Envisioning a Learning Health Care System: The Electronic Primary Care Research Network, A Case Study
Envisioning a Learning Health Care System: The Electronic Primary Care Research Network, A Case Study
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DOI：
10.1370/afm.1313
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发表时间：
2012-01-01
影响因子：
4.4
通讯作者：
Hobbs, F. D. Richard
中科院分区：
文献类型：
--
作者：
Delaney, Brendan C.;Peterson, Kevin A.;Hobbs, F. D. Richard
PURPOSE The learning health care system refers to the cycle of turning health care data into knowledge, translating that knowledge into practice, and creating new data by means of advanced information technology.电子初级保健研究网络 (ePCRN) 是一个由美国国立卫生研究院资助的项目，旨在促进使用初级保健电子健康记录 (EHR) 的临床研究。方法我们确定了通过与 EHR 链接的分布式电子网络提供临床研究所需的要求。在探索了各种信息学解决方案之后，我们构建了该软件的功能原型。 We then explored the barriers to adoption of the prototype software within US practice-based research networks.RESULTS We developed a system to assist in the identification of eligible cohorts from EHR data.为了保护隐私，计数和标记都是远程进行的，并且没有数据从 EHR 中传输出来。 A lack of batch export facilities from EHR systems and ambiguities in the coding of clinical data, such as blood pressure, have so far prevented a full-scale deployment. We created an international consortium and a model for sharing further ePCRN development across a variety of ongoing projects in the United States and Europe.CONCLUSIONS A means of accessing health care data for research is not sufficient in itself to deliver a learning health care system. EHR systems need to use sophisticated tools to capture and preserve rich clinical context in coded data, and business models need to be developed that incentivize all stakeholders from clinicians to vendors to participate in the system.
PURPOSE The learning health care system refers to the cycle of turning health care data into knowledge, translating that knowledge into practice, and creating new data by means of advanced information technology. The electronic Primary Care Research Network (ePCRN) was a project, funded by the US National Institutes of Health, with the aim to facilitate clinical research using primary care electronic health records (EHRs).METHODS We identified the requirements necessary to deliver clinical studies via a distributed electronic network linked to EHRs. After we explored a variety of informatics solutions, we constructed a functional prototype of the software. We then explored the barriers to adoption of the prototype software within US practice-based research networks.RESULTS We developed a system to assist in the identification of eligible cohorts from EHR data. To preserve privacy, counts and flagging were performed remotely, and no data were transferred out of the EHR. A lack of batch export facilities from EHR systems and ambiguities in the coding of clinical data, such as blood pressure, have so far prevented a full-scale deployment. We created an international consortium and a model for sharing further ePCRN development across a variety of ongoing projects in the United States and Europe.CONCLUSIONS A means of accessing health care data for research is not sufficient in itself to deliver a learning health care system. EHR systems need to use sophisticated tools to capture and preserve rich clinical context in coded data, and business models need to be developed that incentivize all stakeholders from clinicians to vendors to participate in the system.