GEMINI Databases as a Resource for Quality Audits of Transfusion Practice in Ontario
Written By:
- Sheharyar Raza, M.D.- F.R.C.P.C (Internal Medicine, Hematology) TM Fellow – Elianna Saidenberg Transfusion Medicine Traineeship – Canadian Blood Services
GEMINI is the largest and most comprehensive hospital data collaborative in the province of Ontario with the potential to significantly inform and accelerate transfusion medicine quality improvements and research. The database is housed at Unity Health Toronto and includes administrative and clinical inpatient data, including transfusion data for all medical and ICU admissions in their growing network of over 30 large hospitals in Ontario, covering care for approximately 60% of the province’s adult inpatients with plans for extension to pediatric inpatients in the near future. The data are extracted directly from hospital information systems and shared with GEMINI, where data quality is rigorously assessed through computational and manual validation, and data are standardized to common data models. GEMINI data can be accessed remotely and securely through a cloud environment hosted by HPC4Health, which enables high-performance computing for complex analyses.
GEMINI includes a wide range of clinical variables, with several years of data collected across hospitals to inform transfusion research. These include patient demographics (e.g., age, sex), medical diagnoses, medical co-morbidities, and laboratory results such as complete blood count and coagulation testing results. Transfusion details include time of order and issuance of blood product, and the number of units issued per order. Further details include administrative aspects of hospital admissions such as the date and time of admission and discharge, discharge disposition (e.g., deceased, alive, transferred to another healthcare facility), and information about the most responsible physician and associated medical department. Physician-level information is also collected including subspecialty, and year of medical school graduation, allowing for more nuanced comparison of transfusion practice across physician groups. Additionally, GEMINI’s rigorous data validation and quality assessment processes ensure that the data used for these analyses are reliable and accurate.
By enabling deep, nuanced, and longitudinal analyses of blood utilization, appropriate use, patient outcomes, and transfusion reactions, GEMINI can provide valuable insights into transfusion practices across different institutions. GEMINI can also be linked with other large databases (e.g. ICES Ontario) to study long-term outcomes of transfusion therapies. Through collaboration with transfusion researchers, GEMINI can contribute to improving the use of the blood supply and enhancing overall patient care.