Harnessing data to drive improvement: DFCM researchers launch dashboard to make better care easier
The digitization of people’s medical records should make it easy for family doctors to manage effectively a patient’s chronic condition, right? Not necessarily, says Dr. Tara Kiran, a family doctor and Vice-Chair of Quality and Innovation at the Department of Family and Community Medicine (DFCM) at the University of Toronto.
“In order for us to be able to understand if we are delivering good care, we have to be able to look at our data. Despite what the public might think, it’s not easy from the electronic medical records (EMR) to give you a snapshot of quality of care in your practice,” says Kiran, who, along with Drs. Adam Cadotte, Noah Ivers, Payal Agarwal and Susie Kim, led the development of a digital tool called CareCanvas to support practice improvement.
CareCanvas is an interactive, online dashboard that summarizes at-a-glance clinical information from a practice’s EMRs to make it easier to look after patients. The dashboard is a collaboration between DFCM and the Primary care Ontario Practice-based Learning and Research network (POPLAR).
Developed by family physicians for family physicians, CareCanvas outlines more than 15 quality of care measuresincluding information on diabetes, high blood pressure and immunizations. The dashboard enables doctors to catch up on chronic and preventive care by letting them see, for instance, which of their patients with diabetes or high blood pressure have not visited in person in the last year, or which of their patients with either of these conditions have a blood pressure reading that is over the target.
“We made the tagline for CareCanvas ‘Better care, made easier’ and that’s really what it’s all about for us. We think the EMRs that we all feel slaves to should give us something back. It’s about using all that data in there to make it easier to identify patients who may need reassessment,” says Dr. Noah Ivers, a family physician and an associate professor at DFCM.
It also informs clinicians which of their patients have not received key vaccines. Kiran notes provincial data show childhood and infant immunization have fallen behind during the last few years. “Many people deferred those types of visits in the pandemic and now we have to play catch-up. In our dashboard, you can see how many of your patients who are 4 to 6 years old have gotten their recommended childhood immunizations. You can easily download a list of the patients who haven’t [done so] and then follow up with those patients,” says Kiran, who holds the Fidani Chair in Improvement and Innovation.
To access CareCanvas, physicians need to contribute their data to POPLAR and use one of the following EMR systems: Telus Practice Solutions, Accuro and Oscar. CareCanvas is private, secure and available at no-cost. Doctors can register here to access the dashboard.
In addition to the physician dashboard, there is one for clinics and one for Ontario Health Teams (OHTs). The clinic dashboard allows a group of physicians to see their overall practice demographics and quality of care metrics. Similarly, the Ontario Health Team dashboard enables OHT leadership to view the demographics of patients being cared for by family physicians in their region. This information can help leaders prioritize areas of improvement and show progress in an area over time. There is no identifiable patient and physician data in the clinic and OHT dashboards.
The aim of the initiative, says Kiran, is to take the legwork out of identifying where a particular doctor or practice needs to focus their improvement efforts. “Some practices end up spending a lot of time trying to find this kind of information in their EMRs. At the DFCM, part of our goal over the last few years is to try and take away the work of measurement from practices, make that super easy for them so they can focus on the improvement.”
The hope, says Ivers, is that CareCanvas will be a tool to help family doctors provide better care in a way that is sustainable for them. “We have limited time, limited resources, limited capacity. My hope is that CareCanvas helps us direct our energy where it will be most beneficial for our patients.”