4S DAWN and AHSNs have been working together to broaden access to key TTR data and improve the management of Atrial Fibrillation nationwide.

For the past two years, Academic Health Science Networks (AHSNs) and Public Health England (PHE) have been working to expand access to key healthcare datasets that allow evaluation of the patient care pathway for Atrial Fibrillation (AF). Through the AF Landscape Tool, data from diagnosis and management in primary practice is integrated with stroke outcomes in secondary care. This tool has enabled the identification of specific local opportunities to better DETECT AF and PROTECT patients from AF-related stroke using appropriate anticoagulation. Access to Time in Therapeutic Range (TTR) data could provide a clear picture of efficacy and safety for anticoagulant regimes and reveal opportunities to CORRECT therapeutic management in high-risk AF patients. Although NICE CG180 guidelines provide recommendations for tracking TTR in patients receiving a vitamin K antagonist, there is currently no mechanism for these data to be publicly reported.

4S DAWN has many years of experience helping anticoagulation services to track and review their TTR data. The DAWN anticoagulation software helps users to assess therapeutic efficacy, review adherence, and closely monitor patient safety, including bleeds. The reporting system also offers the opportunity to benchmark, not just against other services in the UK, but at an international level, in comparison with major treatment centres in the US and Canada.

Recognising an opportunity to share their expertise with the AF Data Landscape project, the DAWN team became enthusiastic collaborators in this nationally important initiative. Agreements were put in place, which encouraged collaboration and information sharing between anticoagulation services, in return offering them a broader perspective on opportunities to improve standards of care.

Initial collaborations with the Innovation Agency (North West Coast) and Greater Manchester (GM) AHSNs have already achieved access to 50,000 patients’ TTR data, and discussions with North East and North Cumbria (NENC AHSN) are in progress. Work is ongoing to deliver similar results elsewhere in the UK, including a new collaboration with Imperial College Health Partners. The AF Landscape Tool will soon incorporate full reporting on currently available TTR data, with the ambition of gaining access to data from across the country. Bridging this key data gap will mark a significant step towards helping to improve the quality of patient care in AF across England.