Original source: Integrated Services for Children Information System, Public Health Unit
Distributed by: Public Health Unit
Suggested citation (see Data Citation Notes): ISCIS [years], Extracted: [date]

Data Notes

• The Healthy Babies Healthy Children (HBHC) program is a voluntary prevention and early intervention initiative designed to help families promote healthy child development and help their children achieve their full potential. Introduced in 1997, HBHC is delivered by public health units across Ontario as mandated in the Ontario Public Health Standards (2008) and is fully funded by the Ministry of Children and Youth Services (MCYS).
• The Integrated Services for Children Information System (ISCIS) is a multi-tier case management system designed to enable public health units across Ontario to effectively administer the HBHC program. ISCIS 1.0 was operational as of July 1999 in the form of a series of stand-alone Access databases, one in each public health unit. In 2002, ISCIS 2.0 was introduced, which operated as a centralized database and upgraded to a different platform with more functionality. In late January 2012, ISCIS software was upgraded to version 3.0. ISCIS software is currently managed by the MCYS, operating on the eHealth Ontario platform.
• HBHC data are collected and entered into ISCIS by public health unit (PHU) staff. PHUs have access to only their own ISCIS data, unless other data sharing agreements have been arranged.
• Data can be extracted from the ISCIS system using pre-defined or custom reports in the HBHC-ISCIS Reporting Sub-System (HBHC-IRSS or IRSS). IRSS is a web-based decision support system that consolidates, transforms and summarizes the data entered into ISCIS so that users can produce analytical reports to help them look for trends in their data. There is a user guide (1) and a data dictionary (2) for IRSS on the ISCIS website (Note: VPN secure access required).
• A pre-defined Epidemiology Report is available in IRSS. Although the ISCIS program is organized by the family unit, the Epidemiology Report generates child and reproductive health indicators at the individual level. Each row on the report represents a pregnancy and/or a child. (1)
• PHUs are the custodians of their own ISCIS data and thus are responsible for the accuracy and completeness of the data. As a result, data quality varies by health unit and comparisons across health units should not be made unless data collection methodology between health units is evaluated and deemed comparable.
• Only those births that occur in a hospital and for which the parents consent for further follow-up as part of the HBHC program can be entered into ISCIS. In particular, hospital births for which consent was not obtained, and midwife-attended home births are excluded. As a result, ISCIS data have incomplete coverage of the total number of births in a given geographical area; these coverage rates will vary by health unit.
• Where a newborn is defined as a member of two different families, only the birth mother's family is reported in the extract record. If the birth mother cannot be determined (e.g., both personal caregivers were female), then both families are reported.
• In each PHU, the data custodians manually enter Reporting Statistics into ISCIS and report them quarterly to MCYS. The reporting statistics are meant to capture a more complete picture of the total population of live births in the health unit region. Specifically, PHUs collect summary counts of the number of families and number of live births on a routine basis (e.g., monthly or quarterly) from local birthing hospitals.
• The Reporting Statistics are available in IRSS in the Monitoring Report. (1) Caution should be taken in using the Reporting Statistics as there may be some data quality challenges in some PHUs. In some cases, local hospitals report the total number of live births that occurred in the hospital, regardless of family's PHU jurisdiction of residence. As such, births for non-resident families that occurred in birthing hospitals within the PHU region may be inadvertently included. Note that births for resident families that occur out of region are included when those families consent to have their information shared and/or participate in the HBHC program. Out-of-region births for resident families who do not consent are missed in the Reporting Statistics, as well as home births.
• The Parkyn Postpartum Screening Tool is designed to identify factors associated with risk of parenting problems or sub-optimal infant health outcomes. The Parkyn typically is completed within 48 hours postpartum, in hospital. It is completed either by maternity nurses, or in some jurisdictions, public health nurses. The MCYS provincial Parkyn Screening tool is available on the ISCIS website (3) (Note: VPN secure access required).
• The Parkyn Postpartum Screening process, as part of the HBHC program, aims to reach all consenting women who give birth in Ontario. The Parkyn is a primary source of information in ISCIS. In addition to the Parkyn, there are a number of other HBHC Program Screening tools for which data can be entered into ISCIS. These including the Larson Prenatal Screen, Brief Assessment, In-Depth Family Assessment, and Nipissing Screening tools.
• The Parkyn Screening tool is designed so that only "yes" responses are checked off, making "no" responses impossible to distinguish from non-responses. The Region of Waterloo identified this non-response problem (4) and consequently redesigned its Parkyn Screen forms to include both "yes" and "no" responses, and completed additional training of hospital and public health nurses to ensure proper and consistent data collection. The Region of Waterloo Public Health Parkyn form is publicly accessible as an appendix to the Maternal and Child Indicator Report for Waterloo Region: HBHC-ISCIS Report 2007.(5)
• Data quality issues have been identified with ISCIS including the high frequency of missing values for some data elements (6, 7); lack of a multiple birth identifier; difficulty identifying pregnancies that resulted in perinatal death; and inconsistencies in recording values in the "para" and "gravida" fields. These data quality issues should be taken into consideration prior to using ISCIS data to report on child and reproductive health indicators.
• Note that as of May 2011, the MYCS is planning to replace the Larson and Parkyn screening tools with a new, more detailed Healthy Babies Healthy Children screening tool. Validation for this tool will occur prior to its implementation in the HBHC program.

1. Ministry of Children and Youth Services. HBHC-IRSS User Guide. Release 3.3.0, 2011. Available at: http://www.iscis.on.ca/documents/hbhc/hbhc_irss_330_user_guide.pdf (Accessed April 26, 2011). 
2. Ministry of Children and Youth Services. HBHC-IRSS Data Dictionary. Release 3.3.0, 2011. Available at: http://www.iscis.on.ca/documents/hbhc/hbhc_irss_330_data_dictionary.pdf (Accessed April 26, 2011).
3. Ministry of Children and Youth Services. Healthy Babies Healthy Children Postpartum Screening Tool, 2005. Available at: http://www.iscis.on.ca/documents/hbhc/parkyn_screen.pdf (Accessed April 26, 2011).
4. Embree B. An analysis of background characteristics and birth outcomes for women in Waterloo Region. Region of Waterloo Public Health, 2002.
5. Sanderson R & Drew S. Maternal and Child Indicator Report for Waterloo Region: HBHC-ISCIS Report 2007. Waterloo, Ontario: Region of waterloo Public Health, 2009. Available at: http://chd.region.waterloo.on.ca/en/researchResourcesPublications/resources/MaternalChild_HealthIndicator.pdf (Accessed January 18, 2012).
6. Yessis J. Methodological Analysis of the ISCIS Data Gathering Process. Region of Waterloo Public Health, 2003. Available at: http://chd.region.waterloo.on.ca/en/researchResourcesPublications/resources/ISCIS_FinalReport.pdf (Accessed January 18, 2012).
7. Mask A. A Comparison of Reproductive Health Data Sources Available for Durham Region. Durham Region Health Department, 2009. Available at: http://www.durham.ca/departments/health/health_statistics/specialReports/dataSourceCompJuly09.pdf (Accessed January 19, 2012).

Date of last revision: January 16, 2013