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