For this term’s "spotlight interview" with the Undergraduate Teaching Team, Simon de Lusignan (Professor of Primary Care and Clinical Informatics) talks computers, COVID and careers in primary care research.
Tell us about your journey into primary care research
I was a full-time GP for eight years before I got involved in anything academic. My journey started through developing a computer system for Primary Care in the late 1980s. This was a system ahead of its time – built in Windows 2 – a “GUI” (graphical user interface) when the other computerised medial record systems were still “CHUI “(character user interface), nearly entirely navigated by the keyboard!
My practice was a teaching practice for St George’s and the Head of Department visited! A few weeks later I was offered a part time job: “Simon, I think computers are going to be big in medicine.” I had beginner’s luck with my first three grants and a paper in the BMJ, good fortune that has not necessarily followed on with subsequent submissions… though I ended up as Head of Primary Care at St George’s. Subsequently, the University of Surrey made me an offer I could not refuse, then the opportunity came to move to Oxford.
What are the main areas of interest for your group at the moment?
My research group is called the Clinical Informatics and Health Outcomes Research Group and we have been at the forefront of COVID-19 surveillance and research, working closely with Public Health England and other collaborators (www.phc.ox.ac.uk/research/clinical-informatics-and-health-outcomes).
We are fascinated by the challenge of how to infer meaning from routine clinical data. We have recently taken on three GPs to help us ensure our assumptions about data are spot on. We are also interested in how new roles and training can be enabled by technology, and the barriers to integrating technology into clinical practice.
Much of our work is with routine data and I incorporate into my post the Directorship of the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC). If any readers’ practices are not a member of the network, please do consider it. (More information at: www.rcgp.org.uk/rsc).
The surveillance network has expanded enormously in Oxford and includes the capability to support research studies and trials, we now have over 1,800 practices signed up and willing to share data. My personal view is that the future of data sharing is bottom-up and professionally led. We are using a new name for this expanded resource, “ORCHID” (Oxford-RCGP Clinical Informatics Digital Hub - https://orchid.phc.ox.ac.uk/).
My research group also has an interest in soft robotics and we are currently working on an abdomen (with haptic feedback) for teaching palpation, which even has a face that gives feedback if you cause pain! If any GP tutor colleagues are interested in seeing this, I can bring it to the Department on Tuesday 27 July – though probably only one socially distanced colleague per hour. Please let Jolanta know by emailing firstname.lastname@example.org.
How does your work as a researcher impact on your clinical practice?
I have been at the same general practice in Guildford since qualifying as a GP. And, I think my experience in practice impacts more on my academic work than the other way round. Without a working understanding of QOF and knowing that acronyms like ARRS (Additional Roles Reimbursement Scheme) are not a joke, it would be much more challenging to interpret routine data. My colleagues give excellent feedback about what will and won’t work.
How do you involve medical students in the work of your research group?
We are delighted to have students who love data come and work with the group over the summer. We had a very successful student from Cambridge last summer who worked really hard setting up and then seeing through two publications from his attachment. One on shielding was in the Journal of Infection (https://doi.org/10.1016/j.jinf.2021.04.033 ), the other on antibody tests in BJGP (https://doi.org/10.3399/bjgp21X715169 )
What advice would you give GPs who are interested in embarking on primary care research?
The key is to get involved in something you really, really, really enjoy. For me this is key, as the research world is quite competitive and if you are getting paid to do things you love doing, what more could you ask! Finding a great supervisor and getting involved with an excellent department (like this one) is also sensible as it will help you build your academic CV.