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The collection, reporting and use of standardized data offers the opportunity to transform healthcare, however, for the most part the standardized data collected to date is predominantly comprised of performance indicators. The uptake and use of standardized clinical data continues to present a challenge in healthcare. Canadian Health Outcomes for Better Information and Care (C-HOBIC) is an initiative of the Canadian Nurses Association (CNA) that is leading the way with the collection of standardized clinical outcomes reflective of nursing practice in Canada. Building on groundbreaking work in Ontario, C-HOBIC introduces systematic structured patient assessments that are documented in standardized clinical terminology across the health care system. The use of standardized clinical terminology to document the assessments enables them to be abstracted into jurisdictional EHRs and anonymized for use in national databases. Thus patients’ clinical outcomes information is available to clinicians through the EHR but also for healthcare executives, policy makers and researchers by way of aggregated and anonymized population data. The C-HOBIC dataset is a Canada Approved Standard.
Work is now underway to advance the collection of this dataset across Canada. With funding from Canada Health Infoway and participating provincial partners, pilot projects were undertaken to demonstrate the feasibility and value of collecting this dataset in different settings and jurisdictions across Canada. The lessons learned from this work are informing future implementations in Canada. To support the inclusion of this assessment data in electronic health records (EHRs) as they are being implemented, the C-HOBIC dataset has been mapped to both ICNP® V2 and SNOMED CT. Because SNOMED CT is the clinical terminology recommended for use in EHRs in Canada this will have far-reaching impact on the uptake of these clinical outcomes in jurisdictions and care settings across Canada.
The approaches to enabling adoption through the development and implementation of the C-HOBIC dataset will be examined with a focus on the opportunities for outcomes data to support evidence based care, improve clinical patient outcomes, inform policy making and enhance health system effectiveness. The strategies for advancing the uptake of the C-HOBIC dataset in healthcare settings across Canada will be discussed.
The importance of adopting clinical data standards to facilitate the consistent measuring, monitoring, and reporting of clinical outcomes cannot be underestimated. Standardizing patient assessments has the potential to demonstrate the collective impact of various providers, interventions, and supports on patient outcomes, system costs, and overall use of the healthcare system.