Digital Health Informatics: Reducing Wait Times, Saving Lives through Data-Led Prioritisation at the Guy’s and St Thomas’ NHS Foundation Trust

The case examines how Guy’s and St Thomas’ NHS Foundation Trust partnered with analytics company Factor 50 to address lengthening hospital waiting lists and medical backlogs exacerbated by Covid-19. Together they developed a data-led prioritisation (DLP) system. The first pilot focused on diabetes patients, seeking to identify people most at risk of deterioration while awaiting care. Using clinical data and risk stratification, the system helped prioritise medical appointments for high-risk patients, while lower-risk patients were redirected to pathways such as patient-initiated follow-up (PIFU). The pilot also exposed a problem – hitherto hidden – of health inequality: a disproportionate number of patients at highest risk came from deprived communities and ethnic minorities, reaffirming the so-called inverse care law.
The case highlights how digital health innovations can improve efficiency and help address inequality, as well as the challenges to be overcome – e.g., scaling up, integrating with existing electronic health records, getting doctors to adopt a data-driven approach. It thus serves to underline the complexity of embedding systemic change in the UK’s National Health Service (NHS).

1. Understand challenges in the health system: how resource constraints, unforeseen disruptions (such as Covid) and increasing demand have created significant backlogs in the NHS and other public health systems.
2. Address inequality of access to health care: how a data-driven approach highlighted and reduced systemic inequality of access, particularly for patients from deprived communities and ethnic minorities.
3. Evaluate digital transformation in health care: the opportunities and limitations of data-driven tools (such as Data-Led Prioritisation) in improving efficiency, reducing wait times, and reallocating scarce clinical resources.
4. Explore innovation and implementation trade-offs: the barriers to adopting digital health solutions, such as integration with legacy systems (EPIC), getting doctors to buy in, organisational culture, and regulatory complexity.
5. Analyse scalability and sustainability: how pilot projects can be scaled across the NHS (or other health system), seeking to balance efficiency and cost.
6. Examine public-private partnerships.