The National Diabetes Repository unleashing the power of data to better understand those living with diabetes and transform diabetes self-management

The National Diabetes Repository unleashing the power of data to better understand those living with diabetes and transform diabetes self-management

How can we improve the access to care to prevent complications from diabetes?  How does this differ in provinces? When we compare Canadian results to international data, are new medications with preventive benefits being used more or less by our population? These are all questions researchers can answer when they have access to data about people living with diabetes. It’s one of the core reasons Diabetes Action Canada has developed the National Diabetes Repository (NDR). The NDR is a tool researchers can use to better analyze information about people living with diabetes across Canada to support improved health outcomes and prevent complications. Oversight of the use of the data is through dedicated Patient Partners working alongside researchers, healthcare providers and experts in privacy and law. Harnessing the power of data to better support people living with diabetes and to improve health care is a key element of our work in this area.  Recent partnerships with organizations using artificial intelligence and advanced analytics are providing unique opportunities for developing algorithms to segment the population and flag those at the highest work for worst outcomes.

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
  • Multi-provincial data = 5 provinces with over 145K 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 which supports AI and Advanced Analytics = No need to purchase expensive equipment
  • Validated Type 1 vs. Type 2 algorithm
  • Collaboration with Primary Care Practice-Based Research Networks (PBRNs) = recruitment for clinical trials
  • In collaboration with PBRNs and Prescribed Entities = 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.

Along with our Patient Partners, Diabetes Action Canada is enabling a digital health solution, with the National Diabetes Repository 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 for analytics. 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), and University of Toronto Practice-Based Research Network (UTOPIAN), Atlantic-Based Primary Care Research Network (APBRN) and Manitoba Primary Care Research Network (MaPCReN) this diabetes repository currently has data from Ontario, Quebec, Newfoundland, Manitoba and Alberta representing over 145,000 patients with diabetes.  Plans are currently underway to expand this dataset to include primary care patient data from other provinces and territories.

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 and oversees the practical and ethical use of the data. 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 NDR 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 and issues that matter most to those living with diabetes.

The NDR is 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.

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