A Vision Long Time Coming

A bit of a throwback for some of you to see that pyramid, right?

In 2007 the use of data in primary care was not at the heart of the conversation. At this time BC family physicians were transitioning from paper to the Electronic Medical Records (EMR) solutions through the Physician Information Technology Office (PITO) program. The promise of data enabling clinical decision support and improved reporting were embedded in the PITO Clinical Value Model , or pyramid that you see below. There was interest in data driven quality improvement, but it wasn’t the headlining topic. I recently stumbled across a copy of the PITO clinical value model pyramid, built to help visualize the physician’s journey to unlock the value of each physician’s individual investment into their EMR.

I’ve annotated on top of the pyramid to indicate where I see the Family Practice Services Committee’s (FPSC) services, like the Practice Support Program (PSP) Panel Management program and HDC Discover application. Back in the early 2010’s, when I first saw this image, I was keen to figure out how to turn it upside down, so we could get physicians to the top faster. One of the theories was to slice a thin wedge, from top to bottom, and allow physicians to gain experience with different data aspects at each of the 5 levels, so that they can also experience success within a smaller scope of their practice. I still believe this is a great approach and I am grateful to know that we have physicians who are accomplishing QI projects, using a similar approach.

In my role as Executive Director at the Heath Data Coalition (HDC), I remain committed to make it easier for physicians to experience the value in using their EMR data to reflect on their own practice, as well as what’s happening in their community.?We often need to understand a clinical reason or purpose that motivates. Our Clinical Services Team takes the time to get to know our users to understand what matters to them . We can help in small ways by tweaking a process or habit, and monitoring via practice data so that primary care professionals have a guide when they introduce change.? Data itself tells a story over time. More often than not, it’s much more interesting to understand the people and context, rather than just looking at what the numbers represent.

Success Stories

I love how we get to highlight our primary care provider's successes. The most recent example of Dr. El Karsh's data-informed and consistent QI approach is incredibly rewarding for us at HDC. Big shout out to HDC's Kent Marley and our partners over at the Practice Support Program (PSP) that provide physicians the support and structure to engage in QI work. As stated in the article, patients are the ones who benefit from this work, which fuels our efforts.

Another clear example of how practice data can confirm program effectiveness was brought to light recently at the Rocky Mountain Health Centre in Fernie B.C. While my Clinical Services team member, David Chan , was reviewing practice data with Dr. Shelley Forrest, they observed a notable change in the HDC Discover graphs for patients with diabetes when it came to hemoglobin A1C (HbA1C) testing. Because they were able to see the dates corresponding with the change in testing, they made the connection to the clinic increasing patient support with a Chronic Disease Team. Dr. Forrest, knowing her patients well, identified the population of focus, which made it easier for the two Chronic Disease RN’s to focus their efforts on patient assessment, education, and support. Quantitative evidence of the impact of Team Based Care is exciting. It’s proof that data is a powerful resource in quality improvement to quantify the change in practice. Plus, what great benefits to the patients receiving that improved care.

To learn from our data, human connection, people and context are required. The more we meet with physicians and empower them to decide how they’d like to change their own data trends or to look for stories in their data, the more we are learning about the care being offered around our province. These stories empower us collectively to be more strategic, more informed and more intentional.

Keep an eye on HDC’s Bright Spots section of our website. Not only are these stories seriously uplifting, they also show the more human side of quality improvement and the passion that our family physicians have for their profession.

A Growing Community

As we’re wrapping up our financial year and looking ahead, engagement remains high on the list of priorities for myself and the team. We have grown our data network by 172% since July 2021, welcoming many new HDC Discover members. The Family Practice Services Committee (FPSC) HDC Payment Program played a strong role in this growth, providing physicians with protected time to enroll and choose which data-informed quality improvements to action in their own practices. We’ve been able to meet with and train many of these new members both virtually and in-person. The HDC Client Service Team is out in the community visiting clinics, meeting physicians, and helping them better understand their own practice data in context to their community aggregates. As one of the HDC founders, Dr. Bruce Hobson , mentioned in a recent article , data allows physicians to build their confidence and improve their own practice, while contributing to something bigger. We can see through enrollment numbers, data flow and interactions with our team that our goal to enable quality improvement in primary care is working.?

See you in June!

With a solid data network that continues to grow, my team is excited to be in-person at some upcoming events in Vancouver this coming June. Engaging with physicians in our community is so valuable. Hearing from physicians what they need from their data and from HDC Discover is integral to our continued success. You can find us at Quality Forum 2023 (June 6-8) and OSCARCON ‘23 (June 17-18). Come by and say hi! Or to book time to connect with one of our team members at either of these events please reach out to me or email [email protected].

In the meantime, what stories is your data telling you? No need to wait for a data party to share and analyze. Log into HDC Discover and see what you can learn from your patient population. See you soon!