An Authoritative Perinatal Information System APHEO AGM, Nov. 20, - - PowerPoint PPT Presentation

Ontario Perinatal Surveillance System

An Authoritative Perinatal Information System

APHEO AGM, Nov. 20, 2008 Toronto, Ontario

Agenda Agenda

Overview and of OPSS Current and Future status Where do the Niday Databases fit? GTA PH-EPI group Opportunity for Public Health

– Access – Standards – Technology

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Surveillance in Canada Surveillance in Canada

Image courtesy of CPSS 3

Historical omissions from Ontario due to “Data quality Concerns”

Overview

Provincial committee struck to provide

guidance for perinatal surveillance in Ontario

Evolved from ON Perinatal Partnership

Program (OP3)

Funded initially to support Niday Perinatal

Database

MoHLTC direction of develop

linkages/partnerships with other provincial data initiatives

OPSS Overview OPSS Overview

Collaboration of programs collecting

maternal/ newborn data, including:

– Niday Perinatal Database – Fetal Alert Network – Midwifery Program – Newborn Screening – ON Maternal Multiple Markers Screening

To develop an integrated web portal

that provides a common repository for all perinatal information

Objective is to contribute towards

achieving optimal health of mother, baby & families

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Data Continuum Data Continuum

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Data Status Data Status

Current perinatal/neonatal data status in ON:

– Many disparate data repositories across continuum. – None inclusive of the entire reproductive population – There is duplicate data collection – Misaligned data element definitions misaligned – There are few appropriate and timely health system planning and accountability measures – There is little data linkage and therefore unfulfilled value and lost potential

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OPSS rationale

Integration Perinatal/Neonatal to ensure a comprehensive data solution that will effectively support the activities and goals of the emerging MoHLTC maternal-newborn- child- youth strategy

Inclusive of all pregnancies and births Allows relational analysis across the

continuum

Provides population and health service

surveillance

Meets principles of information management

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Fetal Alert

Niday/Midwife

MSS

Newborn Screening

OPSS Databases OPSS Databases

OPSS Data Vision OPSS Data Vision

OPSS Web Portal

One stop shopping Users are given privileges to access certain components of portal Data transfer occurs seamlessly to appropriate organizations

Common data fields

• ie. demographics

Maternal Serum Screening Niday Midwifery FAN Newborn Screening

Privilege-based data retrieval

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OPSS Objectives OPSS Objectives

Provide high quality data that supports innovative

health planning and health system management / evaluation

Support evidence-based strategy development and

implementation

Eliminate redundancies and enhance efficiency in

data collection

Mandate data standards Improve linkages between data holdings Track individuals through the “continuum of care” Support research and innovation 11

OPSS Data Uses OPSS Data Uses

The challenge is to reach a practical balance between the improvement of health, the effectiveness of the health care services, and the right to privacy and confidentiality of personal health information.

√ Towards this effort, OPSS has:

– Developed a new data architecture model for an integrated perinatal/neonatal information system – Established a new governance model – Apply for Registry status designation (or equivalent) to support OPSS objectives, collect, use and disclose personal health information in accordance with privacy legislation and data system standards

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Secondary Uses Secondary Uses

Enhanced ability to manage programs and services,

while also allowing the Ministry, LHINs and Public Health Units to:

– develop responsive policies – improve evaluation and accountability in the system – support quality patient-centered care through service delivery improvements – promote health and healthy behaviours – support maternal and newborn disease prevention – inform human resources planning, and – create powerful hypothesis-generating research and innovation initiatives

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Challenges Challenges

Before completing integration, important

to evaluate risk of proposed OPSS system

Various types of risk

– Usability for end users (clinicians, hospitals, planners, etc) – Data quality – Technology – Privacy assurance

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Field of Dreams Field of Dreams

“Build it, and they will come”

Many unanticipated partners and

potential usages

Important to ensure robust yet flexible

system, able to respond to new demands in the future

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Nomenclature Nomenclature

Niday database: collection and reporting

tool

OPSS: term used to designate broader

perinatal surveillance system of the future

OPSS Committee: 11 member committee

to provide guidance and expertise

OPSS Exec Committee: 5 program leads

+ staff to establish data convergence principles and work plan – current focus of all OPSS work

Niday Perinatal Database Niday Perinatal Database

• Developed in Eastern Ontario, by PPPESO, at CHEO
• Web-based database
• Captures 97% of births in Ontario
• “Real-time” perinatal data
• Partnership with hospitals, midwives, public health

units, LHINS, MOHLTC, and other stakeholders

• Program management, benchmarking, CQI, planning,

evaluation and research

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Risk factors and conditions influencing birth outcome

• age
• smoking
• multiple pregnancy
• presentation
• age
• health problems
• previous CS
• group B strep
• reproductive assistance

Intrapartum interventions

• monitoring
• induction
• epidural
• forceps/vacuum
• episiotomy, laceration
• augmentation of labour
• induction
• cesarean
• complications
• steroid use
• antibiotics
• transfer
• duration of second stage

Health service factors

• first trimester visit
• prenatal classes
• care provider
• birth in appropriate setting
• length of stay in hospital

Birth outcome

• gestation
• birthweight
• APGAR 1, 5, 10
• stillbirth
• resuscitation
• Hypoxia

Infant health

• Feeding
• congenital anomaly
• neonatal
• death
• hearing
• health problems
• jaundice
• head

circumference

• surgery
• SNAPS, TRIPS

Niday Database Niday Database Indicator Framework Indicator Framework

Niday Niday “ “Readiness Readiness” ” Activities Activities

Complete provincial implementation of

Niday (136,944 records in 07/08)

Evaluation and data quality initiatives Development of integrated perinatal and

neonatal system

Data Workgroup: aligning and

standardizing data elements within OPSS data holdings

GTA GTA-

• PH

PH-

• EPI

EPI

Support in implementation of Niday Initial data quality initiatives Participation in the CHN Annual

Statistical Report

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Access to OPSS

Membership on OPSS Steering

committee

Support PH access provincially Support PH standards Technology to support reporting

requirements

Influence data collected

Getting there! Thank – You!

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