How OntarioMD Measures Our Success

Since 2004, OntarioMD has supported more than 16,000 Ontario primary care clinicians with the adoption and efficient use of electronic medical records (EMRs) and other digital health technology. From having the lowest rate of adoption among Canadian provinces just eight years ago, the EMR usage rate for Ontario physicians is now one of the highest among all provinces. OntarioMD’s strong industry knowledge, relationships and understanding of the health care goals of both clinician practices and the province are keys to our success.

We assist clinicians directly with their digital health needs by certifying EMRs, connecting clinician practices to provincial digital health services, developing solutions to connect these services to EMRs, and help practices adapt their workflows through hands-on change management support from OntarioMD Peer Leaders and our EMR Practice Enhancement Program, as well as at various OntarioMD events.

The digital health space is evolving rapidly as health care needs change, and potential solutions are regularly introduced. However, not all digital health services are effective solutions for clinician needs or for health care system challenges. With this in mind, we constantly test and measure the success of our innovations and support programs with end users. We also collaborate with system partners on assessment and evaluation activities, with the end goal of continuing to build an integrated, effective, patient-centred system aided by technology. The following are just a few examples of how we measure success.

Health Report Manager (HRM)

Health Report Manager (HRM) enables clinicians using an OntarioMD-certified EMR to securely receive patient reports electronically from participating sending facilities including hospitals and specialty clinics. Clinicians connected to HRM automatically get text-based medical reports such as discharge summaries and transcribed diagnostic imaging reports sent to patients’ charts within the EMR. More than 9,000 physicians receive reports through HRM from over 160 hospital sites and more than 200 specialty clinics locations – and the numbers of connected clinicians and sending facilities goes up each month.

In 2017, we asked Deloitte to conduct a survey-based benefits evaluation of HRM that was supplemented by an OntarioMD-led study where practice advisors studied workflow variations and conducted timing assessments. Findings from Deloitte and OntarioMD found that HRM saves an average of 33 minutes per clinician per day by not having to manually handle paper reports. HRM also reduces hospital expenses on printing and postage, as well as labour related to reports that would otherwise need to be faxed to clinicians. The Deloitte report estimated that HRM avoids an average of $15 million a year in costs to the Ontario health care system.

EMR Practice Enhancement Program (EPEP)

EPEP was launched in 2016 to help clinicians and their staff unlock the full potential of their EMR and realize benefits for their practice and patients. Using a hands-on, evidence-based approach, the EPEP team has helped over 500 clinicians and their staff improve EMR data quality and practice workflows and tap into their EMR to proactively monitor and treat patients.

EPEP works with evidence-based tools developed by OntarioMD: the EMR Maturity Model (EMM) and EMR Progress Assessment tool (EPA). These tools assess maturity on a six-point scale (0-5) across three functional areas: Practice Management, Information Management, and Diagnosis and Treatment Support. During EPEP engagements, advisors conduct baseline assessments of a clinician’s EMR maturity and EMR data quality in several priority measures, such as smoking status, cancer screening adherence, and immunizations. They then reassess at regular intervals during and after an EPEP engagement. Our results of these assessments have revealed that data quality measures show improvement after six months. More importantly, most improvements are sustained or even further improved upon at 12 months.

EMR Quality Dashboard

OntarioMD has recognized the need for busy clinicians to quickly and easily visualize their entire patient roster based on their EMR-based patient data. Working with TELUS Health, OSCAR EMR and various industry partners, we developed an EMR Quality Dashboard. The proof of concept initiative is currently in phase 2 with approximately 500 participating clinicians. The Dashboard:

  • provides clinicians with real-time access to EMR data in a user-friendly visual manner, using widely-recognized primary care indicators from Health Quality Ontario, the Canadian Institute for Health Information and the Association of Family Health Teams of Ontario;
  • provides the ability to drill down to patient-level data for each indicator, enabling clinicians to take immediate proactive steps to improve patient care;
  • helps clinicians standardize their data entry to improve the quality of patient data in their EMR;
  • allows clinicians to trend and compare their indicator metrics with other physicians using the Dashboard;
  • would scale provincially to all Ontario physicians using an OntarioMD-certified EMR, and
  • is easily expanded as practice needs and clinical indicators evolve.

Phase 1 of the proof of concept involved approximately 100 physicians. We conducted a benefits evaluation at the end of that phase, which found that over 75% of participating physicians recognized the Dashboard’s value in identifying target patients and generating actionable patient lists. In addition, 80% said the change management support they received from OntarioMD while using the Dashboard was effective in addressing their questions and concerns and optimizing their use of the technology. Following the end of phase 2 in December 2018, we will conduct a more in-depth analysis of participating clinicians to further demonstrate the clinical impact of Dashboard on participating practices.

In each of these cases, our focus on measuring the success of our initiatives has helped us refine and expand our offerings, and integrate them with OntarioMD’s robust change management and support services. Find out more about HRM, EPEP, Dashboard and our other programs and services at www.ontariomd.ca or by contacting us at support@ontariomd.com.

OntarioMD’s EMR Quality Dashboard and the Important Role of Data Quality

At OntarioMD, we talk frequently about how we add value to the health care system by helping physicians and stakeholder partners realize digital health’s tremendous potential to improve efficiency, reduce wait times, and improve population health management and patient outcomes. That’s a key focus of our 2017-2020 Strategic Plan, and is interwoven in everything we do.  

But what does this mean in practice, exactly? It means that each offering under OntarioMD’s products and services umbrella – whether it’s something developed in-house like Health Report Manager, or a product like eConsult that our head office staff and field teams deploy on behalf of one of our partners – needs to meet these objectives. And it means that the primary care providers that look to OntarioMD as a trusted advisor are confident we’ve done the work needed to ensure the products and services we bring to their practice will help them with patient care and practice efficiency. 

Our ongoing work on the EMR Quality Dashboard initiative is a prime example of the rigorous testing and analysis we apply to ensure our offerings aren’t simply digital health tools, but innovations that integrate and add value to the system. We launched a proof of concept in 2015 to demonstrate how user-friendly dashboard tools use real-time EMR data for improved clinical outcomes and practice efficiency. In phase 1 of the proof of concept, we worked with vendor partners TELUS Health and OSCAR EMR, physician advisory board members and other health care sector stakeholders, to develop a framework that would allow clinicians to view their patients’ data measured against a range of widely-accepted health indicators, and to take immediate action by identifying patients in need of follow up.   

We’ve since expanded both the number of health indicators incorporated into the dashboard and the number of participating clinicians. Today, more than 400 clinicians from across the province are participating in the proof of concept. Their feedback and experiences will be reflected in a benefits evaluation after phase 2 ends in December. But we already know that by using the dashboard to view their patient population data across indicators for conditions including smoking status, cancer and diabetes, participating clinicians can see and quickly respond to preventive care trends among their population.  

They can also easily see where the data in the EMR appears to not match their patient care experience. For example, if the Dashboard shows that smoking status isn’t recorded for most patients, but the clinician knows it is, they can then take action to make sure the information is stored in the right place. An EMR’s potential can only be tapped into if data is being entered effectively. 

In recognition of the importance of change management and ongoing support in the adoption of new tools, this initiative has incorporated the expertise of OntarioMD’s EMR Practice Enhancement Program (EPEP) practice advisors. They are deploying the Dashboard to all participating clinicians and supporting them in getting the most out of the tool. The EPEP process involves first analyzing a practice’s workflow and EMR data and then working one-on-one with clinicians to improve their data quality so that the patient information in their EMR can be effectively used for better patient care. When paired with a digital health innovation like Dashboard, that’s a powerful combination that can lead to better patient care for all. 

We’re currently working on a business plan for the eventual province-wide availability of the Dashboard that will ensure that clinicians on all EMRs have access to both the tool and, crucially, the data quality support offered by OntarioMD’s EPEP team.  

For more information on OntarioMD’s EMR Quality Dashboard initiative, please visit https://www.ontariomd.ca/products-and-services/proof-of-concepts or email us at emrdashboard@ontariomd.com. To talk to an advisor about the quality of your EMR data or about any digital health tool, contact OntarioMD at support@ontariomd.com.  

 

EMR Quality Dashboard: Data Quality and Analytics

In this fourth entry in our video series on the EMR Quality Dashboard, OntarioMD CMO Dr. Darren Larsen discusses the importance of good data quality and how analytics can help patient care through population health management.