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M. Cousins



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    OS05 - Accessing Connected Data - Front Line (ID 4)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS05.04 - Recommendations to Inform the Provincial Primary Care Data Sharing Strategy (ID 498)

      M. Cousins, The eHealth Centre of Excellence; Waterloo/CA

      • Abstract
      • Slides

      Purpose/Objectives: The connecting South West Ontario Program’s Primary Care Data Sharing Proof of Concept (PCDS POC) project, funded by eHealth Ontario, is enabling a sub-set of primary care electronic medical record (EMR) data to be shared as part of Ontario’s integrated electronic health record (EHR). The project is being led by the eHealth Centre of Excellence, on behalf of cSWO. The POC is being conducted with four FHTs in southwest Ontario and has two EMR vendors participating (OSCAR and Telus Health, using Practice Solutions Suite). PCDS will explore the feasibility, challenges and value of sharing patient data from primary care practices.The project will help to identify the processes, integration requirements and data standards required for primary care data sharing to demonstrate clinical and/or organizational value. The POC will inform the broader Provincial primary care data sharing strategy.

      Methodology/Approach: The project involves four Family Health Teams in south west Ontario that will contribute a sub-set of their EMR data to a provincial repository at eHealth Ontario, to then be securely accessed by other authorized healthcare providers within the circle of care through the cSWO Regional Clinical Viewer, ClinicalConnect™. The data contributed by Family Health Teams will be shared with a small, targeted number of viewing sites within their respective catchment areas. These targeted organizations include local hospitals, the Home and Community Care organization (formerly CCAC) and local Health Links. The POC will run for 6 months during which lessons learned and recommendations will be developed to help inform the provincial primary care data sharing strategy. Recommendations will include the data set, data quality improvement, the respective system requirements (data capture and data access), the technology and standards (including integration requirements), implementation and adoption and benefits realization.

      Finding/Results: By Spring 2018, the project will have developed recommendations to help inform the provincial primary care data sharing strategy, this will be undertaken in collaboration with key stakeholders, including the MOHTLC, eHealth Ontario and OntarioMD. The panel discussion will focus on these lessons learned and recommendations and answer key questions: - Do we have the right data set? - What are technology and standards to be used for the provincial strategy? - How can we improve data quality? How do we support primary care practices with tools/templates? - Are the required privacy and security controls in place? How do we support sites to move towards this? - What are the benefits of sharing the data? How are the clinicians using the data? - How do we move toward provincial scalability?

      Conclusion/Implications/Recommendations: The PCDS POC highlights the value of, and challenges associated with primary care data sharing. Outcomes of the POC will help inform the provincial primary care data sharing strategy. The panel will highlight the lessons learned, key challenges, key benefits and key recommendations from the POC. The panel will also look at challenges for provincial scalability. This multi-stakeholder initiative is a priority project for the Province of Ontario and the south west Ontario region. The panel will reflect stakeholders offering varying perspectives and insights on lessons learned.

      140 Character Summary: Outcomes from the connecting South West Ontario (cSWO) Primary Care Data Sharing Proof of Concept to help inform the provincial primary care data sharing strategy.

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    OS18 - Minding the Gap in Our Healthcare Policies (ID 34)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS18.01 - Developing a Data Quality Assessment Framework for Primary Care (ID 385)

      M. Cousins, The eHealth Centre of Excellence; Waterloo/CA

      • Abstract
      • Slides

      Purpose/Objectives: The connecting South West Ontario Program’s Primary Care Data Sharing Proof of Concept (PCDS POC) project, funded by eHealth Ontario, is enabling a sub-set of primary care electronic medical record (EMR) data to be shared as part of Ontario’s integrated electronic health record (EHR). The POC is being conducted across four Family Health Teams in southwest Ontario. A key objective is to improve data quality to enhance data sharing; ensuring the data being shared is accurate, complete and timely and can be used to inform clinical care. The purpose of this presentation is to explain the framework, including tools and templates that was developed by the project team to assess and monitor data quality improvements.

      Methodology/Approach: To create the framework, existing data quality frameworks were assessed and customized to meet project needs. The tools focused on three dimensions: a) completeness: how well the data in the EMR reflects the actual medical state of the patient; b) correctness: how up-to-date the data is in the EMR; and 3) comparability: how much of the data in the EMR is comparable (e.g. coded and easily analyzed). The framework enables the evaluation of these dimensions across several elements of EMR data including: problem list, past medical and surgical history, medications, immunizations, allergies, and risk factors. The framework consists of two data quality assessment tools (an objective and a subjective tool). An online survey to assess the clinician’s perception of their level of confidence of their EMR data and a checklist used to validate data quality by completing a mini chart review. For both tools, a percentage of completeness, correctness and comparability is calculated, and averaged to calculate an overall data quality score.

      Finding/Results: Our analysis resulted in a number of key findings. First, clinicians recognized the necessity of data standardization, but also recognized the need for resources (human and time) to achieve desired outcomes. In addition, continued reinforcement is needed to remind clinicians to motivate change including showing them what their data looks like. Some sites addressed their interest for reinforcement by creating a data quality scorecard that showed data quality status by physician and site. An additional consideration for future work included data capture inconsistencies across clinicians and vendor variation in terms of completion of data queries to support data quality plans. In terms of benefits, standardizing EMR data was shown to enable more accurate identification of patients with complex care needs; allowing clinicians to better focus on providing preventative care. This finding, of course, is vital to consider when the POC is put into the larger system goals of improving patient outcomes and ensuring appropriate use of health system resources.

      Conclusion/Implications/Recommendations: The PCDS POC has designed a framework to assess and monitor data quality improvements over time. The framework includes a number of tools that can be utilized by primary care sites. The tools and templates reveal important potential being developed during a POC centred on Primary Care Data Sharing and offer considerable potential for decision-makers considering scaling and spreading of such an initiative.

      140 Character Summary: Development and validation of a data quality assessment framework to support primary care sites in assessing and monitoring data quality improvement activities.

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