A federated EHR network data completeness tracking system

Author:

Estiri Hossein123ORCID,Klann Jeffrey G123,Weiler Sarah R3,Alema-Mensah Ernest4,Joseph Applegate R5,Lozinski Galina6,Patibandla Nandan7,Wei Kun8,Adams William G9,Natter Marc D101112,Ofili Elizabeth O4,Ostasiewski Brian8,Quarshie Alexander4,Rosenthal Gary E13,Bernstam Elmer V514,Mandl Kenneth D101115,Murphy Shawn N1231516

Affiliation:

1. Laboratory of Computer Science, Massachusetts General Hospital, Boston, Massachusetts, USA

2. Research Information Science and Computing, Partners HealthCare, Charlestown, Massachusetts, USA

3. Harvard Medical School, Boston, Massachusetts, USA

4. Morehouse School of Medicine, Atlanta, Georgia, USA

5. School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA

6. Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, USA

7. Information Services Department, Boston Children’s Hospital, Boston, Massachusetts, USA

8. Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

9. Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, USA

10. Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts, USA

11. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA

12. Program in Pediatric Rheumatology, Department of Pediatrics, Mass General Hospital for Children, Boston, Massachusetts, USA

13. Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

14. Division of General Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA

15. Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA

16. Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA

Abstract

Abstract Objective The study sought to design, pilot, and evaluate a federated data completeness tracking system (CTX) for assessing completeness in research data extracted from electronic health record data across the Accessible Research Commons for Health (ARCH) Clinical Data Research Network. Materials and Methods The CTX applies a systems-based approach to design workflow and technology for assessing completeness across distributed electronic health record data repositories participating in a queryable, federated network. The CTX invokes 2 positive feedback loops that utilize open source tools (DQe-c and Vue) to integrate technology and human actors in a system geared for increasing capacity and taking action. A pilot implementation of the system involved 6 ARCH partner sites between January 2017 and May 2018. Results The ARCH CTX has enabled the network to monitor and, if needed, adjust its data management processes to maintain complete datasets for secondary use. The system allows the network and its partner sites to profile data completeness both at the network and partner site levels. Interactive visualizations presenting the current state of completeness in the context of the entire network as well as changes in completeness across time were valued among the CTX user base. Discussion Distributed clinical data networks are complex systems. Top-down approaches that solely rely on technology to report data completeness may be necessary but not sufficient for improving completeness (and quality) of data in large-scale clinical data networks. Improving and maintaining complete (high-quality) data in such complex environments entails sociotechnical systems that exploit technology and empower human actors to engage in the process of high-quality data curating. Conclusions The CTX has increased the network’s capacity to rapidly identify data completeness issues and empowered ARCH partner sites to get involved in improving the completeness of respective data in their repositories.

Funder

Patient-Centered Outcomes Research Institute

National Patient-Centered Clinical Research Network

National Human Genome Research Institute

National Institute on Minority Health and Health Disparities

National Center for Advancing Translational Sciences

National Institutes of Health

National Library of Medicine

Reynolds and Reynolds Professorship in Clinical Informatics

Cancer Prevention Research Institute of Texas

Data Science and Informatics Core for Cancer Research

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

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