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Canadian Respiratory Journal
Volume 19 (2012), Issue 2, Pages 117-126
Special Article

Pan-Canadian Respiratory Standards Initiative for Electronic Health Records (PRESTINE): 2011 National Forum Proceedings

M Diane Lougheed,1,2 Janice Minard,1,2 Shari Dworkin,3 Mary-Ann Juurlink,4 Walley J Temple,5 Teresa To,6 Marc Koehn,7 Anne Van Dam,8 and Louis-Philippe Boulet9

1Division of Respirology, Department of Medicine, Kingston General Hospital at Queen’s University, Canada
2Asthma Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
3Standards Collaborative, Canada Health Infoway, Canada
4Ontario Lung Association, Toronto, Ontario, Canada
5University of Calgary, AHS Cancer Surgery Alberta, Calgary, Alberta, Canada
6Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
7Gordon Point Informatics Ltd, Victoria, British Columbia, Canada
8Canadian Lung Association, Ottawa, Ontario, Canada
9Centre de Pneumologie, Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In a novel knowledge translation initiative, the Government of Ontario’s Asthma Plan of Action funded the development of an Asthma Care Map to enable adherence with the Canadian Asthma Consensus Guidelines developed under the auspices of the Canadian Thoracic Society (CTS). Following its successful evaluation within the Primary Care Asthma Pilot Project, respiratory clinicians from the Asthma Research Unit, Queen’s University (Kingston, Ontario) are leading an initiative to incorporate standardized Asthma Care Map data elements into electronic health records in primary care in Ontario. Acknowledging that the issue of data standards affects all respiratory conditions, and all provinces and territories, the Government of Ontario approached the CTS Respiratory Guidelines Committee. At its meeting in September 2010, the CTS Respiratory Guidelines Committee agreed that developing and standardizing respiratory data elements for electronic health records are strategically important. In follow-up to that commitment, representatives from the CTS, the Lung Association, the Government of Ontario, the National Lung Health Framework and Canada Health Infoway came together to form a planning committee. The planning committee proposed a phased approach to inform stakeholders about the issue, and engage them in the development, implementation and evaluation of a standardized dataset. An environmental scan was completed in July 2011, which identified data definitions and standards currently available for clinical variables that are likely to be included in electronic medical records in primary care for diagnosis, management and patient education related to asthma and COPD. The scan, sponsored by the Government of Ontario, includes compliance with clinical nomenclatures such as SNOMED-CT® and LOINC®. To help launch and create momentum for this initiative, a national forum was convened on October 2 and 3, 2011, in Toronto, Ontario. The forum was designed to bring together key stakeholders across the spectrum of respiratory care, including clinicians, researchers, health informaticists and administrators to explore and recommend a potential scope, approach and governance structure for this important project. The Pan-Canadian REspiratory STandards INitiative for Electronic Health Records (PRESTINE) goal is to recommend respiratory data elements and standards for use in electronic medical records across Canada that meet the needs of providers, administrators, researchers and policy makers to facilitate evidence-based clinical care, monitoring, surveillance, benchmarking and policy development. The focus initially is expected to include asthma, chronic obstructive pulmonary disease and pulmonary function standards elements that are applicable to many respiratory conditions. The present article summarizes the process and findings of the forum deliberations.