A Platform to Collect Structured Data from Multiple EMRs.

Adoption and use of Electronic Medical Records (EMRs) is continuing to rise across Canada, leading to more data being generated. These data, however, are not being captured in a standardized manner, they are not available for research, surveillance or health system management, and they are not having a real-time impact on healthcare providers at the point of care. Multiple stakeholders, including researchers and system evaluators, require easy access to high quality, structured data. As current EMRs are not able to effectively meet their needs, we engaged multiple stakeholders to assist in designing a solution. A total of 90 stakeholders from various backgrounds participated in an iterative joint design process. After incorporating the feedback of all stakeholders, we developed the design for a scalable platform for capturing structured, evidence-based data from all EMRs in Canada for research, health system management, clinical decision support and other purposes. We discuss the design specification for our proposed solution and explain how, using clinical forms, we can not only capture structured, high quality data from multiple EMRs, but also provide real-time guideline advice to providers at the point of care. The scalability of this proposed solution across multiple diseases and multiple EMRs is also explained. We further discuss the benefits and limitations of this proposed solution to several key stakeholder groups and address issues of privacy and security.