Key Facts at a Glance• Aim to reduce overall mortality for patients with Coronary

Heart Disease (CHD) throughout Scotland

• Automatically updated timely database of acute coronary syndrome (ACS) patients reporting into clinicians

• An e-registry template that can be used across Scotland

NHS Greater Glasgow & Clyde (NHS GGC), Golden Jubilee National Hospital (GJNH), The University of Glasgow and The Data Lab partnered with AstraZeneca to develop an e-registry that will complete a 2-year audit of acute coronary syndrome (ACS) services. The projects started in May 2016 and involved the e-registry supporting improved patient outcomes for patients with ACS and the database will be rolled out across the whole of Scotland.

The ChallengeCoronary heart disease is one of the leading causes of death in Scotland, with higher mortality rates than the rest of the UK.1,2 NHS Scotland has the Information and Statistics Department (ISD), which holds high quality health data, and supports patient based analysis.3,4 However, no Scottish health service contributes to the Myocardial Ischaemia National Audit Project (MINAP), which compares data to help clinicians, managers and health boards monitor and improve the quality and outcomes of local services versus nationally agreed standards.3

Following the success of the ACS registry 1, the previous collaboration between AstraZeneca, NHS GGC and GJNH which took a 12-month snap shot of data sources, the Scottish government has approved the project. This renewed collaboration will build on the ACS registry to create an automatically updating, advance database which will report straight into the NHS with the potential to be rolled out across the country.

The ACS Registry 2 has five main objectives:

• To complete a two-year audit focusing on the delivery of ACS service across NHS GGC and GNJH

• To identify gaps in existing data and seek solutions to improve the completeness of the data set

• To conduct further research to inform ACS patient outcomes and characteristics which can be used to directly impact patient care

• To secure support for the ongoing development of the e-registry

• To gain and share key learnings for transferring the ACS e-registry to other health boards

The Steps TakenThe ACS Registry 2 focuses on demonstrating that a register can be created in NHS Scotland to provide data for the MINAP audit that can be automatically generated and give accurate information about the overall management of ACS.

The project involves the following:

• Data extraction and anonymisation from NHS GGC as well as other healthcare providers

• Transfer of the data to AstraZeneca for analysis• Delivery of an audit report by AstraZeneca• Recruitment of a PhD student to deliver enhanced

e-registry and epidemiological research

AstraZeneca has provided 68% of funding for a PhD student as well as dedicated support for project management and real-world evidence lead input. NHS Greater Glasgow & Clyde has provided clinical leadership via Dr Iain Findlay, project planning and support via the managed clinical network (MCN), data governance support via NHS GGC Safe Haven and IT support for the data extraction. The GJNH has provided clinical leadership via Prof Colin Berry and IT support for data extraction. The University of Glasgow has provided 32% of the funding for a PhD student as well as supervision and sponsorship of the PhD student days. The Scottish Ambulance Service has provided project support.

What We Expect to AcheiveIt is planned that the dataset generated from this project will provide a dedicated resource for the research community and the opportunity to provide feedback to the NHS in near-real time about their service delivery and outcomes.

Patient benefitsThe main project aim is to reduce overall mortality for patients with CHD throughout Scotland. The development of meaningful data will lead to the reduction of variation in service delivery and improved patient experience and outcome.

Ongoing databaseThe key to maintaining improved patient experience and outcomes for GGC and GJNH is to ensure a continuously updated and timely database of ACS patients which can be updated automatically, without manual input, and is accessible to clinical staff.

e-RegistriesThe future of data management in the healthcare sector is likely to be through e-registries. This project will provide new insight into data science techniques and show that the ACS registry can track patients, their status and their medications in order to collate data which will be analysed to better influence and shape patient outcomes.

National ProgrammeThe other key outcome is the development of a functional database and analysis system that provides a template for one which could be rolled out as a service across Scotland’s 14 health boards to help ACS patient management.

1. Bhatnagar P et al, The epidemiology of cardiovascular disease in the UK 2014.2. Scottish Government. Health of Scotland's population - Mortality Rates. Available at:

http://www.gov.scot/Topics/Statistics/Browse/Health/TrendMortalityRates Last accessed June 2018

3. Myocardial Ischaemia National Audit Project. How the NHS cares for patients with heart attack. Annual Public Report April 2013–March 2014. Available at: https://www.ucl.ac.uk/nicor/audits/minap/documents/annual_reports/minap-public-report-2014 Last accessed August 10.

4. Information Services Division Scotland. Index. Available at: http://www.isdscotland.org/index.asp Last accessed June 2018

AstraZeneca Renews Collaboration with NHS Greater Glasgow And Clyde, the University of Glasgow & The Golden Jubilee National Hospital To Build On Positive Results of ACS Registry 1 Joint Working Project

Veeva: GB-8830 | Date of preparation: June 2018

The ChallengeCoronary heart disease is one of the leading causes of death in Scotland, with higher mortality rates than the rest of the UK.1,2 NHS Scotland has the Information and Statistics Department (ISD), which holds high quality health data, and supports patient based analysis.3,4 However, no Scottish health service contributes to the Myocardial Ischaemia National Audit Project (MINAP), which compares data to help clinicians, managers and health boards monitor and improve the quality and outcomes of local services versus nationally agreed standards.3

Following the success of the ACS registry 1, the previous collaboration between AstraZeneca, NHS GGC and GJNH which took a 12-month snap shot of data sources, the Scottish government has approved the project. This renewed collaboration will build on the ACS registry to create an automatically updating, advance database which will report straight into the NHS with the potential to be rolled out across the country.

The ACS Registry 2 has five main objectives:

• To complete a two-year audit focusing on the delivery of ACS service across NHS GGC and GNJH

• To identify gaps in existing data and seek solutions to improve the completeness of the data set

• To conduct further research to inform ACS patient outcomes and characteristics which can be used to directly impact patient care

• To secure support for the ongoing development of the e-registry

• To gain and share key learnings for transferring the ACS e-registry to other health boards

Veeva: GB-8830 | Date of preparation: June 2018

The Steps TakenThe ACS Registry 2 focuses on demonstrating that a register can be created in NHS Scotland to provide data for the MINAP audit that can be automatically generated and give accurate information about the overall management of ACS.

The project involves the following:

• Data extraction and anonymisation from NHS GGC as well as other healthcare providers

• Transfer of the data to AstraZeneca for analysis• Delivery of an audit report by AstraZeneca• Recruitment of a PhD student to deliver enhanced

e-registry and epidemiological research

AstraZeneca has provided 68% of funding for a PhD student as well as dedicated support for project management and real-world evidence lead input. NHS Greater Glasgow & Clyde has provided clinical leadership via Dr Iain Findlay, project planning and support via the managed clinical network (MCN), data governance support via NHS GGC Safe Haven and IT support for the data extraction. The GJNH has provided clinical leadership via Prof Colin Berry and IT support for data extraction. The University of Glasgow has provided 32% of the funding for a PhD student as well as supervision and sponsorship of the PhD student days. The Scottish Ambulance Service has provided project support.

What We Expect to AcheiveIt is planned that the dataset generated from this project will provide a dedicated resource for the research community and the opportunity to provide feedback to the NHS in near-real time about their service delivery and outcomes.

Patient benefitsThe main project aim is to reduce overall mortality for patients with CHD throughout Scotland. The development of meaningful data will lead to the reduction of variation in service delivery and improved patient experience and outcome.

Ongoing databaseThe key to maintaining improved patient experience and outcomes for GGC and GJNH is to ensure a continuously updated and timely database of ACS patients which can be updated automatically, without manual input, and is accessible to clinical staff.

e-RegistriesThe future of data management in the healthcare sector is likely to be through e-registries. This project will provide new insight into data science techniques and show that the ACS registry can track patients, their status and their medications in order to collate data which will be analysed to better influence and shape patient outcomes.

National ProgrammeThe other key outcome is the development of a functional database and analysis system that provides a template for one which could be rolled out as a service across Scotland’s 14 health boards to help ACS patient management.