Researchers develop new tool to identify veterans in secondary healthcare services
A new research report has been published by King's College London and Forces in Mind Trust.
A new automated tool known as the Military Service Identification Tool (MSIT) has been developed by researchers at the King’s Centre for Military Health Research (KCMHR), part of King’s College London, and has been found to successfully identify veterans in electronic healthcare records.
Veteran status is not consistently recorded in healthcare records, making it difficult for clinicians to recognise if someone ever served in the military, whether military-related factors may be relevant to their healthcare, and if they could be entitled to military-specific support. Recording veteran status is also important for researchers to study the health needs of this population.
The Military Service Identification Tool uses machine learning to analyse healthcare records and using the text in those records to make a prediction on whether the patient has ever served in the military.
The Military Service Identification Tool was successful in accurately identifying veterans from the healthcare records of a specific secondary mental healthcare service – South London and Maudsley (SLaM) NHS Foundation Trust. Data was rigorously analysed by checking the tool’s predictions against clinical records and by asking patients themselves for their veteran/civilian status. When asking patients themselves, 84% were accurately classified as having military experience. Researchers found the tool to be substantially more accurate and less time-intensive than other possible approaches, like using military keywords in a simple manual search.
The tool is available for researchers and NHS trusts for further testing and development across other parts of the health service, with the code available in the report. Doing so will provide a better picture of veterans’ health and will help policy-makers, commissioners and other stakeholders ensure the health and support services provided to veterans are appropriate.
Use of the Military Service Identification Tool allowed the researchers to identify and then compare individuals with a military background to those without. They found that veterans accessing SLaM’s mental health services were more likely to have diagnoses of depressive, anxiety, stress, personality and psychotic disorders compared to those without military experience, and veterans were more likely to be detained under the Mental Health Act. The researchers urged caution in generalising these emerging findings, as they are specific to those accessing SLaM services and require further investigation.
Treatment pathways of SLaM patients could not be explored due to a large volume of missing data within healthcare records. Other recent research identifies similar gaps, with many healthcare and support organisations calling for improvements and consistency in data collection. The researchers advocate for veteran status to be more widely recorded, as findings suggest that they may demonstrate different health needs from the general population.
Tom McBarnet, Chief Executive (Acting) of Forces in Mind Trust, said “This tool represents a large saving in human resources, cost and time required to identify veterans using healthcare services.
“There is a clear need for healthcare services that are designed to best meet the sometimes unique health and care needs of ex-Service personnel and their families. There must be sufficient expertise, awareness and understanding of the ex-Service community and their physical and mental health needs, and that these are taken into account in any healthcare provision wherever it is delivered. The Government’s Veterans’ Strategy Action Plan recognises that there is a lack of data which hampers efforts to provide for the needs of ex-Service personnel in our healthcare systems. This research adds to the body of evidence which has identified this issue, but it also points to a possible solution.
“More work is clearly needed to improve veteran health data capture, but this is a really important step.”
Dr Laura Palmer, a researcher and lecturer at KCHMR, said “By helping us identify veterans in electronic healthcare records, the Military Service Identification Tool can open doors to previously unexplored datasets. This will help researchers address the ever-present question of whether individuals with military experiences are similar or different to those without, and whether different treatment approaches are warranted”.
Professor Rob Stewart, Academic Lead for the Maudsley’s Clinical Record Interactive Search (CRIS) platform, said “The Military Service Identification Tool is a useful innovation that solves the lack of marker for veteran status, and will allow a better understanding of why and how veterans use healthcare services in the NHS”.
The research was led by the King’s Centre for Military Health Research at King’s College London and Combat Stress, and was funded by Forces in Mind Trust.
You can download the full report here.
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Notes to Editors
About Forces in Mind Trust (FiMT)
Forces in Mind Trust was founded in 2011 with a £35 million endowment from the National Lottery Community Fund to improve transition to civilian life for Service leavers and their families. Our mission is to enable successful and sustainable transition to civilian life, and the Trust’s strategy is to provide an evidence base that will influence and underpin effective policy making and practice. By funding high quality, credible research where there is an identified gap in relevant understanding, and by then exploiting the findings, FiMT aims to effect positive change.
www.fim-trust.org | @FiMTrust
About King’s College London and the Institute of Psychiatry, Psychology & Neuroscience
King’s College London is one of the top 35 universities in the world and one of the top 10 in Europe (QS World University Rankings, 2021/22) and among the oldest in England. King’s has more than 33,000 students (including more than 12,800 postgraduates) from over 150 countries worldwide, and 8,500 staff. King’s has an outstanding reputation for world-class teaching and cutting-edge research.
The Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s is the premier centre for mental health and neurosciences research in Europe. It produces more highly cited outputs (top 1% citations) on psychiatry and mental health than any other centre (SciVal 2021), and on this metric has risen from 16th (2014) to 4th (2021) in the world for highly cited neuroscience outputs. In the 2021 Research Excellence Framework (REF), 90% of research at the IoPPN was deemed ‘world leading’ or ‘internationally excellent’ (3* and 4*). World-leading research from the IoPPN has made, and continues to make, an impact on how we understand, prevent and treat mental illness, neurological conditions, and other conditions that affect the brain.
www.kcl.ac.uk/ioppn | Follow @KingsIoPPN on Twitter, Instagram, Facebook and LinkedIn
About Combat Stress
Combat Stress is the UK’s leading charity for veterans’ mental health. For 100 years we’ve helped former servicemen and women deal with trauma-related mental health problems such as anxiety, depression and post-traumatic stress disorder.
Our services have constantly evolved to best meet the needs of the veterans who seek our help. No one else does what we do. We are the only organisation in the UK that specialises in veterans with complex mental health needs. Our unique specialist services are life-changing and often lifesaving, helping veterans tackle the past and take on the future.
Find out more at combatstress.org.uk.