Electronic Innovations in Family
Practice Quality Improvement
Shaheena Mukhi, Project Lead, PHC Information CIHI
Selena Davis, Lead, Clinical Usability & Standards, PITO
Ray Simkus, BC Primary Care Physician
eHealth conference
May 27, 2013
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Outline
1. Context
2. Project Background
3. Achievements
4. Findings
5. Next Steps
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Context Setting and Presentation Objectives
CIHI is collaborating with clinicians and jurisdictions to
support PHC performance measurement through indicators,
standards, survey tools, and EMR data collection and
feedback reporting.
Presentation Objectives:
Share how BC clinicians, BC PITO, EMR vendors and CIHI:
• Demonstrated the value of EMR data and PHC VRS
clinician feedback reports
• Highlight the priority areas for EMR standardization
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BC PITO Innovation Diffusion Projects
Population Health Reporting: Background
•
Provincial program to support adoption and effective
utilization of EMRs
•
Collaborated with physician Communities of Practice
(CoPs) to:
• Identify gaps in the use of EMRs
• Support clinical care (e.g., referral, population
health care)
• Improve population health for patients with chronic
conditions
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BC PITO Innovation Diffusion Projects
Population Health Reporting: Methodology
• Environmental Scan
 Key informant interviews – Canadian jurisdictions
• Demonstration Extraction
 Vendors of the two EMR systems
Data mapping, extraction, and submission to CIHI
• Clinician Feedback Reporting for Quality Improvement
 Workshop to explore static and dynamic PHC VRS reports
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Achievements
•
Baseline knowledge of the alignment between EMR
data and PHC EMR Content Standard (2 vendors, 4
practices)
•
Drew from experiences of other jurisdictions
implementing EMR standards and identified systemlevel enablers and barriers
•
Synthesized value and implications for BC for
adopting EMR Content Standards and facilitating
clinician feedback reporting for quality improvement
•
Identified reflections, opportunities, engagement
strategies and implementation considerations
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BC Physician Experience
• Physicians and staff
• Data entry points knowledge transfer
• Data quality efforts
• Follow-up visits with vulnerable patient population
• Enablers- Reports
• Actionable comparative quality measures
• Peer collaboration
• Drive data discipline
• Challenges
• Vendor cost and extraction processes
• Non-linear data capture, storage and extract points
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Baseline Extraction and Reporting- Findings
Mapping, Extraction
and Submission
• Data extraction
o 3 months (.csv)
o 5 months (.XML)
• Iterative process
Analytical Reports
EMR data
• Generated 11
quality care
dimensions
• Enabled aggregate
comparisons to
peers and all PHC
VRS
Clinician Perspective
• Data standards
priority data set
• Education tools –
data dictionary
• Comparative reports
• Align incentives
Opportunities
• PHC EMR CS may support data quality, validation and optimization
• Improve EMR system performance and data extract capacity
• Ensure change management included with implementation
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Next Steps:
Value of the Data for
Clinical:
• Quality improvement
• Portability
• Data quality
Health system:
• Performance measurement
• Interoperability
• Comparability
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Next Steps
Considerations for implementation:
•
•
•
•
•
•
Clinical support
Change management
Pre-standards
Engagement
Collaboration
Governance
Policy enablers
Post Implementation
of Standards
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PHC EMR Content Standard
Jurisdictional Early Implementation View
Jurisdictions implementing or
P planning PHC EMR CSpartial and phased
Jurisdictions supported by
EMR demonstration projects
Planning
P
TBD
2013/14TBC
P
Planning Planning 2013/14
P
2011/12
P
2013/14
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For more information
please contact:
Shaheena Mukhi
416-549-5400
smukhi@cihi.ca
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