The current and potential uses of Electronic Medical Record (EMR) data for primary health care performance measurement in the Canadian context: a qualitative analysis

BMC Health Services Research

Patricia Sidhom¹  Tanya Khan¹  Mary Byrnes¹  Andrea D Foebel¹  Erica Barbazza²  Niek S Klazinga²  Dionne S Kringos²  Sara Allin³ 

[1] Canadian Institute for Health Information (CIHI), Toronto, Canada;Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands;Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada;

关键词: Performance indicators;    Electronic Medical Records;    Quality of health care;    Canada;    Primary health care;    Quality measurement;   

DOI  :  10.1186/s12913-021-06851-0

来源: Springer

【 摘 要 】

BackgroundElectronic 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.MethodsWe 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.ResultsSix 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.ConclusionsThe 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.

【 授权许可】

CC BY