Study tracks diabetes patterns using EMRs

TORONTO – Canadian researchers are the first to use electronic medical records of family physicians to track the prevalence and patterns of care for diabetes across Canada. The findings open the door for future mass-scale exploration of chronic diseases using information technology.

The study, published in the Canadian Journal of Diabetes, began in 2008 when a handful of family physicians pooled their patients’ electronic medical records – careful to remove all patient identifiers to fully protect privacy – to determine patterns in diabetes within the community. Several of these physicians were affiliated with North York General Hospital.

The small partnership later grew to hundreds of family physicians. Electronic records from offices all over Canada were anonymized and then sent to the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), a large, validated national primary care Electronic Medical Records (EMR)-based database.

In the end, the records of 272,469 patients with at least one primary care encounter between January 1, 2011 and December 31, 2012 were analyzed, resulting in one of the largest-ever snapshots of diabetes in Canada.

“We usually think of studying chronic disease by gathering a small number of individuals to provide representation of the population,” says lead author Dr. Michelle Greiver (pictured), Department of Family and Community Medicine at North York General Hospital. “By using electronic records, this enlarges the number of patients that can be studied and relies on new technology to provide patterns in chronic disease so that care can be improved.”

In the end, researchers found that 7.6% of patients had diabetes and patients with diabetes had 1.4 times more practice encounters and 85.2% of patients taking medications to lower sugar were taking metformin. While the results were not surprising, according to Dr. Greiver, researchers now have a large number of anonymized records to study other chronic conditions such as dementia and depression.

About North York General

North York General is a leader in Health Information and Technology. Through eCare, NYGH became the first hospital in Canada to implement barcode scanning that uniquely identifies each medication and each patient, across all of our medical, surgical and critical care units. This milestone reduced the risk for potential medication errors by alerting healthcare providers when administering a medication. NYGH is also the first hospital in Canada to implement a CPOE system that includes the latest evidence and best practices from medical literature, providing physicians with this information when they develop a patient’s treatment plan. Our hospital is one of only three hospitals in Canada to have a Stage 6 designation from HIMSS Analytics (the research arm of the Healthcare Information and Management Systems Society) because of our eCare strategy. NYGH is on its way to a Stage 7 designation, which is where all patient charts are completely electronic. This allows a hospital to share important information with the patient’s family doctor, family health team and Community Care Access Centre, ensuring the right follow-up care is available promptly to any patient when they leave the hospital.