Identifying Transitional High Cost Users from Unstructured Patient Profiles Written by Primary Care Physicians

Zhang, Haoran; Candido, Elisa; Wilton, Andrew S.; Duchen, Raquel; Jaakkimainen, Liisa; Wodchis, Walter P.; Morris, Quaid

doi:10.1142/9789811215636_0012

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Canadian family physicians are the main physician providers of primary care in Canada and currently over 85% of family physicians (FPs) use electronic medical records (EMRs) for their clinical care [ 15 ]. Since FP EMR data contains much clinical information and details about a patient’s health care, FP EMRs are being increasingly used for research and quality improvement [ 16, 17 ]. Algorithms to identify LOD patients seen in primary care have been developed using FP EMRs alone [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of Early Onset Dementia in Population-Based Health Administrative Data: A Validation Study Using Primary Care Electronic Medical Records

Jaakkimainen

Duchen

Lix

et al. 2022

JAD

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Background: Early onset dementia (EOD) occurs when symptoms of dementia begin between 45 to 64 years of age. Objective: We developed and validated health administrative data algorithms for EOD and compared demographic characteristics and presence of comorbid conditions amongst adults with EOD, late onset dementia (LOD) and adults with no dementia in Ontario, Canada. Methods: Patients aged 45 to 64 years identified as having EOD in their primary care electronic medical records had their records linked to provincial health administrative data. We compared several combinations of physician’s claims, hospitalizations, emergency department visits and prescriptions. Age-standardized incidence and prevalence rates of EOD were estimated from 1996 to 2016. Results: The prevalence of EOD for adults aged 45 to 64 years in our primary care reference cohort was 0.12% . An algorithm of ≥1 hospitalization or ≥3 physician claims at least 30 days apart in a two-year period or ≥1 dementia medication had a sensitivity of 72.9% (64.5–81.3), specificity of 99.7% (99.7–99.8), positive predictive value (PPV) of 23.7% (19.1–28.3), and negative predictive value of 100.0% . Multivariate logistic regression found adults with EOD had increased odds ratios for several health conditions compared to LOD and no dementia populations. From 1996 to 2016, the age-adjusted incidence rate increased slightly (0.055 to 0.061 per 100 population) and the age-adjusted prevalence rate increased three-fold (0.11 to 0.32 per 100 population). Conclusion: While we developed a health administrative data algorithm for EOD with a reasonable sensitivity, its low PPV limits its ability to be used for population surveillance.

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Section: Introductionmentioning

confidence: 99%

Identification of Early Onset Dementia in Population-Based Health Administrative Data: A Validation Study Using Primary Care Electronic Medical Records

Jaakkimainen

Duchen

Lix

et al. 2022

JAD

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“…In 2019, 86% of Canadian FP practices use EMRs for their clinical care [ 30 ]. FP EMRs contain a wealth of information describing care provided to their patients and this data has increasingly been used for research and quality improvement [ 31 , 32 ], including how well the healthcare system coordinates care across different health care sectors [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

The receipt of information by family physicians about their patient’s emergency department visits: a record linkage study of electronic medical records to health administrative data

Jaakkimainen

Chung²,

Lu³

et al. 2021

BMC Fam Pract

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Background Canadians are known to be frequent users of emergency department (ED) care. However, the exchange of information from ED visits to family physicians (FPs) is not well known. Our objectives were to determine whether Canadian FPs received information about their patient’s ED visit and the patient characteristics related to the receipt of ED information. Methods This study was a descriptive record linkage study of FP Electronic Medical Record (EMR) data linked to health administrative data. Our study cohort included patients who had at least one ED visit in 2010 or 2015 in Ontario, Canada. An ED visit could include a transfer to or from another ED. The receipt of information from an ED note was examined in relation to patient age, sex, neighbourhood income quintiles, rurality and comorbidity. Results There were 26,609 patients in 2010 and 50,541 patients in 2015 with at least one ED visit. In 2010, 53.3% of FPs received an ED note for patients having a single ED visit compared to 41.0% in 2015. For patients with multiple ED visits, 58.2% of FPs received an ED note in 2010 compared to 45.7% in 2015. FPs were more likely to receive an ED note for patients not living in low income neighbourhoods, older patients, patients living in small urban areas and for patients having moderate comorbidity. FPs were less likely to receive a note for patients living in rural areas. Conclusions Community-based FPs are more likely to get information after an ED visit for their older and sicker patients. However, FPs do not receive any information from EDs for over half their patients. Electronic health record technologies and their adoption by ED providers need to improve the seamless transfer of information about the care provided in EDs to FPs in the community.

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Data structuring of electronic health records: a systematic review

2021

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Identifying Transitional High Cost Users from Unstructured Patient Profiles Written by Primary Care Physicians

Cited by 4 publications

References 11 publications

Identification of Early Onset Dementia in Population-Based Health Administrative Data: A Validation Study Using Primary Care Electronic Medical Records

Identification of Early Onset Dementia in Population-Based Health Administrative Data: A Validation Study Using Primary Care Electronic Medical Records

The receipt of information by family physicians about their patient’s emergency department visits: a record linkage study of electronic medical records to health administrative data

Data structuring of electronic health records: a systematic review

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