Government & policy
Ontario seeks to improve quality of
TORONTO –- As a method of raising the accuracy of data and improving
access to information, Ontario’s government is establishing 14 Local
Data Management Partnerships across the province, Health and Long-Term
Care Minister George Smitherman announced.
“Quality patient care requires quality information,” Smitherman said.
“We are building an information management system to support a new,
patient-focused system of care that will consolidate, coordinate and
standardize the way data are managed.”
The new Local Data Management Partnerships bring together health
information management officials from hospitals and the community care
sector in each of the 14 new Local Health Integration Networks. They
will work together to identify best practices, standards, tools, and
policies for better data quality and management.
management is an area of health care that has suffered from decades of
neglect,” said Dr. Adalsteinn Brown (pictured at
left), Information Management Lead for the Ministry of Health and
Long-Term Care’s Health Results Team. “This initiative is the first step
in the implementation of a strategy that will lead to better information
management in healthcare, and informed decisions made in the best
interest of patients.”
“This is an opportunity to take a more integrated approach to data
management that builds on informal approaches already used by hospitals
and their partners to improve information sharing,” said Hilary Short,
President and CEO of the Ontario Hospital Association. “This is an
important step forward in providing our healthcare workers with the
information they need to provide the safest care possible.”
The government has developed an Information Management Strategy which
involves setting standards for data quality, better coordination of data
collected by healthcare providers, and the consolidation of information
into a common, integrated knowledge base.
It is focused on producing better data, supporting accountability and
quality improvement through performance measurement, and supporting
“Information management is an area whose time has come,” said Jeff Lozon,
President and CEO, St. Michael’s Hospital, Toronto. “From our
perspective, information is vital in supporting our core functions of
care, education and research. The implementation of a formal structure
to improve the management of information, at a local level, is a step in
the right direction for healthcare providers and the system alike. We
look forward to contributing to this effort.”
This initiative is part of the government’s plan to build a healthcare
system that delivers on three priorities -– keeping Ontarians healthy,
reducing wait times and providing better access to doctors and nurses.
Some problematic areas for healthcare information collection in Ontario:
• Data on the use and efficiency of hospital care requires more than
eight months to process – the same as it did in the 1960s.
• Right now there are nearly 100 separate health information databases
in Ontario, many of which contain the same data.
• There are nearly 2,000 separate performance indicators in use in
Ontario. Many are of limited use because they are either difficult to
interpret, they provide only limited information, or they do not relate
to the government’s key health priorities.
• Hospitals are submitting up to 200 separate data reports, some on a
Health care in Ontario is an enormously complex system that depends on
information. At the most fundamental level, it is used by doctors to
decide on the best possible treatment options for their patients. At a
system level, where decisions about the management and delivery of
healthcare services are made, the data that healthcare providers across
the province collect about patients is studied and analyzed to identify
trends in population health, such as the incidence of stroke and
This evidence is then used to plan for and make decisions about which
healthcare services will be provided where. Over the last decade,
advances in technology have dramatically increased the capacity to
collect, store and analyze a large volume of health-related data. The
reality is that collecting all this data is placing a considerable
burden on many healthcare providers.
With close to 100 separate health information databases in operation,
healthcare planners, researchers and analysts are finding it more and
more difficult to access the information they need. At the end of the
day, when system planners and managers are looking to evaluate how the
system is performing, the data itself is coming up short. Key pieces of
information are missing to evaluate basic things like the quality of
care overall in the province are missing.
The Ontario government has committed to breaking the cycle of
ever-escalating health care costs by instilling a culture of
accountability and improved outcomes – one that is tied to results. It
needs accurate and comprehensive information to measure performance and
provide a clear indication of the health system’s performance overall.
Despite having more than 2,000 indicators in Ontario, many of these are
of limited use because they are either difficult to interpret or they do
not relate to the government’s health priorities.
The objectives of the new information management partnerships will be
• Make local data management processes more effective and efficient
• Improve the timeliness and quality of data
• Make more effective use of scarce health information management
• Encourage health care providers to adopt best practices.
The partnerships will be implemented in four phases, over a two-year
period. Each phase will address a different area within the scope of
activities related to health data management:
Phase I – Health records/health information management functions
Phase II – Financial data management functions
Phase III – Clinical data management functions
Phase IV – Primary care data management functions.
A provincial Data Management Council will be responsible for overseeing
the four advisory committees that will be created for each phase of the
partnerships as follows:
Phase I – Health Records Advisory Committee
Phase II – MIS Steering Committee
Phase III – Clinical Data Advisory Committee
Phase IV – Primary Care Advisory Committee
In Phase I, 14 Local Data Management Partnerships will be established in
each of the province’s Local Health Integration Networks. Each
partnership will include those responsible for health records/health
information management from each hospital (e.g., the director of health
records) and those responsible for health information management from
A chair for each partnership will sit on the provincial Health Records
Advisory Committee. The committee will be responsible for recommending
best practices and providing direction to the partnerships related to
the collection and management of data. A representative from the
Ministry of Health and Long-Term Care will chair this committee. Members
will include Local Data Management Partnership chairs, as well as
representatives from the various Health Information Management (HIM)
programs and associations.
During Phase I, the partnerships will also be supported by the Physician
Documentation Expert Panel and the Data Consistency Working Group.
The Physician Documentation Expert Panel is responsible for addressing
documentation issues. The panel was established in September 2005, and
is chaired by Dr. Ralph Kern, Assistant Professor of Medicine at the
University of Toronto and Neurology Program Director at Mount Sinai
Hospital. The panel will evaluate and promote changes to hospital
physician education packages, medical school curricula and provincial
policies related to chart completion, as well as identify other
opportunities for improving chart documentation.
The Data Consistency Working Group will identify and promote
opportunities to improve coding consistency and data quality. This group
will include representatives from the partnerships and from
organizations that use the data for purposes such as research and