Access to data in primary care is difficult, largely because the quality of data in Electronic Medical Records (EMRs) is poor. While it is important to improve the quality of data going into EMRs, it is also worthwhile to get better at using the data and systems as they are. Over 30 Quality Improvement Decision Support Specialists (QIDSS) are dispersed across the province to help members access and use data better to improve care, supported by our Quality Improvement in Primary Care Community of Practice.
Change Concept – EMR Communities of Practice (CoPs): AFHTO convened CoPs for 4 EMRs (TELUS PS, QHR's Accuro, OSCAR, P&P) to engage EMR vendors, QIDS Specialists, Physicians, Interdisciplinary Healthcare Providers, and practice staff to continuously improve user expertise and access to EMR data. Unlike most EMR “user groups” the CoPs have the following characteristics:
- have equality of members
- focus on issues in common
- are led by users (QIDSS, physician ,etc.)
- set priorities collectively via action item list
- solve problems collaboratively through sharing of best practices
- are accountable to the community
- have their own social networking platform
- meet regularly
- Leverage the wisdom of the field
- Change conversations with EMR vendors to expedite improvement
- Identify data extraction tools and processes
Lessons Learned Outcome Measures
- Rapid spread of solutions - 67 teams have implemented standard queries to improve access to data in custom forms, an item assigned high priority by 86% of the Telus PS CoP members.
- Improved vendor role and engagement - Vendor representatives invited to participate are product managers and developers as well as sales staff. They participate as equal members – with rapid resolution to problems posted on the online forum.
- Use of solutions beyond AFHTO membership - A query to more accurately identify patients with COPD is being spread to all EMR users through partnership with the Ontario Lung Association.
Access to good quality EMR data remains a challenge, with low maturity in EMR use and low functionality. Integration with other systems is increasing but still problematic. Increase in the spread of standard EMR data entry and extraction tools, however, illustrates that people and processes can increase the value of the technology, with the goal of being able to show improvements in care.
WHAT’S NEXT? AFHTO continues to support the EMR Communities of Practice to help members access and use data better to improve care. For more information or if you’d like to join an EMR CoP - please contact firstname.lastname@example.org.