University Hospital Southampton NHS Foundation Trust

SDE_W_PROJ_82

People who live with several long-term health conditions, are frail, or have reduced fitness are more likely to have complications after surgery. Spotting who is most at risk early gives doctors and patients a chance to prepare, make shared decisions and plan the best treatment. At University Hospital Southampton (UHS), patients referred for surgery complete a health questionnaire through a secure online system called My Medical Record (MyMR). This helps doctors understand each patient’s health before surgery and offer support to improve their fitness. These patients are then followed throughout their surgical journey and recovery as part of the Fit4Surgery programme. Fit4Surgery already collects a lot of useful information, but it doesn’t always capture how living with multiple health conditions feels from the patient’s point of view. The NIHR MELD-B project has created a system called the Biomedical Burden Ontology (BBO). This uses computers to explore the experience and challenges patients face when living with multiple conditions, across eight areas: • Symptoms • Emotional wellbeing • Dealing with health services and administration • Managing medication • Financial challenges • Learning and adapting to illness • Tests and monitoring • The overall complexity of managing care This new way of thinking about health puts the patient experience at the centre of care planning. The system was developed using general practice (GP) health records but has never been used to understand the experience of patients having surgery. Our goal is to bring this system into the Fit4Surgery programme, linking it with information from GP records so that doctors can see a complete, accurate picture of a person’s health. This will help us understand how the tool works in patients having surgery. Once tested the tool will provide more information on patient experience. We hope this will help us spot patients who may require extra support and help future research use this information safely to support better care for patients across the NHS.

In this study we aim to utilise linked primary and secondary care records to better understand biomedical burden in patients undergoing surgery. We will clinically validate and refine the BBO to support perioperative risk decisions. We will validate the MyMR screening questionnaire and compare conventional approaches to perioperative risk assessment with the BBO. This will be achieved by establishing a procedure to semantically enrich patient data using linked primary (GPs referring to UHS) and secondary care (UHSFT Fit4Surgery) data. The integration of these linked datasets will facilitate a more comprehensive understanding of biomedical burden and its implications on patient outcomes in perioperative care. The pilot will act as a blueprint for scaling primary care linkages regionally and nationally.

25/07/2025

TRE