Integrating Medical Device Product Information into CIHI's Hospitalization Database
e-Health ePoster Library. De Guia N. Jun 6, 2017; 167139; EP07.06
Ms. Nicole De Guia
Ms. Nicole De Guia
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Abstract
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Purpose/Objectives: The medical device industry is an innovative health care marketplace that is regulated less stringently than drugs under federal legislation in Canada and internationally. Currently there is a large information gap in terms of which devices provide the best outcomes with good value in terms of device pricing as well as the need to perform longer-term surveillance of medical device safety. The Canadian Institute for Health Information (CIHI) is expanding the capability of its primary hospitalization database, the Discharge Abstract Database (DAD), to capture medical device product information, beginning with hip and knee replacements, in order to support these patient safety and procurement agendas.

Methodology/Approach: CIHI has managed the Canadian Joint Replacement Registry (CJRR), Canada’s only national medical device registry, since 2001. This Registry captures hip and knee replacement product (barcode) information to support the monitoring of device performance and related outcomes. CIHI is working to integrate the capture of the CJRR information via the DAD, which will directly associate the product information with the associated medical-device related hospitalization. Activities undertaken as part of this initiative included an assessment of the CJRR data elements vis-à-vis the DAD, comparisons with international arthroplasty registries, and consultations with clinical and classifications experts, as part of a multi-disciplinary team that also included IT business analyst, architecture, and developer staff.

Finding/Results: As of April 2018, the DAD will include additional data elements to capture detailed manufacturer and product number information associated with each hip and knee replacement device. The DAD will also have the enhanced ability to received scanned barcode information and parse out requisite information, a key functionality given that the current lack of standard barcode formats in the industry. These additions lay the groundwork for future medical device product capture. Several provinces in Canada have mandated CJRR collection and it is expected that this integration will increase the reporting to support device surveillance and procurement decisions. For instance, product characteristics, such as bearing surface, are known to influence the revision rates of joint replacement surgeries. Early revisions need to be reduced, as such surgeries are significant procedures for the patient, take longer for recovery, and are costly to the health care system. These medical device products have varying costs negotiated through private procurement contracts; under the current pressures to reduce health care costs, it is important that their relative outcomes be considered during purchasing arrangements.

Conclusion/Implications/Recommendations: An estimated half a million medical-device related hospitalizations and procedures occur in Canada annually, incurring significant costs in the health care system. By building in the capability for medical product device capture directly linked with the patient hospitalization record, CIHI is enhancing its ability to provide outcomes data in a manner that supports the work of regulatory and supply chain/procurement agencies.

140 Character Summary: CIHI will be capturing medical device product information in its primary hospitalization database to support improvements in outcomes data.
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