Bridging Electronic Health Records (EHRs) and Clinical Research Data: An Evaluation of an Academic Medical Center Público

Granderson, Chade (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/sb397910b?locale=pt-BR
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Abstract

Background: The conduct of clinical research leads to innovative health solutions that are critical for improving health outcomes and providing scientific evidence needed to support and guide clinical and health policy decisions. As public health has moved towards evidence based scientific standards and interventions, federal rules and regulations regarding the conduct and reporting of clinical research findings also continue to evolve. To assist in meeting these standards and requirements, clinical research studies and the organizational operations surrounding them have grown larger and more complex requiring additional time, staff, and monetary resources.

Purpose: The clinical research infrastructure has become fragmented and perpetuated by the gaps between health records and research data. The primary goal of this project is to propose a systems architecture integrating electronic health records and research data and assess its feasibility within an academic medical center. We also seek to assess whether this integration has the potential to reduce study timelines and errors within research databases. Lastly, we seek to describe barriers to integration.

Methods: A series of data flow analysis and interviews were conducted to understand current research and business workflows and processes within an academic medical center. Additional interviews and a literature review were used to identify and propose an integrated systems architecture and method for pre-populating research databases with data from electronic health records.

Results: A process and systems architecture for auto-populating research databases with relevant data elements from electronic health records was defined allowing for a reduction in data duplication for research staff using the Retrieve Form for Data Capture method. However, several barriers for system integration were identified.

Conclusions: There are several methods for integrating systems, yet identifying a successful architecture for data sharing between health information and research systems remains a challenge due to time, cost, and regulatory constraints. Awareness and advocacy surrounding the requirements and importance of building systems to promote data sharing between electronic health and research records as to contribute to the advancement of public health are needed.

Table of Contents

Table of Contents CHAPTER 1: INTRODUCTION..............................1

INTRODUCTION AND RATIONALE.................................................1

REVIEW OF THE LITERATURE.......................................................3

PROBLEM STATEMENT.................................................................7

PURPOSE STATEMENT.................................................................8

SIGNIFICANCE STATEMENT.........................................................8

CHAPTER 2: METHODOLOGY AND APPROACH.................................9

INTRODUCTION..........................................................................9

PROJECT DESIGN.......................................................................9

PROCEDURES...........................................................................10

CHAPTER 3: PROPOSED SOLUTION.............................................12

INTRODUCTION........................................................................12

THE SYSTEMS..........................................................................12

THE CURRENT STATE OF INTEGRATION.......................................15

PROPOSED SOLUTION...............................................................15

ADDITIONAL REQUIREMENTS.....................................................20

ALTERNATIVES.........................................................................22

EVALUATION MATRIX................................................................24

CHAPTER 4: DISCUSSION..........................................................26

INTRODUCTION........................................................................26

SUMMARY................................................................................26

IMPLICATIONS.........................................................................27

BARRIERS & LIMITATIONS, & RECOMMENDATIONS.......................28

CONCLUSION...........................................................................30

CHAPTER 5: EXECUTIVE SUMMARY.............................................30

INTRODUCTION.......................................................................30

BUSINESS CASE.......................................................................31

APPENDIX A KEY TERMS............................................................51

APPENDIX B INTIATIVES, STRATEGIES, and GOALS......................52

REFERENCES............................................................................53

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