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Open AccessArticle

Identifying Veterans Using Electronic Health Records in the United Kingdom: A Feasibility Study

1
King’s Centre for Military Health Research, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
2
Combat Stress, Tyrwhitt House, Oaklawn Road, Leatherhead KT22 0BX, UK
3
Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK
4
Academic Department of Military Mental Health, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
*
Author to whom correspondence should be addressed.
Joint first author.
Joint last author.
Healthcare 2020, 8(1), 1; https://doi.org/10.3390/healthcare8010001
Received: 25 October 2019 / Revised: 16 December 2019 / Accepted: 17 December 2019 / Published: 19 December 2019
(This article belongs to the Section Health Informatics and Big Data)
There is a lack of quantitative evidence concerning UK (United Kingdom) Armed Forces (AF) veterans who access secondary mental health care services—specialist care often delivered in high intensity therapeutic clinics or hospitals—for their mental health difficulties. The current study aimed to investigate the utility and feasibility of identifying veterans accessing secondary mental health care services using National Health Service (NHS) electronic health records (EHRs) in the UK. Veterans were manually identified using the Clinical Record Interactive Search (CRIS) system—a database holding secondary mental health care EHRs for an NHS Trust in the UK. We systematically and manually searched CRIS for veterans, by applying a military-related key word search strategy to the free-text clinical notes completed by clinicians. Relevant data on veterans’ socio-demographic characteristics, mental disorder diagnoses and treatment pathways through care were extracted for analysis. This study showed that it is feasible, although time consuming, to identify veterans through CRIS. Using the military-related key word search strategy identified 1600 potential veteran records. Following manual review, 693 (43.3%) of these records were verified as “probable” veterans and used for analysis. They had a median age of 74 years (interquartile range (IQR): 53–86); the majority were male (90.8%) and lived alone (38.0%). The most common mental diagnoses overall were depressive disorders (22.9%), followed by alcohol use disorders (10.5%). Differences in care pathways were observed between pre and post national service (NS) era veterans. This feasibility study represents a first step in showing that it is possible to identify veterans through free-text clinical notes. It is also the first to compare veterans from pre and post NS era. View Full-Text
Keywords: electronic health records; mental health; secondary mental health care; national health service; United Kingdom; veterans; feasibility study electronic health records; mental health; secondary mental health care; national health service; United Kingdom; veterans; feasibility study
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M. Mark, K.; Leightley, D.; Pernet, D.; Murphy, D.; Stevelink, S.A.; T. Fear, N. Identifying Veterans Using Electronic Health Records in the United Kingdom: A Feasibility Study. Healthcare 2020, 8, 1.

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