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One of the most important advances to emerge from the covid-19 pandemic is the ability to measure population health at unprecedented scale and speed. Our study of time trends for long term conditions, published in The BMJ (doi:10.1136/bmj-2025-086393),1 shows how electronic health record data routinely captured across primary and secondary care can reveal dynamic changes in disease patterns as they occur. The wider opportunities extend far beyond the pandemic, with implications for public health surveillance, research, and healthcare delivery.