The importance of analysing health data collected as part of clinical care and stored in electronic health records is well-established. This has led to vital research about the occurrence and progression of disease, treatment effectiveness and safety, and health service delivery. The current Covid-19 pandemic has demonstrated the public health need to efficiently use data collected at the point of care to rapidly understand patterns, risk factors and outcomes of emerging diseases. Much of this work comes from primary care electronic health records, where general practitioners (GPs) enter and use structured, coded healthcare data. The picture in hospitals, however, is very different. One in four people in the UK live with one or more long-term conditions like cardiovascular diseases, chronic respiratory diseases, type 2 diabetes, arthritis and cancer, which account for 70% of the NHS budget. Specialised opinion about management of long-term conditions (LTCs) is provided through hospital outpatient care. Data and insight from outpatient clinics, however, is almost entirely absent. There is, surprisingly, no national system for recording diagnoses in hospital outpatient clinics. Information about key clinical events is instead recorded in outpatient letters, which are primarily used to communicate with patients and GPs. The ways in which letters are written and their sensitive content mean that they are not available for larger-scale "secondary use", i.e. to support clinical practice, research or service improvement. For example, shielding for the current pandemic relied on hospital clinical teams going through patient letters manually to identify those who needed shielding based on free-text information about diagnoses and medications, with clear time constraints and risks to under- and over-shield patients. Natural language processing (NLP) and text mining develop computer algorithms to automatically extract relevant information from free-text documents. This project will establish a partnership between academia, secondary care and industry to develop a standards-based information management framework to safely unlock information stored in outpatient letters, link it with other health data and demonstrate its impact and benefits through two case studies. We will develop new methods to extract key clinical events from letters and represent their details (e.g. medication used, duration of symptoms) in a computerised form so that it can be easily accessed. In doing so, we will use the NHS-adopted standards so that the outpatient letters can be linked to other hospital databases and do not live in their own silo. The protection of sensitive data that potentially appear in outpatient data is a prime concern, so we will develop clear rules on who and how can access such data, in particular considering that third parties (e.g. industry) may need to access that data for developing their tools. These rules will be developed in a close collaboration between patient representatives, clinicians and specialists to ensure safeguards, public trust and transparency of decision making. We will demonstrate the potential impact of the proposed methods through two case studies with our clinical and business partners. Our first case study will demonstrate how the proposed models can assist in timely, efficient, dynamic and transparent identification of patients for shielding in a pandemic, or for vaccination prioritisation. In the second case study, we will illustrate how the same information can be used address important gaps in our knowledge about health and care, including, for example, disease prevalence and drug utilisation patterns. All outputs will be developed in a way that can be scaled beyond the single clinical site and single speciality.

DRIVE-Health will train a minimum of 85 PhD health data scientists and engineers with the skills to deliver data-driven, personalised, sustainable healthcare for 2027 and beyond. Co-created with the NHS Trusts, healthcare providers, patients, healthtech, pharma, charities and health data stakeholders in the UK and internationally, it will build on the successes of its King's College London seed-funded and industry-leveraged pilot. Led by an established team, further growing the network of funding partners and collaborators built over the past four years, it will leverage an additional £1.45 of investment from King's and partners for every £1 invested by EPSRC. A CDT in data driven health is needed to deliver the EPSRC Priority for Transforming Health and Healthcare, EPSRC Health Technologies Strategy, and on challenges laid out in the UK Government's 2022 Plan for Digital Health and Social Care envisaging lifelong, joined-up health and care records, digitally-supported diagnoses and therapies, increasing access to NHS services through digital channels, and scaling up digital health self-help. This ambition is made possible by the increasing availability of real-world routine healthcare data (e.g. electronic health care record, prescriptions, scans) and non-healthcare sources (e.g. environmental, retail, insurance, consumer wearable devices) and the extraordinary advances in computational power and methods required to process it, which includes significant innovations in health informatics, data capture and curation, knowledge representation, machine learning and analytics. However, for these technological and data advances to deliver their full potential, we need to think imaginatively about how to re-engineer the processes, systems, and organisations that currently underpin the delivery of healthcare. We need to address challenges including transformation of the quality, speed and scale of multidisciplinary collaborations, and trusted systems that will facilitate adoption by people. This will require a new generation of scientists and engineers who combine technical knowledge with an understanding of how to design effective solutions and how to work with patients and professionals to deliver transformational change. DRIVE-Health's unique cohort-based doctoral research and training ecosystem, embedded across partner organisations, will equip students with specialist skills in five scientific themes co-produced with our partners and current students: (T1) Sustainable Healthcare Data Systems Engineering investigates methods and frameworks for developing scalable, integrated and secure data-driven software systems (T2) Multimodal Patient Data Streams will enable the vision of a highly heterogeneous data environment where device data from wearables, patient-generated content and structured/unstructured information from electronic health records can combine seamlessly (T3) Complex Simulations and Digital Twins focuses on the paradigm of building simulated environments, including healthcare settings or virtual patients, to make step-change advances in individual predictive models and to inform clinical and organisational decision-making. (T4) Trusted Next-Generation Clinical User Interfaces will place usability front and centre to ensure health data science applications are usable in clinical settings and are aligned with users' workflows (T5) Co-designing Impactful Healthcare Solutions, is a cross-cutting theme that ensures co-production and co-design in the context of health data science, engagement with stakeholders, evaluation techniques and achieving maximum impact. The theme training will be complemented with a cohort and programme-wide approach to personal, career, professional and leadership development. Students will be trained by an expert pool of 60+ supervisors from KCL and across partners, delivering outstanding supervision, student mentoring, opportunities, research quality and impact.