How digital health information is being used to improve the quality and safety of our health system: A candid discussion

How digital health information is being used to improve the quality and safety of our health system: A candid discussion

When we think about health system use of electronic data, we think about unleashing the potential of health data’s value. So much can be done to increase the quality, safety and efficiency of our Canadian health care system—and good data is at the heart of these improvements.

We were fortunate to have had a ringside seat for a symposium that discussed this topic. At the recent e-Health 2014 Conference, CIHI brought together a panel of local and international speakers to talk openly and candidly about the way digital health information is being used in their respective arenas.

Highlights from the discussion

Trends in health system use of data in the U.K. and Australia

How does the National Health Service (NHS) in England use data to track patient care trends over time to ultimately balance the demand and supply of health care services? We got the inside scoop from Dr. Geraint Lewis, the chief data officer of NHS England. He shared how millions of hospital episode records currently collected in the Hospital Episode Statistics (HES) database are used to describe, predict, evaluate, compare and audit health services across the country.

Dr. Lewis described several challenges in working with the HES database and presented plans for its expansion to a care episode service database that would hold both hospital-related data and key general practitioner information and community care, mental health and social data, among other types.

Empowering choices in care

This range of data, said Dr. Lewis, would support the ultimate goal of being able to track and predict patient care trends and patient outcomes so that the necessary supports can be made available where they are needed. Future plans, he added, include openly and appropriately sharing data collected through the Care.Data initiative to support accountability with the system and empower citizens to make choices about their care.

Evolving health system use 

Dr. Louise Schaper, CEO of the Health Informatics Society of Australia, discussed the evolution of health system use of data in Australia and the momentum gained through national big data and health analytics events that started in 2011. She opened her talk by stating “we are not prepared,” noting that almost all health care chief information officers believe that data analytics will play a big role in delivering value-based health care but that 75% report moderate or minimal commitment to integrating analytics in practice.

Managing data in real time

Important opportunities for better health system use of data were created in 2011 when the Australian government merged Centrelink, Medicare, the Child Support Agency and CRS Australia (formerly known as the Commonwealth Rehabilitation Service) into the new Department of Human Services (DHS). The vision for the merger is to create a public asset, whereby massive data sets are harnessed from existing administrative service records to support system management and health research. To manage all of this data in real time and create a learning health care system is really where we want to be, added Dr. Schaper. Listen in as Dr. Schaper discusses Australia’s approach. (video)

Using data to build quality and safety in the Canadian health system

Mike Barron, president and CEO of the Newfoundland and Labrador Centre for Health Information, talked about the centre’s history and mandate. He also shared some of the political challenges in using data for health system use at a provincial level. Newfoundland and Labrador has the fastest-aging population in the country and widely distributed services, said Barron, but influencing consumers to believe they can make changes in the health system based on data to meet the system’s needs remains a primary challenge. Barron is hopeful this challenge can be met as the centre matures and further integrates its data to meet the needs of users.

Shedding light on problems in long-term care 

Dr. John Hirdes, chair of the interRAI Network of Canada and professor at the University of Waterloo, discussed the ‎progress of the interRAI family of products, particularly in the long-term care sector. Hirdes talked about the impact of shedding light on quality problems in long-term care using data collected at the point of care, so that we can focus on improving those problems and supporting some of our most vulnerable patients.

As an example, he cited how data that was used to shed light on poor quality in home care facilities in Michigan and Ontario led to direct improvements in the relevant areas. Dr. Hirdes left his audience with 2 big ideas: keep people out of nursing homes and, if folks have to use them, make the care better. You can watch Dr. Hirdes’ entire talk here. (video)

Moving away from the electronic paper record

Dr. Bill Clifford, chief medical information officer at Northern Health in British Columbia, talked about the progress made by implementing and using electronic medical records in the primary care environment. He stressed the importance of moving away from the “electronic paper record” and the silos they create toward better use of good records and data to support collective learning among the medical profession. Watch Dr. Clifford’s entire talk here. (video)

Communicating results in a meaningful way

Dr. Douglas Cochrane, chair and provincial patient safety and quality officer at the B.C. Patient Safety and Quality Council, discussed recent implementations of peer review for radiology diagnostic imaging work. He talked about the challenges of trying to apply a technically simple solution to a complex, adaptive, regional system. Cochrane referred to this as a “people system” and stressed the importance of including those who provide care in the development of information systems. Why? Because they have a good idea of what constitutes good outcomes, he stressed. “Systems have improved,” said Clifford, “but it is not just the measuring that matters. to be communicated in a meaningful way.”

Benefits well worth the efforts

Brent Diverty, VP of programs at CIHI, wrapped up the symposium by saying that great work is being done in health system use of data in Canada, the U.K. and Australia, but there is still a lot of work to do.

“There are risks involved that need to be managed,” said Diverty, adding that clinical data collection systems need to incorporate content standards that enable health system use of data in the long run. The benefits are well worth the efforts being made. “By continuing to collaborate on the supply side and by identifying business opportunities, we can move the health system use agenda forward.”