By Dr. Oona Hayes
Most readers will agree that health care delivery is undergoing serious change. Working through time of change can be challenging but inspiring. I’m excited to work with an organization that supports continual improvement and reflection. The Health Data Coalition was founded and exists to empower primary care clinicians and community organizations to use data to inform continual improvement. HDC seeks to aggregate electronic medical record data with the goal of providing practitioners with insights about their practice and community populations. For example, practitioners can access their rates of preventive health, screening and chronic disease management interventions. The HDC Discover application is a technological tool that supports evaluation and quality improvement of health care delivery and outcomes, thus enabling the Patient Medical Home and the Primary Care Network models of care.
The HDC founders recognized that meaningful engagement with data would not be possible without patients’ and providers’ trust in data security. HDC’s commitment to privacy is implemented through its design philosophy that protects patient identification through aggregation. Providers’ data is private unless they choose to share it with others. We believe data interpretation requires context and practice level context is given by the practitioner involved.
HDC founders also recognized the urgent need for provincial and national data standards for health data. Patients’ health information is encoded in a myriad of ways – PDFs, lab results with associated LOINC identifiers, drug prescription data, demographics, billing diagnoses and problem list diagnoses to name a few. The lack of data standards means that agencies will send important health information (e.g. colonoscopy results) as a PDF. We want to capture the screening, prevention and chronic disease efforts of a practice. Information in PDF format is not easily searchable, so it must be transcribed into the appropriate section of the Electronic Medical Record (EMR) to be usable. This is an example where systemic action to improve the data quality from the source system could greatly reduce the administrative burden on the practitioner and their team. I will always prioritize patient care and connection over transcribing data that could easily be delivered into the EMR, as will almost all my colleagues, yet I know this data is vital to system improvement. I refuse to believe there is not an affordable solution to this problem that would simplify and lighten the burden on practitioners and contribute to their overall capacity. I also believe it could have a meaningful impact on provider satisfaction and patient safety and quality of care. Thankfully, data standards and interoperability are high priorities at the provincial and federal levels, and I hope that this specific example is one of the first challenges they tackle.
Learning and understanding the reasons why my predecessors created the HDC has influenced my perspective. As one of the medical directors of the HDC, my hope for the near future is that we can promote a health care culture that uplifts the BC Health Quality Matrix. Evidence shows those patients with reliable access to longitudinal primary care experience better outcomes and at a more affordable cost. The Longitudinal Family Practice payment model has some flexibility that could enable family physicians to do work that aligns with the Quality Matrix, including effective screening and prevention services and efficient and equitable care. Providing equitable care means having curiosity about what perspectives (and data) are not currently prioritized and facilitating connection to them. I want the health care system to reduce the gap between knowledge and action, prioritizing continual improvement of services and outcomes in our commitment to reduce suffering. At the same time as we promote change, we must uplift practitioners’ ongoing work and effort and acknowledge our common humanity.
Nurturing culture and promoting data standards are the art and science that will drive health care change. I see a lot of opportunities for positive change in BC healthcare. I’m proud to be a part of the culture valuing trust and transformation that built the HDC and will propel our health system forward.