Last September Dr. Janet Fisher, MD, CCFP-EM joined our board. Here are some thoughts she shared on data, quality improvement and her role with the current HDC board.
I have always been interested in data and looking at trends. EMRs (Electronic Medical Records) became widespread in Canada in the 2000s. In 2010, at the early stages of my clinic’s adoption, I was part of a group looking to come up with a plan as a community of practice. At that time, we thought the only way to have pooled aggregate data was to use the same EMR, and at that time, that probably was true. Throughout the transition to digital records, I was always thinking about how to encourage good coding and make information accessible to practitioners, while keeping data confidential.
Since clinics began transitioning to EMRs, the study of patient data has been a major focus. Early on, we recognized that standardization was crucial. In my region, the Kootenays, like many others, a “Community of Practice” was formed to select a standard EMR. The Physician Information Technology Office (PITO) led the effort, curating a list of compliant vendors for us to choose from.
In those early days, we envisioned a central repository of anonymized patient data, hoping to use it to improve patient outcomes. We also believed that better data would motivate clinicians to code accurately and standardize how information was recorded in the EMR. However, as expected, individual clinicians and clinics had varying needs and priorities. With the range of different EMRs in use, the technology to pool anonymized data wasn’t available… until 2016 and the creation of the Health Data Coalition (HDC).
I learned about the HDC through the Kootenay Boundary Division of Family Practice in 2020. We were offered some links to check it out and shown how to register. I also attended a Quality Improvement (QI) learning session that involved HDC data a few years prior. I played around with the application, HDC Discover, and was interested in the potential but initially we didn’t prioritize it in our clinic discussions, and it fell off our “to-do” list. My curiosity was sparked when our office had a visit from David Chan, HDC Clinical Services Manager. He began visiting our clinic with sandwiches and thought-provoking observations about our data. His expertise in walking us through the clinic information showed us the possibilities.
As a primary care provider, managing information is a large—and sometimes overwhelming—part of my day. At times, it can seem like a challenging use of our time, but when we streamline our input and use that data to improve patient care, it becomes invaluable.
Seeing the value of the data also began sparking questions:
- “Why was our practice so different from the provincial average, or even from our regional peers, on certain measures?”
- “How should we interpret and investigate those differences?”
My colleagues and I began talking about how we were coding, where we were entering data in the EMR, and how we were practicing.
With the support of the Practice Support Program (PSP) and our fantastic MOA team, we started implementing simple QI projects to advance our screening rates. Our clinic reviewed how we were coding, because we thought we were doing better than the HDC data showed. Reviewing these aggregates made us aware of what we’re putting in patients’ charts. Over time, using HDC Discover data, we tackled bigger projects, most recently collaborating with the respiratory therapist in our Primary Care Network (PCN) to transition patients off high-carbon inhalers.
Last spring, Dr Christie Newton reached out to ask if I would be interested in applying for a position on the HDC board. I’ve always been curious about how the HDC selects topics, how data queries navigate the complexity of different EMRs, and how clinicians code and enter their data. Now, as a new board member, I’m in awe of the depth of the organization—the knowledge, the vision, the curiosity. The HDC board is an incredibly accomplished group of professionals. Many of them have a much more sophisticated understanding of data utilization than I do, but I know my value to the board is that I have boots on the ground. I am a clinician working in the clinic, doing the day-to-day grind. I offer a unique perspective as a data user within my clinic.
There are also exciting opportunities to leverage data on a community, regional, and provincial level, yet my passion remains with the everyday use of data by clinicians:
- “How can we better support clinicians in applying HDC data at the patient level?”
- “How can we provide easy, robust EMR queries directly to clinicians?”
- “What support do clinics need to make quality improvement a regular part of practice?”
- “How can data affect the ways teams are working together to optimize today’s care?”
I see HDC as an inspiration for people to use their data differently. When a practitioner has a question or is seeking information, we should be able to log in, do a query, and pull the information to guide next steps. Collaborative quality improvement in primary care is essential and data plays a big part in that narrative. It offers answers but also sparks questions, which push us to step back and examine the way we work. I’m looking forward to my role on the board, what I can share, and all I can learn and bring back to my teams.
For information on joining HDC Discover, visit https://hdcbc.ca/ or contact us.