Asthma Life: integrating performance evaluation into the process of asthma care
Chronic Care and Patient-Centred Care
Practical systems which support chronic disease management, including performance measurement, benchmarking and continuous quality improvement (CQI) are not routinely available. The proposed innovation is an electronic asthma registry and performance evaluation system, auto-populated from electronic medical record (EMR) data using standardized terminology. We hypothesize that integration of an electronic asthma performance evaluation system into the process of care will improve patient care and outcomes, enable patient monitoring, health system performance evaluation, benchmarking and CQI. By choosing an open-source, provincially approved EMR vendor (OSCAR) for this demonstration project, the system developed may be readily adopted by other OSCAR users and adapted to other approved vendors as well as other chronic diseases. Ultimately, the findings may lead to transformation of chronic disease management.
INTRODUCTION: Performance measurement and benchmarking are key priorities for chronic disease management systems. Electronic medical records (EMRs) offer an innovative means of supporting chronic disease management, performance measurement and benchmarking.
HYPOTHESIS: Integration of the performance evaluation into the process of care will improve the quality of asthma care and enable continuous quality improvement (CQI).
OBJECTIVES: i) To extract data elements from 2 asthma e-records and generate electronic asthma performance indicator (e-API) reports; ii) to create an asthma performance evaluation system, and integrate it into the process of care in the Southeastern Ontario Asthma Care Network; and iii) to document performance, begin to benchmark and evaluate benefits of the system.
METHODS: An e-API reporting system was designed based upon stakeholder focus group input, to collect data elements from 2 EMRs: the KGH Asthma Education Centre’s Asthma Management and Outcomes Monitoring System, and a new asthma form in OSCAR at Queen’s Family Health Team (QFHT). E-API reports were designed. RESULTS: Seventeen of 22 (77%) QFHT attending physicians and both KGH asthma educators consented to participate. Data collection is occurring during routine care in each practice setting, from patients whose most responsible physician or asthma educator respectively consented to participate. Primary outcomes are feasibility, accuracy, use, provider satisfaction/perceived utility and quality of care based upon actual e-API data.
ANTICIPATED IMPACT: We envision point-of-care capture of EMR data, integrated into a performance evaluation system, will enable benchmarking and improve outcomes. The findings will inform e-health care challenges and priorities, including EMR integration, EMR interoperability, performance measurement, and CQI.