April 2017 HDC Progress Report

By Dr. Bruce HobsonNews

The Health Data Coalition (HDC) is a data sharing initiative funded by the General Practice Services Committee (GPSC). Established to enable quality improvement in primary care and support a learning health system, the HDC is a federally-registered not for profit society, governed by physicians to work for physicians and their health care partners in BC. This update is provided to inform your support and participation.

The HDC supports and enables physicians to collaboratively use EMR data in a secure, trusted environment to improve health outcomes. The tool aggregates patient level data across disparate Electronic Medical Record systems (EMRs), creating a feedback mechanism to support self-reflective practice for the individual physician.

The HDC tool provides the means to improve individual practices, delivery of health services and population health outcomes by unlocking the power of healthcare data available to family physicians and their peers. This approach bridges EMR “silos” of data, using queries to answer clinical questions, and giving physicians the ability to use clinical data in a meaningful way.

What progress has been made so far?

One year ago in April 2016, the resources of AMCARE and the Physicians Data Collaborative were brought together to form the HDC. HDC developed an initial 18-month plan to aggregate data from electronic medical records (EMRs) in the practices of family doctors in BC to support clinical quality improvement in population health.

HDC achieved all foundational objectives as planned for this first year:

  • successfully amalgamated the technologies of PDC and AMCARE into a single solution;
  • went live with HDC 1.0 in October 2016 across the OSCAR, Osler and MOIS EMRs;
  • enrolled users from all three legacy EMRs;
  • established an interim board and business operations, toward a first AGM in 2017;
  • invested in the first phase of Privacy By Design certification from Deloitte;
  • established HDC data as the basis for quality improvement coaching and population data measurement across Northern Health;
  • began development of learning modules with UBC CPD and Northern Health;
  • engaged with CPQI to ensure HDC supports PSP coaching and Doctors of BC initiatives;
  • contracted for Intrahealth adaptor design;
  • currently in discussions with Telus toward connection of Wolf and MedAccess.

How does the HDC tool support quality and practice improvement?

Using the HDC tool helps physicians discover new ways to support quality care for patients. The system’s design supports individual use, small group peer learning, the evaluation of learning modules, Division-led and provincial projects and BC Ministry of Health system planning and population metrics. In the five months since the system went live, proof of concept for all these uses has been established in Northern Health. User feedback confirms that the HDC helps physicians gain insight into patient needs and practice improvement.

As the HDC supports the Patient Medical Home, we have developed specific PMH data measures which users can view. We are developing plans in concert with our Doctors of BC partners to create a critical mass of well-trained champions across the province who will share their expertise and knowledge.

What’s in place to protect data?

The HDC is a secure platform undergoing Privacy By Design certification. Physician data sharing agreements to ensure HDC data will never be used to monitor individual physician or practice performance to the detriment of patient care.

Who can participate now?

If you are an Oscar, Osler or MOIS EMR user, you can sign on as a contributor now, and be part of the release of HDC 1.3 in April 2017. Depending on your level of interest, you may choose to subscribe to channels of indicators, view various report templates, and create shares and groups with peers.

Enrolment as of March 10, 2017
Patient Records 168,957
Physicians 171
Clinics enrolled 71
Clinics enrolled/awaiting upload 10
Clinics requesting enrollment 34
Divisions of Family Practice with contributors 11

Legacy user enrollment has increased steadily since the launch in October, recently resulting in a waiting list for physicians who wish to enroll.

Integrating use of the HDC data into Doctors of BC programs will be an important next step.  To accomplish this work, HDC is working closely with Doctors of BC partners in the Community Practice Quality and Integration (CPQI) teams, and is engaging with Divisions.  To support peer learning, a new module based on HDC data is being developed in partnership with Northern Health and UBC’s Clinical Professional Development (CPD) program .

How is the HDC expanding its contributor base?

This month, HDC signed an agreement for the design of the Intrahealth adaptor. With this adaptor in place, HDC’s connectivity will increase to 58% of the family physician EMR vendor market.

HDC is in technical discussions with TELUS to ensure that the estimated 26% of EMR users who use Wolf and MedAccess will also have access to the learning and community of the HDC system.

Meanwhile, we’re developing systems to engage and support enrolled users, and to integrate supports through coaching and peer mentorship programs.

In the next phase of its technical development, HDC will complete the “back-end” technological merging of the Oscar, Osler and MOIS EMRs.  Completing the design for an Intrahealth adaptor and contracting with Telus for the MedAccess/Wolf adaptors will allow us to anticipate costs and timelines for building these adaptors.

How soon will all EMR users be able to contribute?

Working with its initial GPSC funding, the HDC network is being developed in a phased way, in collaboration with EMR vendors. The eagerness we hear from physicians who wish to enroll is encouraging, and affirms our plan to ensure that all family physician EMR users will have access to the HDC as soon as resources allow.

In response to these expectations, HDC will present GPSC with a resource proposal which will create an option for adaptor development and enrollment to proceed more quickly than planned within current resourcing.

Determining our unique value proposition

The HDC supports a learning health system by displaying aggregated data from individual physician practices, providing a provincial lens on family practice data – without a commercial motive. HDC has emerged as a physician-led alternative to commercially-driven and far more costly tools.

In response to the high degree of interest being expressed by potential partners, a strategic planning process now underway is engaging organizations such as the UBC Faculty of Medicine, CPCSSN, and other research networks to discuss ways that HDC data can support population-level research.

If you would like to be part of the discussion about the longer-term vision for the HDC, please contact Kate Fagan Taylor, Executive Director, at kate.fagantaylor@hdcbc.ca.

How is the HDC evolving as a physician-led organization?

The concept of the HDC grew out of grassroots efforts by physicians, and their insight, passion and energy has continued to guide its evolution.

As the interim board successfully amalgamated and formed the HDC’s operations over the past year, it recognized that the need to keep an informed clinical lens on everything we do.  The leadership model of the HDC has evolved into a shared leadership approach, with an Executive Director (Kate Fagan Taylor), a Technical Director (Lynda Pattie), and two part-time Medical Directors.

At the end of March, Dr. Bill Clifford and I will step down from our roles on the HDC Board to provide leadership as the HDC Medical Directors, learning from “on the ground” engagement to ensure the physicians and their staff are well supported and to make the registration and training process as informative and easy as possible for the practicing physician.

Outcomes of the strategic planning process now underway will inform HDC membership and board composition, to ensure that key stakeholders have representation in its governance.  The HDC is working with the Watson Group to prepare for its first AGM later this year.  More information and invitations to the first Annual General Meeting will be circulated in the Doctors of BC network later this spring.

How can I get onto the new HDC web platform?

Contact HDC Physician Engagement Lead, Cathy McGuinness at cathy.mcguinness@hdcbc.ca or call her at 604-307-7620; general enquiries can be sent to info@hdcbc.ca.

Thank you for your belief that this important work can be done by physicians. We look forward to building stronger relationships with physicians and Divisions, and especially in understanding your needs to further develop our services and tools.

Sincerely,
Dr. Bruce Hobson, Chair, HDC Interim Board of Directors

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