The Health Quality Council of Alberta (HQCA) is a provincial agency with a legislated mandate to promote and improve health system quality and patient safety. The HQCA delivers on this mandate by reporting on various health system measures from an individual provider to a system-level.
The HQCA’s use of SAS Visual Analytics to deliver high-quality, secure and actionable data to family physicians would be reason enough to make it a candidate for the SAS Analytics Insight Award. However, the HQCA is also a useful lesson in how collaborating with a vendor’s team delivers a more seamless and less stressful development experience.
“Our goal from the outset has been to provide information that family physicians trust, and can use to drive improvement in their practices,” says Markus Lahtinen, Director of Health System Analytics at the HQCA.
The complexities of patient care
Patients move through a variety of environments in their healthcare journey – family physician’s offices, clinics, their homes, community and hospitals – but family physicians are generally considered the gatekeepers to secondary and tertiary treatment. The tools and resources available to help family physicians drive improved patient outcomes have been evolving over the years. The HQCA has historically provided family physicians with yearly reports (in PDF format) that include a unique combination of measures that reflect on preventative care, chronic conditions, pharmaceuticals, and health service utilization.
To equip Alberta’s approximately 4,000 family physicians with a tool to help them reflect on their patient data.
The SAS Viya platform.
In a 2019 survey, about 70 per cent of family physicians who receive the HQCA Primary Healthcare Panel Report say the report helped them identify a quality improvement opportunity for their practice.
The tools and resources available to help family physicians drive improved patient outcomes have been evolving over the years.
The HQCA has historically provided family physicians with yearly reports (in PDF format) that include a unique combination of measures that reflect on preventative care, chronic conditions, pharmaceuticals, and health service utilization.
“One of the challenges with offering information in strictly PDF format is that family physicians are unable to interact with their data, which means they are unable to dive deeper to ask questions and gain extra insights,” says Walie Aktary, Health System Analytics Lead.
For example, the data may tell family physicians that a number of their patients have not been screened for a chronic condition, such as diabetes. “It is difficult to action a number without an interactive reporting platform,” Aktary says, so family physicians and their care teams would have to spend a considerable amount of time working in their electronic medical record to identify who the patients are and whether their age and medical background make them a high risk.
“We recognized these limitations and realized there might be a better way to support family physicians,” says Jody Pow, Senior Data Manager at the HQCA.
In 2017, HQCA began moving its reporting system to a SAS Viya platform. This enabled the HQCA to update its Primary Healthcare Panel Report to provide confidential, actionable and personalized information about family physician practices in an enhanced digital format.
Family physicians can drill down into these free, on-demand reports to spot patterns or trends in their data so they can identify quality improvement opportunities – everything from focusing on screening for specific conditions to prioritizing care for high-risk patients.
As a result, there is significant potential for patient care to become more proactive, and for stronger patient relationships to be forged.
“On an ongoing basis, we’re adding new content and new measures such as lab test utilization,” says Pow. “And as the health system changes and family physicians look to respond, we can adapt and tailor the content of these reports.”
Family physicians or their approved care team members can access their patients’ private information. However, in aggregate, the report data is also valuable to decision-makers on a larger scale, across clinics, Primary Care Networks, Alberta Health Services Zones or, indeed, across the province.
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Building the beast
Building a solution to meet all these needs was a tall order. The HQCA wanted a single platform for gathering and quality assurance of data, report rendering and viewing, and – critically – security. “The HQCA has built a trusted relationship with family physicians, so we needed a software solution that we could trust,” Aktary says.
The solution had to allow each measure to be reported as a single instance, but with row-level security to protect patient confidentiality. Data layering would allow family physicians, and their approved care team members, to load tables to explore in memory on the fly. The right platform was not a decision to be taken lightly.
“We spent considerable time looking at front-to-back solutions,” Lahtinen says. “We spent months comparing.”
Eventually, the team chose a SAS Viya-based solution that provided the tools necessary for every step in the process: SAS Data Explorer and Data Studio for structuring data; SAS Visual Analytics for building reports; SAS Visual Statistics for advanced analytics; and SAS Environment Manager for application management.
“The single platform approach offered many advantages,” says Pow. “It streamlined the report production process and eliminated the human error associated with PDF production. It allowed the build team to incorporate user feedback seamlessly to improve the value of the reports, and the interactivity of the report promotes a data literacy among providers that can lead to quality improvement.”
However, the final sign-off required a successful proof-of-concept, which is where the collaborative culture of the HQCA shone as an advantage.
SAS advisors collaborated with the HQCA team to grind out the details and deliver a functioning model. In what could have been an environment fraught with push-back, finger-pointing and blame-storming, the teams worked together to hone a solution for approval. That relationship continues today.
“The HQCA is a model client,” says Kwok Seto, account executive for SAS. “They were approachable, collaborative, willing to work on co-marketing the solution together. They made it easy to deliver the project. And we continue to collaborate to drive the most value possible out of the solution.”
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