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NHS could save millions by switching to open-source software ‘R’


Advanced medical diagnostic equipment

The NHS could save millions of pounds - and remain ‘data secure’ - by switching to open-source software known as ‘R’ - that’s according to a University of Bradford academic.

Professor Mohammed Amin Mohammed is founder and principal consultant of the NHS R-community, which has just been highlighted by the Goldacre Review, which looks at improving safety and security in the use of health service data.

Professor Mohammed says: “R is already used by companies and organisations such as Google, Microsoft, Lloyds bank, the BBC, the pharmaceutical and automotive industry, academia and many others in the private sector. Why? Because It’s powerful, versatile, supported by a vibrant worldwide community, driven by experts and it is open and free to all.

“If the NHS is to be fit for the 21st Century, it needs to transition to an open-source software model such as R. At the moment, the NHS relies heavily on licensed software but these are often very expensive, come with expensive training courses, offer limited support, and involve restrictions that prohibit sharing and learning. If the NHS was to transition to using R, there is the potential to save millions of pounds in licence fees, and training and support - because these would essentially be free. It would also enable the NHS to unlock the power of big data.”

He added: “To draw an analogy, Microsoft developed a high quality multimedia encyclopaedia called Encarta in 1993 but discontinued it in 2009 because it was eclipsed by Wikipedia. R is like Wikipedia when it comes to data science solutions - it’s open, crowd-sourced and not owned by any private corporation.”

The Goldacre Review

The Goldacre Review was commissioned by the Secretary of State for Health and Care, and will be responded to in the forthcoming Data Strategy for Health and Social Care, which sets the direction for the use of data in a post-pandemic healthcare system. The Review states: “In keeping with the aim of the Advanced Analytics programme to improve analytical capability across the health and care system, those running the NHS-R community (led by Mohammed A Mohammed, Professor, University of Bradford and Principal Consultant at the Strategy Unit) aim to promote and enable the use of R in the NHS to improve data analysis and develop shared solutions to common analytic challenges.”

It also states: “Modern open working methods can avoid duplicated effort, and drive efficient delivery. The NHS has already collected unparalleled lifetimes of data, from tens of millions of patients, in thousands of organisations, over endless decades of effort. Secure platforms can be built for less than the cost of digitising one hospital. If this job is done well, then the system can finally unleash the full power of all NHS data ever collected, in one fell swoop.”

Student nurses practising triage

NHS-R Community

The NHS-R community began in 2018 with funding from the Health Foundation and now attracts over 1,000 people to its annual NHS-R conference with speakers from all over the world. The NHS-R Community is free to join and open to all including members of the public and patients.

Professor Mohammed says: “The meteoric rise of NHS-R is a testimony to the amazing people in the NHS-R Community, who volunteer their time, skills and expertise to develop open source R solutions for the NHS.”

Why data is the new oil of the digital economy

Professor Mohammed says big data can be used to streamline and improve some health services - a good example is the University-run CARSs* system, which has the ability to take data such as blood type, age, sex and other information to make a prediction about the likelihood of patient mortality. It is estimated that 10,000 sepsis-related deaths per year could be prevented if such care systems were automated.

“The NHS is one of the largest and best healthcare systems in the world. It was launched in 1948 with the guiding principle of being free at the point of delivery – a kind of crowd funded open-source freeware equivalent of healthcare. More than half of the public say the NHS is what makes them most proud to be British, placing it above the armed forces, the Royal Family, Team GB, and the BBC. The NHS in England deals with about one million people every 36 hours and is continually generating vast amounts of data about the health and care of people.

“This data is one of the most precious, yet under-tapped, resources in the NHS. Data is the new oil of the digital economy and drilling and mining NHS data could improve the NHS. But mining these mountains of data is a colossal task. This is where R comes in. R was conceived in 1992 as a free open-source statistical programming environment, which is now widely used in industry. But its use in the NHS is scant. The absence of R at scale in the NHS, means that the NHS is unable to take advantage of the huge benefits of R, including cutting-edge visualisation and statistical tools, and a worldwide R community, which freely shares learning and resources.

“R software could be used automate many aspects of the business of healthcare including automation of repetitive tasks such as letters to patients, board reports, performance dashboards, and to use machine learning and AI to create new statistical models based on the vast amount of data available to the NHS to support clinical and non-clinical decision making in the NHS. There have been concerns about the security of data but these are mostly red herrings, because as I said, many large organisations already use R, including the government, so it can be engineered to be secure."

*CARSs: Computer Aided Risk Scores System.