Key features of the National Diabetes Repository
- Secure remote access in a Privacy compliant analytic environment = Privacy legislation satisfied and data security meets or exceeds ISO standards
- Data across provincial boundaries = 5 provinces with over 123k patients living with diabetes
- Ability to collect Patient Reported data (PREMs and PROMs)
- Eliminates the need for Data Sharing Agreements and Data Transfers = Less Risk and substantial cost savings
- High-Performance computing = No need to purchase expensive equipment
- Validated Type 1 vs. Type 2 algorithm
- In collaboration with Primary Care Practice-Based Research Networks (PBRNs): recruitment for clinical trials
- In collaboration with PBRNs and Administrative data Partners: Primary Care EMR Data linked with Administrative data = Linkage of deep EMR and broad Administrative Data
By 2020, over 3 million Canadians (~10% of the population) will have diabetes, with vulnerable populations, including Indigenous Peoples and new immigrants, more likely to be affected. Those living with diabetes have an increased risk for heart disease, stroke, kidney failure, nerve disease, blindness, mental illness, and decreased life expectancy - all conditions that not only affect those who have the condition but the loved ones who care for them. Earlier diagnosis and effective interventions to prevent diabetes complications are needed, as is improved access to chronic disease self-management support systems and medical care. These improvement strategies must be achieved in large part through digital health solutions that improve access to patient data by clinicians, patients and researchers.
Diabetes Action Canada is enabling a digital health solution, with the launch of the National Diabetes Repository (NDR) led by Dr. Michelle Greiver (University of Toronto). The NDR contains de-identified primary care electronic medical record (EMR) data of patients with diabetes. With the application of privacy and security compliant methods, these data reside in a data safe haven and can be safely linked with other relevant data (retinopathy screening reports, and clinical trial information) for analytics. Canadian investigators are now able to access this repository data for their patient-oriented observational or population-based studies. Through partnerships with the Canadian Primary Care Sentinel Surveillance Network (CPSSCN), Southern Alberta Primary Care Research Network (SAPCReN), Northern Alberta Primary Care Research Network (NAPCReN), Réseau de recherché en soins primaries de l’Université de Montréal (RRSPUM), Atlantic Practice Based Research Network (APBRN) and University of Toronto Practice-Based Research Network (UTOPIAN) this diabetes repository currently has data from Ontario, Quebec, Manitoba and Alberta representing over 123,000 patients with diabetes. Plans are currently underway to expand this dataset to include primary care patient data from other provinces and territories and patient-reported data.
To ensure the use of this data aligns with the vision and mission of Diabetes Action Canada and that research studies have received appropriate ethics review, a volunteer Research Governing Committee was established. Half of the members of the committee are persons living with diabetes and the other half of primary care physicians and researchers, an unprecedented composition, truly reflecting patient engagement. This governance model will ensure that the Diabetes Repository data will be used for studies that fulfill our mission of developing patient- and research-informed innovations in health care delivery designed to prevent diabetes complications.
The National Diabetes Repository was a key component of our original SPOR grant proposal as it brings Canada closer to linking digital health systems and patient health data to ensure accurate surveillance of diabetes-related risk factors. Our goal is to position the National Diabetes Repository as a tool for researchers to provide the evidence necessary for health system change to improve the outcomes of Canadians living with diabetes and its related complications.