Implementation of data management and effect on chronic disease coding in a primary care organisation: A parallel cohort observational study

Michelle Greiver,Dave Jackson,Kimberly Wintemute,Babak Aliarzadeh,Maggie Siu,Shahriar Khan,Ken Martin,Jannet Leggett,Anita Lambert-Lanning

doi:10.14236/jhi.v23i3.843

Abstract

BackgroundConsistent and standardized coding for chronic conditions is associated with better care; however, coding may currently be limited in electronic medical records (EMRs) used in Canadian primary care.ObjectivesTo implement data...

Highlights

Chronic disease coding within the organisation increased significantly more than in other primary care sites
Eight physicians had not implemented electronic medical records (EMRs), or did not use key aspects of the EMR such as medication prescribing; they did not participate in Canadian Primary Care Sentinel Surveillance Network (CPCSSN) and were not included. 315 physicians at CPCSSN sites across Canada were included in the parallel cohort
Data management activities were implemented in the primary care organisation we studied

Summary

Introduction

Chronic diseases are largely managed in the primary health care setting.[1,2,3] The adoption of electronic medical records (EMRs) in primary care has been associated with expectations that these applications would support quality improvement efforts for chronic conditions.[4,5]the implementation of EMRs has not been consistently associated with better care.[6,7,8,9,10] Improvements in care require management of data to support quality improvement activities.[11,12] Gaps exist in terms of the EMR software used to manage data, the availability of data management personnel in primary care and the quality of data in the EMRs.EMR applications were built to help record care for individual patients rather than for analyzing data to manage quality for practice populations.[12,13] These applications often have rudimentary reporting, data export and analytic capabilities.[14]. Chronic diseases are largely managed in the primary health care setting.[1,2,3] The adoption of electronic medical records (EMRs) in primary care has been associated with expectations that these applications would support quality improvement efforts for chronic conditions.[4,5]. The organisation implemented a central analytical data repository containing their EMR data extracted, cleaned, standardized and returned by the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), a large validated primary care EMR-based database. They used reporting software provided by CPCSSN to identify selected chronic conditions and standardized codes were added back to the EMR. We compared changes in coding over six months for physicians in the organisation with changes for 315 primary care physicians participating in CPCSSN across Canada

Objectives

Methods

Results

Conclusion