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Rodney Burns



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    OS11 - The Value of Moving to Digital...Realizing the Benefits (ID 18)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Technical/Interoperability
    • Presentations: 1
    • Coordinates: 5/27/2019, 04:30 PM - 05:30 PM, Pod 7
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      OS11.02 - Primary Care: Analytical Value of Standardized and Linked EMR Data (ID 450)

      Rodney Burns, CIO, Alliance for Healthier Communities; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      Standardizing Electronic Medical Record (EMR) primary care data for clinical and secondary analysis is a challenge across Canada. This session explores how EMR content standards and a systematic approach to structuring EMR data can improve the quality and usability of community-based primary care information. The session will also present evidence on the value of linking structured primary care EMR data to hospital administrative data to analyse the client journey across the continuum of care.


      Methodology/Approach:
      This initiative is a partnership between a pan-Canadian organization and a group of community-based primary care organizations in Ontario. In July 2018, linkable primary care EMR data from 570,000 clients across the primary care organizations was extracted from a data mart which houses the set of high-quality data. The 73 organizations use a common and innovative approach to standardizing data. As a first phase, the EMR data quality and structure was assessed according to the pan-Canadian partner?s Data Source Assessment Tool and Primary Care EMR Content Standard. Once deemed fit for use, the EMR data was linked to hospital data including emergency department (ED) visits and acute care in-patient stays. A proof of concept analysis was conducted on a cohort of primary care clients with Chronic Obstructive Pulmonary Disease (COPD), with a focus on their socio-demographic and prevalence characteristics, how they were managed in primary care and their journey through the continuum of care.


      Finding/Results:
      Key findings include: ? Minimal data processing was required to make quality EMR data fit for analysis ? Of enrolled clients, 76% had a valid health care number to enable linkage ? Diagnosis and related data are highly codified and complete ? The data are in good alignment with the pan-Canadian EMR content standard ? For the proof of concept analysis, COPD clients most commonly had between 10-19 primary care (PC) visits per year with multi-disciplinary care. Common reasons for PC visits included health advice/ instructions, medication renewal and discussion regarding the treatment plan. ? In exploring the client journey through the continuum, COPD clients had an average of 5 ED visits and 2 acute care stays over the 3 year study period, which is representative of a disease that has a significant impact on a patient?s quality of life. ? Results for prevalence rates and ED/ acute care utilization were comparable to recent Canadian studies. ? Rich information about health concerns, interventions, risk factors, social determinants of health, vaccinations, referrals and non-physician providers were highly valuable to explore the characteristics of clients and their management in primary care. ? Key challenges included the absence of EMR data about medications, lab results and risk factors in the data mart, as well as low completeness rates of certain data elements due to recent implementation


      Conclusion/Implications/Recommendations:
      Standardized EMR data that is also linkable provides opportunities to explore the client journey through the care continuum, in an innovative way beyond what other data sources can provide. Lessons from this partnership can inform future progress in EMR data standardization efforts in primary care models across Canada.


      140 Character Summary:
      Partnership shows value of standardized primary care data linked to hospital data, to understand the client journey across the care continuum

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