Professor Aileen Keel
Director, Innovative Healthcare Delivery Programme, University of Edinburgh
Tell us about your background and your journey to your current role.
My clinical background is in haematology, and until 2017 I was still doing a weekly clinic. However, since 1992, my main job has been as a medical civil servant in Scottish Government. I was first appointed as a Senior Medical Officer and worked my way up through the ranks. In 1999 I was appointed Deputy Chief Medical Officer (DCMO) for Scotland, a post I held until May 2015 (including a year as acting Chief Medical Officer). As DCMO, my portfolio covered (amongst many other areas!) cancer, and I’ve been chair of the Scottish Cancer Taskforce for many years. During that time, I have been constantly struck by the volume of cancer data collected by the NHS, but the enormous difficulties (both technical and organisational) which lie in the way of using that data to improve patient outcomes. Add to that the fact that Scotland’s cancer outcomes are worse than those in the rest of the UK and other comparable northern European countries, and there was a strong motivation for me to become more deeply involved in trying to improve cancer data structures and access.
In 2015 the opportunity arose for secondment to UoE to focus on pursuing this goal, and I was appointed Director of the Innovative Healthcare Delivery Programme, which aims to harness the power of informatics to deliver value rapidly to patients, health care professionals and the wider NHS through collaboration with academia, industry and the third sector. There are seven of us on the IHDP team (bringing together clinical, technical, admin and third sector expertise), and our first priority has been to develop a Scottish Cancer Intelligence Framework (SCIF), linking primary, secondary, and ultimately social care data to improve patient outcomes. The backbone of the SCIF is the Scottish Cancer Registry, which has undergone a fundamental independent review, commissioned by IHD. The report of that review has now been implemented jointly by IHDP and colleagues in National Services Scotland (NSS), and the registry now includes greatly enhanced data content, with the ability to link to all of the centrally held datasets in ISD. Those linkages are being achieved through the use of an innovative (at least in terms of NHS application) technique called data virtualisation (DV). DV is a novel approach to data integration, where silos of data can be integrated without moving or duplicating the data – DV presents the data as a virtual layer which is independent of the underlying system, and removes the need to develop technical interfaces between different systems.
IHDP is tasked with applying the approach it’s taken to linking cancer data to other areas in due course, to avoid reinvention of the wheel and demonstrate that we’re part of a Learning Health Service. We’ve already begun this by working with NSS colleagues to use DV to link data on rare diseases, starting with building a Congenital Anomalies Register for Scotland.
What does a typical day at work look like for you?
No such thing! The only fixed diary point is our weekly IHDP team meeting. We all spend a lot of time making connections and bringing people together to further the Programme’s aims, be that from the NHS (clinical and eHealth), academia, industry or the third sector – I describe IHDP as a kind of dating agency! I also have a number of ongoing Scottish Government functions, including chairing the Cancer Taskforce, so still spend quite a lot of time with colleagues in St Andrews House.
Do you have a vision for the Data-Driven Innovation programme?
My vision for the DDI programme at the university is that data can be accessed (and therefore used) more easily than is often the case at present, and that this will translate into benefits not just to academia, but to the population of the city and the wider region. Before this happens, the current problems with information governance will have to be resolved, and public “buy in” to potentially innovative uses of their data will have to be achieved.
What are you particularly passionate about in your work?
I’m very lucky indeed to be doing a job that greatly interests me. As a clinician, my main motivation has always been to improve patient care and outcomes, and this hasn’t changed. In my current post, I’m most proud of the fact that IHDP has produced some concrete outputs over the past four years in terms of making cancer data more accessible and joined up. That in itself will not be enough to improve outcomes, but it seems a fairly fundamental starting point to be able to use data to benchmark services and measure improvement. Building the technical infrastructure is the “easy” part. Much more effort needs to expended on ensuring uptake of new systems, which can mean tackling underlying cultural barriers to adoption, particularly within the NHS. That’s why we’re now embarked on a systematic comms and engagement programme, to ensure that the cancer community is fully aware of the potential benefits of SCRIS and the wider cancer intelligence framework, and that everyone is plugged in!
Can you tell us about any interesting data sets or analysis techniques you are working with?
The datasets we’re working with in cancer are all of interest in terms of outcomes, and the ability to link these using the technique of Data Virtualisation I’ve described above is very exciting. The new SCRIS can link to all of the centrally held data sets in ISD, so co-morbidiities (which of course greatly affect outcomes) can easily be linked to the cancer data. The potential for these linked datasets to answer previously unanswered questions is obvious, and the new “wrap around” Intelligence Service associated with the Cancer Registry will be a great asset in terms of doing just that.
What challenges remain for women and girls in the data science scene, and related fields?
I feel a little under qualified to answer this, being a late arrival on the data scene! At a more generic level, clearly there are significant challenges to women making equal progress in their careers, particularly in STEM subjects.
I don’t know what the answer is, but the more flexible approaches now being pursued to career pathways seems to be a good thing. In medicine, it’s interesting that many more men are now choosing to pursue their careers on a part time basis. If this means that they share more of the domestic responsibilities, in theory at least that should make it possible for their wives/partners to deal more easily with the challenges they face in juggling job and family……
Is there anything you would recommend to women and girls who would like to do what you are?
Given my somewhat unorthodox journey to my current role, this is a difficult one! In any case, there’s no one path to working with data. In general terms, a bit of dogged determination and enthusiasm is always useful, and grabbing opportunities as they arise!
Do you have a fun fact you’d like to share?
I used to play in the Scottish Fiddle Orchestra!
Do you have any heroes or heroines?
One of my heroes is Sir David Carter, previously Regius Professor of Surgery at UoE, and then CMO Scotland. I learned a great deal about how to handle tricky people and meetings from him – to say nothing about staying calm in the eye of the potential political storm!
What does the future hold – what do you look forward to in your work?
Consolidating what we’ve already achieved, and ensuring widespread adoption of what we’ve developed, particularly SCRIS. I look forward to ongoing collaboration with colleagues across the NHS and academia, including the new National Digital Platform (NDP) based in NHS Education for Scotland (NES). There will be lots of innovative opportunities arising from the NDP and IHDP is well placed to take full advantage of them.
I’m most proud of the fact that IHDP have produced concrete outputs in terms of making cancer data more accessible and joined up.