Primary Health Care EMR Reporting System Gets Green Light to Grow

Moving to a national conversation

It looks like we’ve got a winner on our hands.

After a very successful pilot, our Primary Health Care Voluntary Reporting System (VRS) has been endorsed by our Board and given the go-ahead to expand into a full-fledged electronic medical record (EMR) data source for stakeholders across Canada by 2015. 

When we launched the system early in 2009, it wasn’t entirely clear what the response would be—but it’s been great.

Our three-year pilot project has shown us that primary health care (PHC) providers are definitely willing to voluntarily contribute data from their EMRs to the reporting system (in a privacy-sensitive manner), especially when they receive reports from us on their patient population to support planning and outcome analysis, as well as comparative results for other patient groups.

There have been some bumps that highlight the need to improve the standardization of EMR data and the ease of extracting it, and although what’s gleaned from the EMR is far from perfect, we’ve seen that it supports a range of valuable feedback and analytical reports. It’s increasingly meeting the primary care data needs of providers, regions and jurisdictions, and the more providers use their data, the better it gets.

So why does this matter?

PHC is the most common health care we experience, which makes it one of the busiest parts of the health system. It’s where chronic conditions are managed and prevented and where patients are linked into the system. 

Despite this, clinicians have traditionally had limited information about their patient populations—especially on the quality of care and outcomes. 

System managers and policy-makers have also told us they need more and better PHC data to support policy development and decision-making. As a collector of pan-Canadian health data, we felt we had a role to play in filling this information gap.

What We Did 

Although significant investments were being made to implement EMRs in primary care settings, little had been done to ensure that the data collected was structured to support point-of-care benefits such as alerts, reminders, e-referrals, monitoring and follow-ups. That limited its usefulness in supporting coordinated interdisciplinary care and quality improvement efforts. 

Along with the jurisdictions and Canada Health Infoway, we led the development of content standards to ensure that data from EMRs is more standardized and extractable, allowing it to be used to support patient care as well as health system management needs. To get the maximum benefit out of our EMRs and avoid inefficiencies, we’re now working to implement these standards nation-wide.

These standards were critical to ensuring our reporting system was going to succeed. It’s fair to say it has—we’re now growing to keep up with the demand of voluntary participation.

“It’s exciting to see how much value primary care providers are getting from the system,” says Greg Webster, CIHI’s Director of Primary Health Care and Clinical Registries. “It’s increasingly providing essential data for understanding PHC in practice settings and across the country. Once we connect it to CIHI’s other data holdings, we’ll all have a much more comprehensive picture of how different parts of the health system are inter-relating.”

Currently, the VRS has data on 300,000 patients from 300 primary care providers. While that’s primarily used to create the feedback reports, participants have also helped us shape the reports to best meet their needs and inform care across Canada.

“This will allow us to have a national conversation about what’s working in primary care, what reform activities seem to be generating the best outcomes. And at the end of the day, providers will have the most to benefit, by allowing them to have tools that are robust and that can be more interoperable,” says Dr. David Daien of Summerville Family Health in Mississauga, a VRS participant.

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