com/" style="line-height:2;">https://nhsrcommunity.com/</a>

<img src= './assets/funnelplotr.png' width=10% height=10% align="middle"> `FunnelPlotR` now available on CRAN!
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<img src= './assets/NHSR-logo.png' width=100% height=100% align="middle"> 
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