Enhancing the use of EHR systems for pragmatic embedded research: lessons from the NIH Health Care Systems Research Collaboratory.

Delivery of Health Care Electronic Health Records Humans Research Report Software Surveys and Questionnaires
data standards electronic health records learning health systems pragmatic clinical trials

Journal

Journal of the American Medical Informatics Association : JAMIA
ISSN: 1527-974X
Titre abrégé: J Am Med Inform Assoc
Pays: England
ID NLM: 9430800

Informations de publication

Date de publication:
25 11 2021
Historique:
received: 26 05 2021
revised: 05 08 2021
accepted: 02 09 2021
pubmed: 2 10 2021
medline: 22 1 2022
entrez: 1 10 2021
Statut: ppublish

Résumé

We identified challenges and solutions to using electronic health record (EHR) systems for the design and conduct of pragmatic research. Since 2012, the Health Care Systems Research Collaboratory has served as the resource coordinating center for 21 pragmatic clinical trial demonstration projects. The EHR Core working group invited these demonstration projects to complete a written semistructured survey and used an inductive approach to review responses and identify EHR-related challenges and suggested EHR enhancements. We received survey responses from 20 projects and identified 21 challenges that fell into 6 broad themes: (1) inadequate collection of patient-reported outcome data, (2) lack of structured data collection, (3) data standardization, (4) resources to support customization of EHRs, (5) difficulties aggregating data across sites, and (6) accessing EHR data. Based on these findings, we formulated 6 prerequisites for PCTs that would enable the conduct of pragmatic research: (1) integrate the collection of patient-centered data into EHR systems, (2) facilitate structured research data collection by leveraging standard EHR functions, usable interfaces, and standard workflows, (3) support the creation of high-quality research data by using standards, (4) ensure adequate IT staff to support embedded research, (5) create aggregate, multidata type resources for multisite trials, and (6) create re-usable and automated queries. We are hopeful our collection of specific EHR challenges and research needs will drive health system leaders, policymakers, and EHR designers to support these suggestions to improve our national capacity for generating real-world evidence.

Identifiants

DOI: 10.1093/jamia/ocab202 PMID: 34597383 PMC: PMC8633608
pubmed: 34597383
pii: 6378994
doi: 10.1093/jamia/ocab202
pmc: PMC8633608
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

2626-2640

Subventions

Organisme : NIH HHS
ID : UG3NR019943
Pays : United States
Organisme : NCCIH NIH HHS
ID : UH3 AT010621
Pays : United States
Organisme : NIDDK NIH HHS
ID : UH3 DK102384
Pays : United States
Organisme : NIH HHS
ID : UG3DA047003
Pays : United States
Organisme : NIH HHS
ID : UH2AT007769
Pays : United States
Organisme : NIDDK NIH HHS
ID : UH3 DK104655
Pays : United States
Organisme : NIAMS NIH HHS
ID : UH3 AR066795
Pays : United States
Organisme : NIH HHS
ID : UG3AG060626
Pays : United States
Organisme : NCCIH NIH HHS
ID : UH3 AT009838
Pays : United States
Organisme : NIMH NIH HHS
ID : UH3 MH106338
Pays : United States
Organisme : NINR NIH HHS
ID : R01 NR018848
Pays : United States
Organisme : NIAMS NIH HHS
ID : UH3 AR076387
Pays : United States
Organisme : NIH HHS
ID : UG3AT011265
Pays : United States
Organisme : NIH HHS
ID : UH2MH106338
Pays : United States
Organisme : NCI NIH HHS
ID : UH3 CA188640
Pays : United States
Organisme : NIH HHS
ID : UH2AT007755
Pays : United States
Organisme : NIH HHS
ID : UG3AT009844
Pays : United States
Organisme : NIH HHS
ID : UH2AT007788
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA047003
Pays : United States
Organisme : NIH HHS
ID : U24AT009676
Pays : United States
Organisme : NIH HHS
ID : UH2AG049619
Pays : United States
Organisme : NIH HHS
ID : UH2AT007766
Pays : United States
Organisme : NIH HHS
ID : UG3AG067593
Pays : United States
Organisme : NIA NIH HHS
ID : UH3 AG067593
Pays : United States
Organisme : NIAID NIH HHS
ID : UH3 AI113337
Pays : United States
Organisme : NIA NIH HHS
ID : UH3 AG060626
Pays : United States
Organisme : NCCIH NIH HHS
ID : UG3 AT011265
Pays : United States
Organisme : NIH HHS
ID : U24AT010961
Pays : United States
Organisme : NIDDK NIH HHS
ID : UH3 DK118748
Pays : United States
Organisme : NIH HHS
ID : UG3AT010739
Pays : United States
Organisme : NIH HHS
ID : UG3AR076387
Pays : United States
Organisme : NIH HHS
ID : UG3AT009838
Pays : United States
Organisme : NCCIH NIH HHS
ID : U24 AT009676
Pays : United States
Organisme : NHLBI NIH HHS
ID : UH3 HL144163
Pays : United States
Organisme : NCCIH NIH HHS
ID : U24 AT010961
Pays : United States
Organisme : NIMH NIH HHS
ID : UH3 MH007755
Pays : United States
Organisme : NINR NIH HHS
ID : UH3 NR019943
Pays : United States
Organisme : NCCIH NIH HHS
ID : UH3 AT009844
Pays : United States
Organisme : NIH HHS
ID : UG3AT010621
Pays : United States
Organisme : NIH HHS
ID : UG3HL144163
Pays : United States
Organisme : NINDS NIH HHS
ID : UH3 NS088731
Pays : United States
Organisme : NCCIH NIH HHS
ID : UH3 AT010739
Pays : United States
Organisme : NIA NIH HHS
ID : UH3 AG049619
Pays : United States
Organisme : NIH HHS
ID : UH2DK104655
Pays : United States
Organisme : NIH HHS
ID : UH2AT007782
Pays : United States
Organisme : NINR NIH HHS
ID : UG3 NR019943
Pays : United States
Organisme : NIH HHS
ID : UH2AT007797
Pays : United States
Organisme : NIH HHS
ID : UG3DK118748
Pays : United States

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Références

Lancet. 2019 Mar 23;393(10177):1205-1215
pubmed: 30850112
JAMA Surg. 2021 May 1;156(5):462-470
pubmed: 33688908
PLoS One. 2014 Jan 22;9(1):e84933
pubmed: 24465452
J Am Med Inform Assoc. 2015 Jul;22(4):914-6
pubmed: 25614143
Health Policy. 2018 Aug;122(8):900-907
pubmed: 29935730
Acupunct Med. 2021 Dec;39(6):612-618
pubmed: 34080441
Am J Med Qual. 2018 Jul;33(4):359-364
pubmed: 29258323
J Am Med Inform Assoc. 2017 Sep 1;24(5):996-1001
pubmed: 28340241
BMC Public Health. 2008 Oct 01;8:343
pubmed: 18826655
Prev Med Rep. 2019 May 29;15:100910
pubmed: 31198661
JMIR Ment Health. 2020 Dec 1;7(12):e24066
pubmed: 33258791
Crit Care Med. 2020 Nov;48(11):1612-1621
pubmed: 32804789
Br J Sports Med. 2014 Apr;48(8):731-6
pubmed: 24659611
BMJ Open. 2019 May 30;9(5):e028488
pubmed: 31152039
Fam Pract. 2016 Dec;33(6):639-643
pubmed: 27471224
JAMIA Open. 2019 Apr;2(1):73-80
pubmed: 30976756
BMJ Open. 2020 Jul 14;10(7):e040999
pubmed: 32665394
Rheumatology (Oxford). 2020 Jul 1;59(7):1662-1670
pubmed: 31665477
Contemp Clin Trials Commun. 2020 Apr 24;18:100570
pubmed: 32426550
JAMA Intern Med. 2020 Aug 1;180(8):1070-1078
pubmed: 32628258
N Engl J Med. 2021 Jul 1;385(1):5-7
pubmed: 34192427
JAMA. 2003 Sep 24;290(12):1624-32
pubmed: 14506122
J Am Soc Nephrol. 2019 May;30(5):890-903
pubmed: 31000566
Patient. 2018 Dec;11(6):591-598
pubmed: 29968179
JAMIA Open. 2020 Oct 12;3(4):488-491
pubmed: 33619464
J Palliat Med. 2021 Aug;24(8):1221-1225
pubmed: 33826860
J Clin Epidemiol. 2021 Jan;129:60-67
pubmed: 33002635
J Gen Intern Med. 2021 Feb;36(2):296-304
pubmed: 33111240
Appl Clin Inform. 2015 Aug 26;6(3):536-47
pubmed: 26448797
Clin Trials. 2017 Apr;14(2):140-151
pubmed: 28068789
J Acquir Immune Defic Syndr. 2013 Jun 1;63 Suppl 1:S26-31
pubmed: 23673882
Support Care Cancer. 2018 Jan;26(1):41-60
pubmed: 28849277
Appl Clin Inform. 2021 May;12(3):675-685
pubmed: 34289504
J Am Med Inform Assoc. 2013 Dec;20(e2):e226-31
pubmed: 23956018
J Am Med Inform Assoc. 2021 Mar 1;28(3):427-443
pubmed: 32805036
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):578-82
pubmed: 24821743
Health Policy. 2017 Jun;121(6):629-636
pubmed: 28420540
Implement Sci. 2016 Apr 30;11:58
pubmed: 27130272
BMJ Open. 2019 Jul 27;9(7):e030099
pubmed: 31352424
J Chronic Dis. 1967 Aug;20(8):637-48
pubmed: 4860352
J Am Med Inform Assoc. 2013 Jan 1;20(1):122-4
pubmed: 22940670
JAMA Intern Med. 2018 Sep 1;178(9):1174-1181
pubmed: 30083752
N Engl J Med. 2020 Apr 16;382(16):1488-1491
pubmed: 32294344
EGEMS (Wash DC). 2019 Apr 03;7(1):10
pubmed: 30972359
Contemp Clin Trials. 2018 Apr;67:91-99
pubmed: 29522897
Am Soc Clin Oncol Educ Book. 2018 May 23;38:122-134
pubmed: 30231381
J Patient Rep Outcomes. 2018 Aug 17;2:34
pubmed: 30175316
Clin Psychol Rev. 2011 Feb;31(1):79-88
pubmed: 21130938
Transl Behav Med. 2021 Oct 23;11(10):1832-1838
pubmed: 34080636
Dialogues Clin Neurosci. 2011;13(2):217-24
pubmed: 21842619
Glob Adv Health Med. 2021 May 26;10:21649561211007091
pubmed: 34104574
JAMA. 2017 Jul 11;318(2):197-198
pubmed: 28586821
Am J Manag Care. 2016 Dec 1;22(12):e403-e408
pubmed: 27982672
EGEMS (Wash DC). 2017 Jun 14;5(1):13
pubmed: 29930961
Trials. 2016 Sep 15;17(1):452
pubmed: 27634417
Circ Cardiovasc Qual Outcomes. 2021 May;14(5):e007015
pubmed: 33993727
Contemp Clin Trials. 2015 Nov;45(Pt B):157-163
pubmed: 26493088
J Clin Transl Sci. 2020 Apr 06;4(6):498-507
pubmed: 33948226
BMC Med Inform Decis Mak. 2020 Jan 28;20(1):13
pubmed: 31992301
Am J Kidney Dis. 2021 Jun;77(6):920-930.e1
pubmed: 33279558
BMC Med Res Methodol. 2017 Sep 18;17(1):144
pubmed: 28923013
Ann Fam Med. 2014 Nov-Dec;12(6):573-6
pubmed: 25384822
JAMA Netw Open. 2020 Sep 1;3(9):e2015713
pubmed: 32886121
Qual Life Res. 2020 Feb;29(2):347-355
pubmed: 31606809
JAMA Intern Med. 2020 Oct 1;180(10):1328-1333
pubmed: 32744612
Pain. 2021 May 1;162(5):1545-1555
pubmed: 33230010
BMJ. 2015 May 08;350:h2147
pubmed: 25956159
N Engl J Med. 2016 Dec 8;375(23):2293-2297
pubmed: 27959688

Auteurs

Rachel L Richesson (RL)

Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Keith S Marsolo (KS)

Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

Brian J Douthit (BJ)

Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
US Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
ORCID: 0000-0001-6634-8171

Karen Staman (K)

Duke Clinical Research Institute, Durham, North Carolina, USA.

P Michael Ho (PM)

Department of Medicine, University of Colorado Medicine, Denver, Colorado, USA.

Dana Dailey (D)

Center for Health Sciences, St. Ambrose University, Davenport, Iowa and Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa, USA.

Andrew D Boyd (AD)

Department of Biomedical and Health Information Sciences University of Illinois Chicago, Chicago, Illinois, USA.

Kathleen M McTigue (KM)

Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Miriam O Ezenwa (MO)

Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, Gainesville, Florida, USA.

Judith M Schlaeger (JM)

Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois, USA.

Crystal L Patil (CL)

Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois, USA.

Keturah R Faurot (KR)

Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Leah Tuzzio (L)

Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA.

Eric B Larson (EB)

Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA.

Emily C O'Brien (EC)

Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

Christina K Zigler (CK)

Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

Joshua R Lakin (JR)

Palliative Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

Alice R Pressman (AR)

Center for Health Systems Research, Sutter Health Center for Health Systems Research, Walnut Creek, California, USA.

Jordan M Braciszewski (JM)

Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA.

Corita Grudzen (C)

Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA.

Guilherme Del Fiol (GD)

Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Enhancing the use of EHR systems for pragmatic...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Documents › Dossiers médicaux › Systèmes informatisés de dossiers médicaux › Dossiers médicaux électroniques › Enhancing the use of EHR systems for pragmatic...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Enhancing the use of EHR systems for pragmatic...
questionsmedicales.fr › Sciences de l'information › Langage › Arts du langage › Écriture › Rapport de recherche › Enhancing the use of EHR systems for pragmatic...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Logiciel › Enhancing the use of EHR systems for pragmatic...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enhancing the use of EHR systems for pragmatic...