The purpose of this section of the document is to identify issues related to data collection and registry configuration. When designing a disease registry, it is important to consider the registry's purpose and target population as this will influence the type of data, source(s) of data, and the manner in which it is collected. A data dictionary defining the specific data elements to be collected is key to ensuring registry data quality. Compliance of physicians and patients who provide registry data is instrumental to data collection and should be addressed early. Additionally, it is important to consider if the registry will be linked to other databases. Finally, it is important to address procedures for making changes in the registry and to establish what types of documentation are necessary. In preparation of this section, we reviewed the literature, scholarly sources, and consulted with medical experts and registry/database specialists on the topics mentioned above. RELEVANT LITERATURE In preparing the information below 139 full text articles were reviewed. Conventional and Innovative Roles for Registries Most registries aimed to serve conventional registry roles. As examples, Byrne et al used a registry to examine the natural history of Pompe disease 68 ; three registries pursued quality improvement (stroke care, cardiac catheterization and management of childhood diabetes 69-71); disease subgroup characterization was facilitated for pituitary and lung tumors, 72,73 post-market device monitoring for cardiovascular stents, 74,75 as well as monitoring of treatment outcomes and safety follow up for cardiac transplant patients receiving everolimus, general cardiac care, biological agents for arthritis, giant intracranial aneurysms, and TPA for ischemic stroke. 76-80 Other registries aimed to serve innovative roles: • examining the impact of a diagnostic test on patient management (i.e. PET scanning on management of cancer patients), 81
Communication during patient transitions is difficult in a fragmented health care system. eHealth technologies are often seen as a panacea, but a large proportion of eHealth projects fail, primarily because of human, not technological, elements. To combat this tendency, concepts derived from institutional ethnography were applied to create an electronic communications solution, which enabled careful mapping of communications gaps; their consequences; and the diverse needs of multiple health care providers. Institutional ethnography allowed researchers to trace social relations across locations in the health system and determine how action could be coordinated to ensure that family physicians were informed of patients’ acute care encounters, while simultaneously strengthening relations between clinicians and information technology workers. As a result, an automated electronic notification system was piloted, evaluated, and spread to more than 92 percent of community physicians in one region of British Columbia, Canada, improving communication between providers and enhancing patient care.
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