Poster Presentations


P-25: Using electronic medical record data to better understand and provide quality care for patient populations

Ms. Lindsay Donaldson

Alexandra Piatkowski*,
Billy Bostad*,
Michelle Cousins,
Sunny Ng,
Dr. Mohamed Alarakhia,
Kathryn Flanigan,
Jillian Bauer,
Barb Lather,
Dr. Ambreen Moazzam,
Debi Page,
Dr. Kirk Hollohan

eHealth Centre of Excellence
Benefits Realization

Topic: Knowledge Translation, Health Services, eHealth

Background
Adoption of electronic medical records (EMRs) in Canada has risen in recent years and evidence suggests that EMRs support clinicians in providing quality care. There is, however, opportunity for primary care organizations to gain additional value from these investments by using the data stored within their EMRs to help manage and provide better care to their patients.

Objectives
The objective of this presentation is to demonstrate how coded EMR data can be used to enable clinical and organizational value for primary care providers and their patients.

Description
Research on the value of coded EMR data for primary care was facilitated through the connecting South West Ontario (cSWO) Program’s Primary Care Data Sharing (PCDS) Project; a Proof of Concept (POC) project funded by eHealth Ontario and developed and implemented in partnership with  OntarioMD and the Ministry of Health and Long-Term Care. The Project, led by the eHealth Centre of Excellence (eCE) in its role as the cSWO Change Management & Adoption Delivery Partner in the Waterloo Wellington Local Health Integration Network (WWLHIN) involved the participation of four primary care organizations in south west Ontario in data quality improvement initiatives. Data quality was assessed before and after these initiatives, using chart review and a survey. Initiatives involved back-coding EMR data and ensuring it was up-to-date. The eCE consulted with program managers and clinicians to explore how improved data quality could generate value for each organization, and is developing case studies to demonstrate this value to clinicians.

Results
Improvements in EMR data quality made it possible to:

  1. Generate patient population searches to identify groups of patients with a particular risk factor (i.e. smoking) or condition (i.e. chronic obstructive pulmonary disease or asthma), eligible for condition-specific interventions (i.e. spirometry testing and smoking cessation interventions). This facilitated best practice diagnosis and the provision of preventative care interventions.
  2. Generate patient lists for particular conditions and aggregate the data to display the prevalence of chronic conditions in a clinic. This allowed clinics to better understand their patient population and to allocate resources to where they would have the most impact.
  3. Develop an EMR search that identifies complex patients (i.e. those who are 55 years of age or older, have four or more chronic conditions, and are taking five or more medications). Clinicians were able to use these searches to proactively care for their cohort of complex patients by initiating referrals to Health Links and/or conducting medication reconciliations.


Conclusions
In preparation for the widespread sharing of primary care EMR data, the PCDS project has demonstrated value for clinicians and patients within primary care by investing in data quality improvements. When EMR data is up-to-date and coded, practices can identify and mobilize to care for specific patient populations. While the initial phases of this initiative show promise in achieving more proactive primary care, there is cause for further optimism when high-quality data is shared along the care continuum to support improved care continuity around the broader circle of care.