An AOHC-CIHI Project to Test the PHC EMR CS: Project Approach & Lessons Learned

Transcription

1 An AOHC-CIHI Project to Test the PHC EMR CS: Project Approach & Lessons Learned Mary Byrnes, Manager, Primary Health Care Information, CIHI Rodney Burns, Chief Information/Privacy Officer, AOHC June 8, 2016

2 Presenter Disclosure Presenters: Mary Byrnes Rodney Burns Relationships to commercial interests: Grants/Research Support: None None Speakers Bureau/Honoraria: None None Consulting Fees: None None Other: None None

3 At the end of this presentation, participants will be able to describe: The potential of CIHI s Primary Health Care EMR Content Standard (PHC EMR CS) and resulting structured data to improve the quality and usability of primary health care information; Session Learning Objectives Key AOHC/CIHI EMR CS demonstration project findings related to PHC EMR CS implementation within an existing EMR system 3

4 About CIHI The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization that provides essential information on Canada s health systems and the health of Canadians. 4

5 Some CIHI Initiatives to Support PHC Pan-Canadian Primary Health Care Indicators 2006 Release of 105 pan- Canadian PHC indicators 2012 Updates to create a subset of 51 unique PHC indicators* 2015 Select PHC indicators in Demo Project Feedback Reports *30 for Policy Makers, 30 for Providers EMR Data Elements in PHC EMR CS v Subset of 45 EMR Data Elements* in PHC EMR CS v Ontario Demo Projects Start Pan-Canadian PHC EMR CS Voluntary Reporting System (EMR data repository prototype)** ** AOHC/CHC Involvement 5

6 PHC EMR Content Standard v3.0 DE # Data Element Name DE # Data Element Name A1 Patient Identifier E29 Height Unit of Measure* A2 Patient Identifier Type* E30 Weight A3 Patient Identifier Assigning Authority* E31 Weight Unit of Measure* A4 Patient Date of Birth E34 Clinician Assessment A5 Patient Gender* F1 Intervention A9 Patient Status* F2 Intervention Date A14 Patient Postal/Zip Code G1 Lab Test Ordered* B4 Clinician Identifier G2 Lab Test Ordered Date B5 Clinician Identifier Type* H1 Lab Test Performed Date B6 Clinician Identifier Assigning Authority* H2 Lab Test Name* B7 Clinician Role* H3 Lab Test Result Value C1 Service Delivery Identifier H4 Lab Test Result Unit of Measure* C4 Service Delivery Postal Code I1 Diagnostic Imaging Test Ordered D1 Appointment Creation Date I2 Diagnostic Imaging Test Ordered Date D2 Reason for Visit J1 Diagnostic Imaging Test Performed Date D3 Visit Date K1 Referral* D4 Visit Type K2 Referral Requested Date E11 Health Concern L1 Referral Occurred Date E12 Health Concern Date of Onset M1 Prescribed Medication E14 Social Behaviour M2 Prescription Date E23 Systolic Blood Pressure O1 Vaccine Administered* E24 Diastolic Blood Pressure O2 Vaccine Administered Date E28 Height 6

7 PHC EMR CS Demonstration Projects: Purpose CIHI Partnerships with jurisdictions, clinicians and vendors to pilot PHC EMR CS implementation, at the practice and health system level to: 1. Consider usefulness, availability and value of structured EMR data for clinical and health system use purposes 2. Assess the quality of resulting EMR data and its potential utilization in both direct care and health system use at population health (regional/national) and chronic disease management (for clinicians) on a pan-canadian basis. 3. Gather insights via a project evaluation to inform evolution of PHC EMR CS moving towards a regional, jurisdictional and pan-canadian approach. 7

8 CIHI/AOHC Demonstration Project Parameters Association of Ontario Health Centres (AOHC) Chose Number of sites Chose PHC EMR CS Data Elements & Pick Lists Implementation EMR data elements 10 Community health centres (CHCs) 22 of 45 EMR data elements and 6 of 8 Clinician-Friendly Pick-Lists (CFPLs) Back-end approach to mapping AOHC data fields to appropriate EMR CS data elements Implementation EMR data elements with CFPL Data Extraction, Submission via Secure Channel, Analysis Impact on Clinician Workflow Transformed synonymous CFPL type terms to 6 sets of EMR CS CFPL terms Data extracted from Business Intelligence Reporting Tool (BIRT) into 1 flat data file. Data extract submitted to CIHI. Analysis of the data and feedback reports generated. No impact on clinicians (no change in EMRs or clinician workflow) 8

9 PHC EMR CS Demonstration Projects: Preliminary Lessons 1. Support for the use of a PHC EMR CS in AOHC EMR model Proof of concept - ability to extract & submit usable, structured data. Consider updates to CS definitions and data relationships re: CHC model of care. 2. Availability of structured EMR data has improved. However, further work on EMR data quality indicators is required and continues to be explored. 3. More change management emphasis is required if there are changes to the EMR user interface in the future Education sessions with clinician champions would be needed to support front end changes. 9

10 PHC EMR CS Demonstration Projects: Preliminary Lessons 4. Confirms the CFPL approach in general Additional analysis is needed to inform updates to pan-canadian CFPL terms 5. Practice statistics and measures in demonstration project feedback reports High interest but feedback reports could benefit from refined technical definitions for practice indicators and longer periods of data collection 10

11 PHC EMR CS Demonstration Projects: Next Steps A Project Reports May Jun Jul Aug Sept Oct Nov Dec 2016 Data Quality Work/ Enhancements / updates to CS Recruitment of new demonstration projects and project management A: Destruction of Data - AOHC Project Reports Lessons learned as defined by the project parameters and evaluation plan. Evolution of the PHC EMR CS & Implementation approach Build on lessons learned and insights from project partners Recruitment Discussions under-way regarding additional demonstration or Proof of Concept projects 11

12 An AOHC-CIHI Project to Test the PHC EMR CS: Project Approach & Lessons Learned Thank You June 8, 2016