Abstract
Introduction: Digital health technology is an enabler of integrated care that brings clinical systems together. Primary care has a unique perspective of the role that harmonized health records play in the patient experience. In Southeastern Ontario, Canada healthcare providers are collaborating to implement shared electronic medical records (EMRs) between hospitals and primary care practices through the Regional Health Information System (RHIS) project. Given the duty of primary care providers to ensure that the people they serve receive proper care, evaluating primary care knowledge, attitudes and willingness to engage in the project from the outset is an essential step of the planning process.
Aims, Objectives, Theory or Methods: A multi-disciplinary Primary Care Working Group (PCWG) representing three Ontario Health Teams (OHT) was formed. Members include technology, financial and project leaders from hospital organizations, a primary care physician, a person with lived experience, and an OHT Impact Fellow.
The PCWG’s goal is to engage primary care providers in designing and piloting primary care functionality within the RHIS, and on concerns/benefits associated with it. The PCWG conducted a rapid impact evaluation to uncover primary care perspectives at early stages of project planning. The baseline survey instrument was co-designed with OHT staff, healthcare providers and academic experts across the region.
Highlights or Results or Key Findings: The “Pulse Check on Primary Care Perspectives and Support for the Regional HIS” was uploaded on a digital platform and tested. Each OHT’s primary care network emailed a backgrounder and the survey link to primary care practices. At least one physician per practice was asked to participate, and additional health providers were encouraged to a maximum of 2 responses per practice. Participants were given two weeks to respond, yielding a sample of n=45 participants and a participation rate of 73%.
First the presentation will outline the survey instrument before interpreting baseline quantitative findings concerning current knowledge and attitudes towards the RHIS project. We will then demonstrate how these results will inform primary care’s participation and the RHIS project’s engagement strategy. Finally, qualitative data pertaining to the benefits and challenges primary care associates with a shared EMR will be reviewed alongside how this data will also support the engagement framework.
Conclusions: Rapid impact evaluations cast light on current knowledge and attitudes and while helping inform project planning for integrated care systems by offering baseline data.
Co-designing survey tools that engage primary care while gathering necessary information can start discussion in a meaningful way to help launch a successful digital transformation strategy.
Implications for applicability/transferability, sustainability, and limitations: This rapid impact evaluation approach can inform and guide future digital transformation projects in other integrated health systems. While the sample was small, it was representative of a rural region. It offers insights on how to meaningfully engage primary care providers who are a critical audience in health system transformation.