BORN Information System

The Better Outcomes Registry & Network (BORN) is Ontario's prescribed maternal, newborn and child registry with the role of facilitating quality care for families across the province. BORN collects, interprets, shares and rigorously protects high-quality data essential to making Ontario the safest place in the world to have a baby.

The BORN Information System (BIS) is a database established to collect, manage, protect and share critical data about every pregnancy, birth and child in Ontario.

Original Source:	Better Outcomes Registry Network (BORN) Ontario
Distributed By:	Better Outcomes Registry Network (BORN) Ontario
Suggested Citation:	BORN Information System [month, year – month, year], Extracted: [month,year]

See Data Citation Notes.

Report an Issue Website

Related OPHS Standards

Healthy Growth and Development

Data Notes

Background

BORN Ontario is a provincial program funded by the Ontario Ministry of Health and Long Term Care (MOHLTC) and supported by CHEO (The Children’s Hospital of Eastern Ontario) that was established in 2009 to:

facilitate and improve care for mothers, children and youth by linking information and providers to address care gaps spanning the spectrum from normal to high acuity and rare conditions;
be an authoritative source of accurate, trusted and timely information to monitor, evaluate and plan for the best possible beginnings for life-long health;
mobilize information and expertise to optimize care and contribute to a high-performing healthcare system, improving the lives of individual mothers and children; and
provide scientific and technical leadership for Ontario’s maternal, child and youth health system through the support of research and innovation. (This is BORN’s 4th mission statement).

The five founding members of BORN (Fetal Alert Network (fetal and congenital anomalies), Prenatal Screening Ontario, Niday Perinatal & NICU/SCN Database, Ontario Midwifery Program, Newborn Screening Ontario) have integrated their data into one accurate and timely maternal-child registry to form the authoritative information system. The BORN Information System (BIS) provides access to real-time population-based mother and child health data to organizations and practice groups providing health care to mothers and children in Ontario, including: hospitals, midwives, labs and treatment/follow-up centers and fertility clinics.
The new BIS was launched in January of 2012 and operates on a secure, web-based platform administered by the Children's Hospital of Eastern Ontario (CHEO). Over 100 hospitals and 84 midwifery practice groups contribute data to the BIS capturing 100% of all hospital births in Ontario. With the addition of the Midwifery encounter in 2012, all home births attended by midwives are now in the system as well.
The information supports the MOHLTC, the Provincial Council for Maternal and Child Health (PCMCH), Local Health Integration Networks (LHINs) and Public Health Units (PHUs) of Ontario in measuring maternal-child health status and outcomes, developing responsive health policies, and improving evaluation and accountability.

BORN Data Structure and Specifics

Specific information is collected for each patient encounter, which is integrated across the continuum of care for the mother and infant. Please see the BORN Data Dictionary for a list and description of data elements captured in the BORN database.
Maternal encounters include: assisted reproduction, prenatal screening, prenatal screening follow-up, antenatal care (antenatal general and antenatal specialty), labour, birth mother and postpartum mother. Infant encounters include: birth child, postpartum child, newborn screening, NICU/SCN (Neonatal ICU/Special Care Nursery), and NICU follow-up. The system architecture was designed to allow for new encounters to be added as new data sources are identified.
Information collected for the birth mother encounter includes maternal demographics and health behaviors; pre-existing maternal health problems; obstetric complications; intrapartum interventions; and, birth outcomes. When a woman is admitted to hospital to give birth, data are collected by health care providers and hospital staff from charts, clinical forms and patient interview, and subsequently entered into the database either through a secure website by hospital staff, or uploaded directly from hospitals that have electronic record capability. An ongoing program of data verifications, quality checks, and formal training sessions for individuals collecting and entering data assures a high level of data quality is maintained.

Working with BORN Data

BORN reports for recent LHIN and PHU reports are available on the BORN website.
The BORN database is a web interface that includes both a data entry and a reporting system. The reporting system is comprised of three components: clinical dashboards, standard reports and analytical cubes.

Clinical dashboards display outcomes for key performance indicators from maternal‐newborn care settings. BORN is currently working to develop dashboards for other care settings, including NICU and SCN, prenatal screening, prenatal screening follow‐up, newborn screening and newborn screening follow‐up.
Standard reports are designed to assist clinical programs and practice groups to examine their performance, outcomes and utilization, and also to assist with planning. These reports are meant to be generated from the system on a regular basis (monthly, quarterly or annually) and will have drill down capability when further information is required, as well as display comparator values.
Analytic Cubes are being developed for those who want to have the ability to perform custom queries of the BORN data. Specific analysis Cubes are being designed for maternal newborn health, pregnancy and birth, prenatal and newborn screening, as well as for public health and midwifery practices. Users having access to these cubes will have the ability to manipulate data to answer specific questions.

Access to the BORN reporting system is based on status as a Health Information Custodian (HIC) and various levels of access can be given based on an individual's clearance to see personal health information. BORN data is available to PHUs by custom request and through the BORN Ontario reporting environment as Standard Reports and the Public Health Analytics Cube. The Standard Reports include three groupings: 1) Pregnancy (e.g. age group, parity, prenatal classes, pre-pregnancy BMI, smoking during pregnancy), 2) Birth (e.g. number of births, location), and 3) Newborn (e.g. preterm, multiple, birth weight, HBHC screen, congenital anomalies, infant feeding at discharge). Tables and graphs provide information for the health unit, peer group (if applicable) and Ontario. The Public Health Analytics Cube allows users to drill down to more specific information for their health unit.

For a custom data request, please submit the request form available on the following site: http://www.bornontario.ca/en/data/data-requests/
If you are working in a Public Health Unit in Ontario and would like to gain access to either the BORN Ontario standard reports or the public health analytics cube, please contact privacy@bornontario.ca for details on the requirements.

Analysis Checklist

General Checklist for All Associated Indicators

BORN data are available to PHUs by custom request and through the BORN Ontario reporting environment as Public Health Standard Reports and the Public Health Cube. All users are required to sign a data sharing agreement and adhere to strict privacy and security measures.
Refer to the BORN Information System (BIS) resource for more information about the data and the BORN Data Dictionary for a list and description of data elements captured in the BIS.
For key information used by the Reproductive Health Sub-Group (RHSG) in their revision of the reproductive health core indicators and accompanying resources, refer to the Reproductive Health Core Indicators Documentation Report.
The BORN licensing agreement with health units does not require suppression of small cells however BORN recommends the suppression of cells less than 6, although zero counts may be presented. This practice decreases the risk of re-identifying individuals. In general, caution should be used when reporting data at a level that could identify individuals (e.g., reporting at the dissemination area by maternal age).
Aggregation (combining years, age groups, geographic levels, categories or pick-list items) should be considered for small numbers.
In general, analyze by mother’s residence, not place of infant’s birth. The standard reports and cube are tabulated by maternal residence. Ontario births include only Ontario residents and exclude births to mothers that reside out-of-province.
Data available represents all data that has been entered, submitted and acknowledged into the BIS as of the time of extraction and as such, the numbers are subject to change. The BIS is a live database. For any analysis of the BIS, ensure that all or a majority of hospitals and midwifery practice groups in your area have acknowledged their data.
Caution should be taken when interpreting data if the percentage of "missing data” is greater than 5%. BORN Ontario recommends not reporting data if the missing is 30% or more. See "Indicator Notes” below for more information.
Although the BIS was launched in January 2012, data may not be complete for some elements and geographical areas in that first year. It is recommended that analysis begin for calendar year 2013.
Niday Perinatal Data (i.e., data prior to April 1, 2012) is available from BORN upon request, however some variables were not part of Niday and were added to the BIS later.

Associated Indicators

Fertility Rates Total Fertility Rate Pregnancy Rate Smoking During Pregnancy

Gestational Weight Gain Crude Birth Rate Birth Weights Age of Parent at Infant's Birth

Preterm Birth Rate Multiple Birth Rate Perinatal Mortality and Stillbirth Rates Congenital Anomalies

Maternal Mental Health Breastfeeding Initiation and Duration Breastfeeding Exclusivity at Discharge from Hospital Infant Feeding

References

General References

For more information, please visit the BORN website: www.bornontario.ca

Revision History

This Core Indicator Product webpage is maintained by the Reproductive Health Subgroup.

Date	Review Type	Author	Changes	PDF
June 16, 2014	Date of Last Revision	Reproductive Health Subgroup
December 2, 2019	Website Update: No Content Review	Caitlyn Paget, on behalf of the CIWG	Migrated to new website structure and format, including: Reorganized content to provide high-level information at a glance, and move in-depth analytic information into dedicated sections for users to access when needed. Added short data source description in header. Moved Analysis Checklist items that are specific to the data source from the indicators pages to this data source page to reduce duplication. Crosslinked to relevant Core Indicators webpages including OPHS program standard(s) and associated indicator(s). Added Revision History table, with PDF copy of previous version for reference.

APHEO's Core Indicators Project has been developed through collaboration across the field of public health in Ontario,

to provide standardized methodology for population health assessment, to measure complex concepts of individual and community health.

Please contact core.indicators@apheo.ca for further information.