An essential step in managing or reviewing the management of patients with chronic disease is to build a register of patients.

Practice Registers are accurate listings of patients with certain disorders, developed by the doctors from their own records.

Provincial Registers are probabilistic. They are developed from those administrative records of paid services that are statistically likely to indicate individuals who suffer from a chronic disorder. The identification is not certain (see limitations of the data), as the case definition used may exclude some individuals who do have the disorder, and may include a few who do not. In aggregate the registers are estimated to be about 90 per cent accurate but they cannot be relied upon to be accurate for any individual. They do not contain clinical information from medical records as this information is not available from administrative data bases.

Provincial Registers

The Ministry of Health is developing two forms of registers: complete registers and partial registers.

Complete provincial registers can be developed once the administrative records are complete - usually a year or more after the end of the period. Complete registers are used to estimate performance; for example, the proportion of patients with diabetes who receive tests such as HbA1c in a year. The actual value of any measure must be interpreted with caution because of limitations of the registers. However, changes in the measures over time and variation among regions can be very useful in the evaluation of programs intended to improve care.

Partial provincial registers use current, though incomplete, administrative records and attempt to be as current as possible at the risk of being even less accurate than the complete registers. Their value is that they are the most current list of patients and can be used by doctors as an aid to building their own practice registers.

Current provincial registers:
»  Congestive Heart Failure
»  Diabetes

Practice Registers

Family doctors are encouraged to develop their own registers of patients with chronic disorders. These registers are needed to provide planned, pro-active care to patients with chronic diseases. They assist in ensuring that patients receive recommended care at appropriate intervals and with reminder systems. The registers help doctors perform audits of their practices as part of quality improvement processes.

The ministry makes available each doctor's portion of the provincial registers on the secure web site. The doctor's portion of the provincial register is determined by assigning individuals on the register to the doctor who provides the greatest number of services to that individual. Thus, doctors who have registered with the secure web site can obtain their portion of the provincial registers to assist them with developing their own practice registers.

Last Revised: December 17, 2007