Integrating population-wide laboratory testing data with audit and feedback reports for Ontario physicians

Audit and feedback reports, distributed by Health Quality Ontario to consenting primary care physicians, provide doctors with a confidential summary of how they manage patients with diabetes; these reports currently lack clinical information. We examined the feasibility of linking the Ontario Laboratories Information System (OLIS), a large provincial database of laboratory test results, with the existing provincial audit and feedback reporting structure to integrate measures of glycemic and cholesterol control among patients with diabetes. We found that we could ascertain glycated hemoglobin (69.9%) and low-density lipoprotein cholesterol (64.1%) test results in the previous year for most patients and that there was wide variation among physicians in the proportion of patients who exceeded clinical thresholds for these measures. Our study highlights the potential value of reporting more clinically rich information to physicians to improve diabetes care and management and demonstrates the feasibility of using OLIS data at the population level to enhance ongoing research and quality improvement.