using de-identified electronic medical record data to deliver insights into diabetes
TRANSCRIPT
Use of De-Identified Health Data
Introduction: Real World Evidence has emerged as critical to valuing medicine and understanding the burden of illness
RWE Integrated Hospital:GP:Pharmacy:
EMR
Real World Evidence (RWE)
Electronic medical record and lab data
Longitudinal patient data – Prescriptions and admin data
Admin data and prescription data – snap shot
Transactional data
Genomics mHealth
Personalized Medicine
2015
2015+
2014
2000’s
1980’s
1970’s
Increased access to clinically relevant outcomes metrics
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
Examples of databases in Canada used to undertake health and disease studies
CIHI: Provincial:
Canadian Management Information System Database (CMDB) British Columbia cancer Registry
National Health Expenditure Database (NHEX) British Columbia eHealth
Discharge Abstract Database (DAD) British Columbia Healthcare Utilization Database
National Rehabilitation Reporting System (NRS) Canadian Community Health Survey
National Prescription Drug Utilization Information System (NPDUIS)
Organization for Economic Co-operation and Development (OECD) Health Database (Canadian Segment) Chronic Disease Registry
National Ambulatory Care Reporting System (NACRS) Government of Alberta: Health and Wellness
Canadian Joint Replacement Registry (CJRR) Health Services Data and Early Development Instrument
National Trauma Registry (NTR) Manitoba Centre for Health Policy
Therapeutic Abortions Database (TADB) Manitoba Health Research Database
Ontario Mental Health Reporting System (OMHRS) National Diabetes Surveillance System
Hospital Morbidity Database (HMDB) New Brunswick Department of Health
National Health Expenditure Database (NHEX)
Canadian Organ Replacement Register (CORR) Newfoundland and Labrador Centre for Health Information
Continuing Care Reporting System (CCRS) Nova Scotia Data Catalogue 2004
Hospital Mental Health Database (HMHDB) Ontario Case Costing Initiative
Canadian Management Information System Database (CMDB) Ontario Health Planning Data Guide
Canadian Multiple Sclerosis Monitoring System (CMSMS) Pediatric Inpatient and Outpatient Rehab
Population Health Research Unit
IMS Health: RAMQ - Quebec Canada
IMS Brogan LRx Saskatchewan Health Databases
IMS Brogan E360 EMR database Saskatchewan Health Research Services
IMS Brogan Rx Dynamics & claims ICES
CPCSSN Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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What to look out for with databases
» Does the data contain the variables required for the study – based on the disease state?
» Drug utilization
» Lab results
» Diagnostics
» Diagnosis
» Vital signs
» Mortality
» Demographics
» Full treatment pathway
» Costs (Intervention and drug)
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Where does IMS data come from?
Up to 5.3 million patients
If required for specific studies
500,000+ patients
with full data permission
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Minimizing patient re-identification and security
EMR
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Minimizing patient re-identification and security
EMR
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Minimizing patient re-identification and security
Physician Red Zone PHI
EMR
Static
De-identify & Risk Mitigate
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
9
Minimizing patient re-identification and security
Physician Red Zone PHI
EMR
Static
De-identify & Risk Mitigate
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Minimizing patient re-identification and security
IMS Evidence 360 IMS Data Warehouse
IMS Green Zone – No PHI Physician Red Zone PHI
EMR
Static
De-identify & Risk Mitigate
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Minimizing patient re-identification and security
IMS Evidence 360 IMS Data Warehouse
IMS Green Zone – No PHI Physician Red Zone PHI
EMR
Static
De-identify & Risk Mitigate
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
IMS E360 observes BMI, BP, other CV risk factors, and interventions, providing additional insight into the full value of medicines
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
The IMS E360 EMR data has validated well with PHAC and longitudinal patient data*
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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IMS E360 enables fast insights to data not readily available previously in Canada
Understanding HbA1c levels of patients taking diabetes medications
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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In this study, 906 patients who have received a DPP4 prescription exhibit the following characteristics
Sex Age Smoking Status
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Patients taking DPP4s also typically receive the following medications
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Test results for DPP4 patients show a significant proportion are hypertensive
* Mayo clinic categorization
n=857
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Test results for DPP4 patients show a significant proportion are obese
n=581
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
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Summary
» Research of this type has been undertaken in Europe since the 1990s
» Databases such as CPRD, THIN and IMS Disease Analyzer in Europe have long delivered similar insights from de-identified patient data
» IMS Evidence 360 is the first tool built on a highly structured EMR system which delivers instant insights into patients health and treatment in Canada
» Studies are well controlled, ethics approved and designed by IMS epidemiologists and statisticians
“The Doctor doesn’t believe in computers, he likes to lose patient records the old fashioned way”
I think we have moved on quite a long way since I started working in the Health System
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.
Thank you, questions?
Copyright IMS Health 2014 - All rights reserved. IMS Brogan does not hold any personally identifiable patient information. All patient-level data is de-identified as part of IMS Brogan's risk management program to ensure the protection of patient privacy.