Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis

BMC Health Services Research

Research

Rukia Swaleh¹  Peter Senior²  Roseanne O. Yeung³  Taylor McGuckin⁴  Brock Setchell⁴  Denise Campbell-Scherer⁵ 

[1] Division of Endocrinology & Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Division of Endocrinology & Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada;Division of Endocrinology & Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada;Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada;

关键词: Regional quality improvement;    Administrative health data;    Electronic medical record;    Diabetes;    Learning health system;   

DOI  :  10.1186/s12913-022-08882-7

 received in 2022-04-06, accepted in 2022-11-24,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLinked electronic medical records and administrative data have the potential to support a learning health system and data-driven quality improvement. However, data completeness and accuracy must first be assessed before their application. We evaluated the processes, feasibility, and limitations of linking electronic medical records and administrative data for the purpose of quality improvement within five specialist diabetes clinics in Edmonton, Alberta, a province known for its robust health data infrastructure.MethodsWe conducted a retrospective cross-sectional analysis using electronic medical record and administrative data for individuals ≥ 18 years attending the clinics between March 2017 and December 2018. Descriptive statistics were produced for demographics, service use, diabetes type, and standard diabetes benchmarks. The systematic and iterative process of obtaining results is described.ResultsThe process of integrating electronic medical record with administrative data for quality improvement was found to be non-linear and iterative and involved four phases: project planning, information generating, limitations analysis, and action. After limitations analysis, questions were grouped into those that were answerable with confidence, answerable with limitations, and not answerable with available data. Factors contributing to data limitations included inaccurate data entry, coding, collation, migration and synthesis, changes in laboratory reporting, and information not captured in existing databases.ConclusionElectronic medical records and administrative databases can be powerful tools to establish clinical practice patterns, inform data-driven quality improvement at a regional level, and support a learning health system. However, there are substantial data limitations that must be addressed before these sources can be reliably leveraged.

【 授权许可】

CC BY   
© The Author(s) 2022

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