using epr2020 for clinical research diana gumas, director of clinical and clinical research it 1
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Using EPR2020 for Clinical Research
Diana Gumas, Director of Clinical and Clinical Research IT
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Migration of clinical data to EPR2020 (powered by Amalga)
EPR- JHH & JHBMCDischarge summaries
Operative notes
Clinic Notes
Problems, Allergies, Meds
Lab Results
Radiology Results
EPR2020Read-Only
Data Discovery
for
Clinical Care
Research
Quality Improvement
JHCP
External Labs
Additional Hospitals
Clinical Research Management System
Patient Portal
HDM/CasemixInpatient & OutpatientDiagnoses/Procedures
Other JHH/JHBMCClinical Systems
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Multiple Applications – Including Research Support
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Research App View:Patients on “My Studies”
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Now drill down to see Clinical Data for the Research Participant
Clinical detail for the Patient:Problems, Allergies, Immunizations, MedicationsLabsDocumentsActive Research Study enrollment
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Research App View:Research Lab Results
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Exporting Lab Results Saves SignificantResearcher Hours!
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Researcher App View: Diagnosis“Find my patients who had a cardiac diagnosisin the 1st quarter of 2010”
Provides assistance gathering:
• Preliminary, anonymous data for feasibility, grant applications and statistical sample-size estimates
• IRB-approved case-finding--for study enrollment (mailings, phone solicitation), chart review, and cohort/case-control studies
• Research data extracts - monthly/quarterly integrated extracts from EPR, POE, ORMIS, lab/PDS, billing systems, vaccination/transfusion/culture data, etc.
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Electronic Patient Record (EPR) and Research
One major source
of clinical data for JHH/JHBMC
Research documentation• New EPR clinical research note
just for researchers• Access to scanned consents
&
Can look at statistics for race, gender, age, diagnosis description
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Diag Seq 1 - the primary for this encounter.Notice patient has a pacemaker… so…
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Search patient’s documents for pacemaker
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Future Plans
• My Research Patients’ Outpatient Diagnosis• My Research Patients’ Procedures• Alerts for significant events
– Participant admission– Lab value out of range
• Evaluate Microsoft cohort discovery tool• Evaluate use of i2b2 with data from EPR2020• Provide result data to Case Report Forms in Research System• Interface to Specimen Tracking Tool (caTissue)• Natural Language Processing to mine documents
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EPR2020 Data Contents
Available today from EPR for JHH & JHBMC - *view-only*4.4M Patients, 32.6M Visits
16.2M Documents, 8.5M Radiology Reports
78M Lab Tests, 402M Lab Results
1.7M Problems, 2.5M Medications, 159K Allergies, 475K Immunizations
5.8M Inpatient Diagnoses (409K distinct)
In progress: • Community physician visits and summary documents• Outpatient diagnosis codes & procedures• Images• Improve speed of display• Additional clinical research tools