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2007 Medical Education Conference
Conférence de 2007 sur l’éducation
médicale
Welcome
AFMC – CAME – CFPC – MCC – RCPSC
AFMC – ACÉM – CMFC – CMC – CRMCC
Bienvenue
Using Electronic Health
Records
For education and research
Robyn Tamblyn, McGill University
Outline



Key Components of Electronic Health Records
Uses in Education
Uses in Research
Key Components of EHR
Health Problem
List
Retrieval of lab, drug, dx test + report
information from feeder systems
Medication List
Drug and Visit Profile Information
from Regional/ Provincial Repositories
List of Drugs Dispensed over
Past 6 Months
Costs of Medications
Dates of Hospitalizations &
ER Visits
.
Structured order entry
Clinical Notes
Uses in Education
Educate About Preventive Care
and Provide Practice Reminders
Reminders
E-Rx Pad
Educate + Reduce Potential Errors by Providing
Menus for Dose Selection & Treatment Indication
cou
Educate about Drug Interactions & Reduce
Errors in Drug Selection by Providing Alerts
for Prescribing Problems
Evidence-Based Asthma Decision Support
Customized for Individual Patient Profiles
CIHR supported RCT-2004-2008
Uses in Research
Practice Profiles
COPD
Hypertension
Diabetes
CHF
Risk Factor Vulnerable
Management
Patients
100
Percentage of Eligible
Patients
Asthma
80
60
40
20
0
Mammograms
PAP Smears
Prostate Screens
ER Visit
Hospitalization
Mortality
100
Percentage of All
Patients
My Practice
Profile
80
60
40
20
0
My Practice
Profile
Asthma
COPD Hypertension
Diabetes
CHF
Risk Factor Vulnerable
Management
Patients
Disease Control
My Asthma Patients
Proportion of my asthma patients with poor control
Number of asthmatics
Average age (years)
Female (%)
Receive an income subsidy (%)
My Practice
2004
45
37
45
4
2005
52
38
48
7
100
2006
64
34
45
6
Comorbidity:
Percentage of
Asthma Patients
Demographics:
80
60
40
20
0
Average number of serious health
problems
Average number of medications
0.68
0.72
0.84
3
3.1
2.1
ER Visit
Overall Poor
Control
2004 2005 2006
Continuity of care:
Average number of visits to my
practice
Average number of visits to other
physicians
Patients with all asthma therapy Rx
by me (%)
Excess Rescue
Medication
4
5
1.8
Compliance with Rx
Asthma Quality Indicators
1
1.2
0.9
65
68
72
All asthma patients should have an action plan
All asthma patients with poor control should have inhaled
corticosteroids
Show me my current asthma treatment outcomes
Compare my asthma treatment outcomes to those of my peers
My Practice
Profile
Asthma
COPD Hypertension
Diabetes
CHF
Risk Factor Vulnerable
Management
Patients
Disease Control
My Asthma Patients
Proportion of my asthma patients with poor control
Number of asthmatics
Average age (years)
Female (%)
Receive income subsidy (%)
2006
64
34
45
6
Comorbidity:
Average number of serious health problems
Average number of medications
0.84
2.1
Continuity of care:
Average number of visits to my practice
Average number of visits to other physicians
Patients with all asthma therapy Rx by me (%)
1.8
0.9
72
Compliance with Rx
100
Mean Compliance
Demographics:
80
60
40
20
0
Inhaled Steroids
Long Acting BAgonist
Leukotriene
Asthma Quality Indicators
All asthma patients should have an action plan
All asthma patients with poor control should have inhaled
corticosteroids
Compare my asthma treatment outcomes for the past 2 years
Compare my asthma treatment outcomes to those of my peers
My Practice
Profile
Asthma
COPD Hypertension
Diabetes
CHF
Risk Factor Vulnerable
Management
Patients
Disease Control
My Asthma Patients
Proportion of my asthma patients with poor control
Demographics:
2006
Compliance with Rx
Asthma Quality Indicators
Number of asthmatics
Average age (years)
Female (%)
Receive income subsidy (%)
64
34
45
6
All asthma patients should have an action plan
All asthma patients with poor control should have inhaled
corticosteroids (guidelines)
Comorbidity:
0.84
2.1
Continuity of care:
Average number of visits to my practice
Average number of visits to other physicians
Patients with all asthma therapy Rx by me (%)
1.8
0.9
72
Percentage of Patients with ICS
Average number of serious health problems
Average number of medications
100
80
60
40
20
0
Poor Control
Good Control
Compare my asthma treatment outcomes for the past 2 years
Compare my asthma treatment outcomes to those of my peers
Asthma
COPD Hypertension
Number of asthmatics
Average age
Female (%)
Receive an income subsidy (%)
My
Practice
2006
64
34
45
6
My
Peers
2006
89
36
42
7
Comorbidity:
Average number of serious health
problems
Average number of medications
Risk Factor Vulnerable
Management
Patients
Proportion of my asthma patients with poor control
100
80
60
40
20
0
0.84
0.72
2.1
3.1
Continuity of care:
Average number of visits to my practice
Average number of visits to other
physicians
Patients with all asthma therapy Rx by
me (%)
CHF
Disease Control
My Asthma Patients
Demographics:
Diabetes
Percentage of
Asthma Patients
My Practice
Profile
Excess Rescue
Medication
My Practice
ER Visit
Overall Poor
Control
My Peers
Compliance with Rx
1.8
0.9
2.2
0.6
Asthma Quality Indicators
All asthma patients should have an action plan
72
64
All asthma patients with poor control should have inhaled
corticosteroids
Show me my current asthma treatment outcomes
Compare my asthma treatment outcomes for the past 2 years
My Practice
Profile
Asthma
COPD Hypertension
Diabetes
CHF
Risk Factor Vulnerable
Management
Patients
Disease Control
My Hypertension Patients
Hospitalizations for hypertension complications
Demographics:
Number of hypertensives
Average age (years)
Female (%)
Receive an income subsidy (%)
2006
100
80
64
34
45
6
60
40
Comorbidity:
20
Average number of serious health problems
Average number of medications
0.84
2.6
0
HTN
Stroke
MI
All CV
Continuity of care:
Compliance with Rx
Average number of visits to my practice
Average number of visits to other physicians
Patients with all anti-hypertensive therapy Rx
by me (%)
1.9
1.0
72
Hypertension Quality Indicators
All hypertension patients should have their blood pressure
monitored regularly
All patients with complicated hypertension should be
prescribed an ACE Inhibitor (unless contraindicated)
Compare my hypertension treatment outcomes for the past 2 years
Compare my hypertension treatment outcomes to those of my peers
The voyage begins…
Thank you.
robyn.tamblyn@mcgill.ca