Theme 5. Advancing manageable meaningful measurement
Presentation Materials (Members only)
Optimizing EMR Use: Merging Data, Managing Patients and More Cancer Screening
Learning Objectives
- Learn how to access Cancer Care Ontario’s Screening Activity Report (CCO SAR) for all family health team (FHT) physicians and merge it with EMR data.
- Describe how to use postal code to understand variation in cancer screening rates by neighbourhood income quintile and the impact of interventions on equity.
- Learn how use of physician billing codes, and the creation of IHP tracking codes have helped to account for the work produced by Markham FHT, as well as enabled the creation and evaluation of clinical programs.
Summary
1. How to Optimize EMR Use for Maximum Data Usability: EMR search capability and data extraction has moved beyond the “keyword search” and into the next level of meaningful management. With the introduction of Quality Improvement Plans, Ministry of Health and Long-Term Care reporting requirements, and now the Association of Family Health Team’s Data to Decisions, Markham FHT has had no difficulty extracting the data necessary for submission, due in large part to the careful planning and attention to how EMR data is entered and interpreted. 2. Managing Patient Rostering: Patient rostering data is an important area that could be optimized within EMR systems. Patient rostering is central to a high-performing primary health care system. Rostering can enable the practice to better define its panel size, manage access to care, track health indicators and outcomes. In 2014, North York FHT reviewed and updated 3,864 (4%) patient records, and mailed out 1,758 roster invitation letters to patients. Similarly, Queen Square FHT reviewed and updated nearly 4,000 (11%) patient charts, and invited 2,000 (50%) patients by telephone to roster. We will discuss roster management and cleanup processes in Queen Square and North York FHTs. 3. Merging data sources to understand and improve cancer screening rates and related inequities Last year, Cancer Care Ontario made it easy for physicians to download an integrated summary of their patients eligible and overdue for cervical, breast, and colorectal cancer. We will describe how we accessed this data for the majority of our FHT physicians and merged it with our own EMR data. We noted a large variation in cancer screening rates between our physicians as well as significant disparities in screening related to patient income. Our FHT used the merged cancer screening data to deliver a multifaceted, evidence-based quality improvement intervention that included patient recall letters signed by their physician, physician audit and feedback, and enhanced point-of-care reminders. The intervention improved overall screening rates and improved rates for most physicians. We noted a narrowing of income-related inequities for colorectal cancer but not cervical or breast. The results of our intervention have spurred further work on how to improve disparities in cancer screening in our FHT
Presenters
- Markham FHT
- Lisa Ruddy, RN, Clinical Program Manager
- Tony Pallaria, IT Manager
- St. Michael’s Hospital Academic FHT
- Tara Kiran, MD
- Sam Davie, QIDSS
- Marjan Moenedin, QIDSS, North York FHT
- Abel Gebreyesus, QIDSS, Queen Square FHT
Authors and Contributors
- Markham FHT:
- Stephen McLaren, MD
- Tom Filosa, MD
- Allan Grill, MD, Lead Physician
- Deepti Pasricha, MD