By Dr. Oona Hayes, HDC Medical Director
This is my last installment of MD’s corner. It’s with genuine sadness that I made the difficult decision to resign from my role as co-medical director of the Health Data Coalition (HDC). Between my roles of co-medical director, my three clinical jobs and my recent naming as the successor chair to the Doctors of BC Economics committee, my time and cognitive bandwidth is stretched too thin for comfort. As I prepare to transition out of this role, I am lucky to have the opportunity to reflect on how I have contributed, been inspired, and will continue to advocate for data-informed health care practice.
I’ll miss the organizational culture of the HDC. In my first article for this series, I spoke about the prerequisites for “Joy in work”. The staff and board of the HDC all have passion for advancing data-informed healthcare while respecting the context and concerns of individual family physicians and nurse practitioners. It is enlivening to work purposefully to uplift clinicians’ use of clinical data. The HDC team deliberately sets a tone of respect and curiosity when working with clinicians and their data, encouraging clinicians to examine their practice panel size and composition before approaching measures of practice management. It’s been a true joy collaborating with this team.
I’m inspired by the “Bright Spots” across the province, areas where data from Discover is being used to help with local issues. Our health care system is challenged by multiple factors. Clinicians and their teams, along with program supports from the Family Practice Services Committee (FPSC) and the Nurses and Nurse Practitioners of BC, are using aggregate data from HDC Discover to approach and problem-solve issues that matter to their patients and their communities. Looking at practice level measures is akin to looking at a vista after a long scrabble up a mountain: there’s an awe and reverence for the collective impact of action that is seldom appreciated while climbing. I envision a time where more colleagues regularly take a breather from their daily grind to look out on the vista of their practice, both to feel the impact and importance of their work and to plan and prepare for their next climb.
During my time with the HDC, I’ve come to a deeper understanding and appreciation of the complexity of software development and management, especially as it comes to health data. Have you seen the new HDC Discover interface? It’s stunning! The technical team at HDC systemically approached the user interface updates by interviewing users about their experience, wants and needs from the application. The new interface makes it easier for users to share graphs and trends easily while respecting the privacy of others. In this time of system crisis, data sharing provides quantitative measures of the context and results of our work and supports the transformation of our system to meet the needs of the population. Other improvements include information on how the data for each Measure is pulled from their Electronic Medical Records (EMR), under the “concepts and logic” tab in the Measure description. EMRs do not have common data standards – yet – and thus the logic for each Measure must be updated for each EMR.
My wish for the near future is for the development and implementation of Pan-Canadian Data Standards in a way that reduces the administrative burden of clinicians. Patient care suffers because of the lack of data standards. A lot of important health information is pushed in PDF form, which results in administrative burden. It shouldn’t be the receiving clinician’s responsibility to transcribe this information, that will most likely be placed in a non-standard place in the EMR. More importantly, when this information is stuck in a PDF, it may impact patient care. Take the example of a cardiac ejection fraction (EF). How does this come into your inbox? How do you track a patient’s results over time? How do you share this with their specialist? How does the specialist populate their EMR? Do they have to re-enter this data? Access to good data impacts care, but how much time is wasted trying to pull it up? Most specialists require accurate data to triage and manage patients and ask family physicians and NPs to include these with their referrals. Growing chronic disease burden amongst our aging, increased need for shared care with consultant specialists, and ever evolving care guidelines increase the complexity of patient and practice management. The cognitive load of ensuring timely, personalized, up-to-date and guideline-informed care for a panel of patients is gigantic. With so many people needing care, clinicians should spend their time using the data to manage their patients and practice, not be tasked with transcribing it into a different format. We urgently need updated data standards that reduce the administrative burden of clinicians.
I stepped into medical leadership to uplift principles of generalist quality care and to amplify the voices of patients and physicians who want change. I’m grateful for the opportunities I’ve had to do this with the HDC and my support for a data-informed approach to practice will continue. As an HDC Discover user, I intend to take in the vista when reviewing my practice progress to acknowledge my and my clinic’s accomplishments.
