Implementing and maintaining a researchable database from electronic medical records: a perspective from an academic family medicine department.

Electronic medical records (EMRs) are posited as a tool for improving practice, policy and research in primary healthcare. This paper describes the Deliver Primary Healthcare Information (DELPHI) Project at the Department of Family Medicine at the University of Western Ontario, focusing on its development, current status and research potential in order to share experiences with researchers in similar contexts. The project progressed through four stages: (a) participant recruitment, (b) EMR software modification and implementation, (c) database creation and (d) data quality assessment. Currently, the DELPHI database holds more than two years of high-quality, de-identified data from 10 practices, with 30,000 patients and nearly a quarter of a million encounters.

[1]  Marc Verbeke,et al.  The International Classification of Primary Care (ICPC-2): an essential tool in the EPR of the GP , 2006, MIE.

[2]  M. Gulliford,et al.  Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database , 2007, BMJ : British Medical Journal.

[3]  C. Schoen,et al.  On the front lines of care: primary care doctors' office systems, experiences, and views in seven countries. , 2006, Health affairs.

[4]  Janet E Hux,et al.  Diabetes in Ontario: determination of prevalence and incidence using a validated administrative data algorithm. , 2002, Diabetes care.

[5]  Jean-Karl Soler,et al.  The coming of age of ICPC: celebrating the 21st birthday of the International Classification of Primary Care. , 2008, Family practice.

[6]  Don E Detmer,et al.  Research challenges for electronic health records. , 2007, American journal of preventive medicine.

[7]  G E Fryer,et al.  The role of family practice in different health care systems: a comparison of reasons for encounter, diagnoses, and interventions in primary care populations in the Netherlands, Japan, Poland, and the United States. , 2002, The Journal of family practice.

[8]  Sarah Krein,et al.  Advancing evidence-based care for diabetes: lessons from the Veterans Health Administration. , 2007, Health affairs.

[9]  Ilias Iakovidis,et al.  Towards personal health record: current situation, obstacles and trends in implementation of electronic healthcare record in Europe , 1998, Int. J. Medical Informatics.

[10]  Julie O'Halloran,et al.  Defining chronic conditions for primary care with ICPC-2. , 2004, Family practice.

[11]  C. Feifer,et al.  Improving Diabetes Care Through a Multicomponent Quality Improvement Model in a Practice-Based Research Network , 2007, American journal of medical quality : the official journal of the American College of Medical Quality.

[12]  J. Williams,et al.  Recruiting family physicians as participants in research. , 1989, Family practice.

[13]  M. Stewart,et al.  The Adoption of Electronic Medical Records in Family Practice : The Providers ’ Perspective , 2009 .

[14]  Blacklock Sm.  The symptom of chest pain in family practice. , 1977 .

[15]  Thomas M Vogt,et al.  Electronic medical records and prevention quality: the prevention index. , 2007, American journal of preventive medicine.

[16]  Gunnar H. Nilsson,et al.  Clinical effect of computer generated physician reminders in health screening in primary health care - a controlled clinical trial of preventive services among the elderly , 2004, Int. J. Medical Informatics.

[17]  Jeremy M Grimshaw,et al.  Improving management of hypertension in general practice: a randomised controlled trial of feedback derived from electronic patient data. , 2005, The British journal of general practice : the journal of the Royal College of General Practitioners.

[18]  J. Gill,et al.  Quality of Outpatient Care for Diabetes Mellitus in a National Electronic Health Record Network , 2006, American journal of medical quality : the official journal of the American College of Medical Quality.

[19]  Jerrett Wa.  Lethargy in general practice. , 1981 .

[20]  S. Blacklock.  The symptom of chest pain in family practice. , 1977, The Journal of family practice.

[21]  D. Protti.  Comparison of information technology in general practice in 10 countries. , 2007, Healthcare Quarterly.

[22]  J. Hippisley-Cox,et al.  Married couples' risk of same disease: cross sectional study , 2002, BMJ : British Medical Journal.

[23]  H. Mcdonald,et al.  Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. , 2005, JAMA.