Using EPR 2020 for Clinical Research Diana Gumas

Using EPR 2020 for Clinical Research Diana Gumas, Director of Clinical and Clinical Research IT 1

Migration of clinical data to EPR 2020 (powered by Amalga) EPR- JHH & JHBMC EPR 2020 Discharge summaries Operative notes Clinic Notes Problems, Allergies, Meds Lab Results Radiology Results Read-Only Data Discovery for Clinical Care Research Quality Improvement Clinical Research Management System HDM/Casemix Patient Portal Inpatient & Outpatient Diagnoses/Procedures JHCP Other JHH/JHBMC Clinical Systems External Labs Additional Hospitals 2

Multiple Applications – Including Research Support 3

Research App View: Patients on “My Studies” 4

Now drill down to see Clinical Data for the Research Participant Clinical detail for the Patient: Problems, Allergies, Immunizations, Medications Labs Documents Active Research Study enrollment 5

Research App View: Research Lab Results 6

Exporting Lab Results Saves Significant Researcher Hours! 7

Researcher App View: Diagnosis “Find my patients who had a cardiac diagnosis in the 1 st 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. 8

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 9

Diag Seq 1 - the primary for this encounter. Notice patient has a pacemaker… so… 10

Search patient’s documents for pacemaker 11

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 i 2 b 2 with data from EPR 2020 • Provide result data to Case Report Forms in Research System • Interface to Specimen Tracking Tool (ca. Tissue) • Natural Language Processing to mine documents 12

EPR 2020 Data Contents Available today from EPR for JHH & JHBMC - *view-only* 4. 4 M Patients, 32. 6 M Visits 16. 2 M Documents, 8. 5 M Radiology Reports 78 M Lab Tests, 402 M Lab Results 1. 7 M Problems, 2. 5 M Medications, 159 K Allergies, 475 K Immunizations 5. 8 M Inpatient Diagnoses (409 K distinct) In progress: • • • Community physician visits and summary documents Outpatient diagnosis codes & procedures Images Improve speed of display Additional clinical research tools 13