COMPETE III Review

52 Ontario Physicians Join the Study

Between October 2004 and March 2005, 52 physician practices from 18 different sites within Hamilton, Niagara, Kitchener-Waterloo, Toronto and Ottawa regions, joined the study. The participants’ offices ranged in size from solo sites to a 9-physician office. The majority were participating in Primary Care Renewal.

Each of the 52 physicians in the study uses one of five Electronic Medical Record (EMR) systems: OSCAR is used by 17, MacMedical by 16, PEPPER by 10, YorkMed-Purkinje by 7 and P&P by 2.

COMPETE III Technical Review

A real-time Clinical Data Repository (CDR) that consolidates data from a variety of clinical sources such as EMR and paper, was developed to present a unified patient data view. Data extraction and integration with EMRs present many challenges due to the research quality required and the priorities of our multiple stakeholders. Even with a paperless primary care office, paper sources of clinical information abound. Therefore we developed fax and web collection functions using Optical Character Recognition (OCR) Other data were collected from on-line web forms, e.g. patients and physicians were able to open up a web browser to enter clinical and demographic information in a secure environment.

The colour-coded Vascular Tracker (CIII VT), a 16-item chart that monitors everything from blood pressure to stress level, opened automatically on the physician's desktop as (s)he opened the patient record. The Vascular Tracker gave the physician an at-a-glance update highlighting the urgency of addressing each risk factor. Instead of spending the visit looking for information, now the physician could work with the patient on action items. The same information was available to the patient either via secure Internet or paper summary.

Patient Recruitment and Education Review

A research ethics committee-approved COMPETE III recruitment package was mailed to more than 5000 eligible patients inviting them to participate in the study. There was an approximate 12-14% acceptance rate in the first phase, a mail-back postcard. New privacy laws forced us to take this less efficient approach to recruitment. Over 1100 patients were randomized in the study.

Intervention patients were encouraged to attend Education Sessions on Vascular Health presented by the COMPETE III Clinical Coordinators. Sessions were scheduled in advance at different locations in each region to accommodate all patients. Intervention patients unable to attend an Education Session were sent the educational materials.

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