TY - JOUR
T1 - The current and potential uses of Electronic Medical Record (EMR) data for primary health care performance measurement in the Canadian context: a qualitative analysis
AU - Barbazza, Erica
AU - Allin, Sara
AU - Byrnes, Mary
AU - Foebel, Andrea D.
AU - Khan, Tanya
AU - Sidhom, Patricia
AU - Klazinga, Niek S.
AU - Kringos, Dionne S.
N1 - Funding Information: We acknowledge the contributions and are grateful for and to the following: the time and expertise of key informants, CIHI?s Jurisdictional Advisory Group members and observers, and Client Affairs Managers; the additional support to review by Kavita Mehta and Sandeep Gill (Association of Family Health Teams of Ontario), Jennifer Rayner (Alliance for Healthier Communities), John Queenan (Canadian Primary Care Sentinel Surveillance Network), Simon Lang and Darren Larsen (OntarioMD), Donna Bell and Siddhesh Talpade (Manitoba Health) and Kim Morrison (Shared Health Manitoba), William Clifford and Gordon McNeil (Health Data Coalition); the guidance of HealthPros consortium members Gregory Marchildon (University of Toronto) and Kathleen Morris (CIHI); logistical support of Jennifer Trebell (CIHI) and Monika Roerig (University of Toronto); reviews by HealthPros Fellows; draft documents that served as a basis for this study prepared by CIHI?s PHCiTeam; and the support of the Amsterdam Public Health research institute Quality of Care research programme for visiting researchers. Funding Information: This work was carried out by the Marie Skłodowska-Curie Innovative Training Network (HealthPros – Healthcare Performance Intelligence Professionals) that has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement Nr. 765141. Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Background: Electronic Medical Records (EMRs) are a rich data source to measure and improve quality of care. As Canadian primary health care (PHC) EMRs mature, there is increasing potential use of EMR data for performance measurement. This study identifies and describes current uses of EMR data for performance measurement and considerations to further its potential in the Canadian context. Methods: We applied a qualitative case study design and descriptive assessment in three phases, consulting multiple data sources including scientific and grey literature, system leaders (n = 41), and clinician/researchers (n = 20). Phases included a multimethod approach to identify initiatives using EMR data for performance measurement across Canadian jurisdictions; in-depth review of current initiatives identified from a healthcare performance intelligence lens; and triangulation and thematic analysis across data sources to explore considerations for advancing performance measurement uses of EMR data in the Canadian context. Results: Six initiatives of EMR data use for performance measurement were identified: one multi-jurisdictional; five jurisdiction-specific in the provinces of British Columbia, Manitoba and Ontario. EMR data uses were predominately for micro-level PHC physician and team performance improvement, with some use for meso-level organization/network-wide improvement. Indicator sets varied in number, though shared emphasis on chronic disease management and prevention/screening and to a lesser extent medication management. Key considerations for governing, resourcing and implementing EMR data for performance measurement were identified. Conclusions: The extent of EMR data use for performance measurement varies across Canada. To further its potential, pan-Canadian data and privacy standards, performance intelligence competencies and renewed core PHC indicators should be prioritized. Experiences across countries, coupled with increasing momentum for performance measurement using real-world data, should be leveraged to avoid unnecessarily slow progress in Canada and abroad.
AB - Background: Electronic Medical Records (EMRs) are a rich data source to measure and improve quality of care. As Canadian primary health care (PHC) EMRs mature, there is increasing potential use of EMR data for performance measurement. This study identifies and describes current uses of EMR data for performance measurement and considerations to further its potential in the Canadian context. Methods: We applied a qualitative case study design and descriptive assessment in three phases, consulting multiple data sources including scientific and grey literature, system leaders (n = 41), and clinician/researchers (n = 20). Phases included a multimethod approach to identify initiatives using EMR data for performance measurement across Canadian jurisdictions; in-depth review of current initiatives identified from a healthcare performance intelligence lens; and triangulation and thematic analysis across data sources to explore considerations for advancing performance measurement uses of EMR data in the Canadian context. Results: Six initiatives of EMR data use for performance measurement were identified: one multi-jurisdictional; five jurisdiction-specific in the provinces of British Columbia, Manitoba and Ontario. EMR data uses were predominately for micro-level PHC physician and team performance improvement, with some use for meso-level organization/network-wide improvement. Indicator sets varied in number, though shared emphasis on chronic disease management and prevention/screening and to a lesser extent medication management. Key considerations for governing, resourcing and implementing EMR data for performance measurement were identified. Conclusions: The extent of EMR data use for performance measurement varies across Canada. To further its potential, pan-Canadian data and privacy standards, performance intelligence competencies and renewed core PHC indicators should be prioritized. Experiences across countries, coupled with increasing momentum for performance measurement using real-world data, should be leveraged to avoid unnecessarily slow progress in Canada and abroad.
KW - Canada
KW - Electronic Medical Records
KW - Performance indicators
KW - Primary health care
KW - Quality measurement
KW - Quality of health care
UR - http://www.scopus.com/inward/record.url?scp=85112478678&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12913-021-06851-0
DO - https://doi.org/10.1186/s12913-021-06851-0
M3 - Article
C2 - 34392832
SN - 1472-6963
VL - 21
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 820
ER -