PHIS+: Augmenting the Pediatric Health Information System with Clinical Data

描述（由申请人提供）：PHIS+项目的目标是建立在美国儿童健康公司（CHCA）提供的现有基础设施上-一个商业联盟网络42个北美领先的儿童医院-以增加其现有的数据库，为6家大型儿童医院的门诊和住院部的儿童提供实验室和放射学数据。现有的数据库称为儿科健康信息系统（PHIS），是一个综合性的儿科数据库，包含600多万例患者的临床和财务详细信息。增强后的数据库称为PHIS+，将为学术临床医生提供丰富的数据源，以真实的时间回答影响住院儿童的比较有效性问题，从而显著提高儿科比较有效性研究的质量和范围。具体目标是：1.开发基础设施，以便准确可靠地执行从6个CHCA成员儿童医院到现有儿科健康信息系统（PHIS）的实验室结果和放射学报告的季度下载。2.为了证明PHIS+数据库在进行多项比较有效性研究中的实用性，与该提案合作的医院是电子病历使用方面的全国领先者，并将提供作为常规部分收集的高度准确和完整的临床数据。临床护理。该提案将建立数据平台，以在以下4个领域取得进展：（1）最有效地利用我们的诊断设备（即实验室检测和影像学研究），以预测结果，选择适当的干预措施，并改善住院儿童的健康状况;（2）将最先进的观察性研究设计和分析应用于管理和临床数据库中的现有数据，以评估治疗、预后、（3）对住院病人管理策略进行经济学评估，为资源分配提供信息，并结合结果测量，更好地理解价值;以及（4）开发质量测量和严重程度调整工具，以使用大型行政和临床数据库研究多个机构的住院质量（比较医院，供应商，系统）。PHIS+项目将使用现有的强大的计算基础设施-联邦犹他州研究和翻译健康电子库（FURTHeR）-将来自6家儿童医院的数据链接起来（有可能扩大到更多）和护理地点（住院、门诊、急诊、日间手术），并在几个AHRQ优先领域为几个AHRQ优先人群进行有意义的比较有效性研究，包括儿童、患有多种合并症的儿童、少数民族和社会经济地位较低的儿童。 公共卫生相关性：本申请中提出的PHIS+数据库的构建将为学术临床医生提供丰富的数据源，以研究大比例的儿科人群，并真实的时间回答影响住院儿童的比较有效性问题。有了这个增强的数据库，研究人员将能够预测结果，评估治疗策略，选择适当的干预措施，评估成本效益和衡量护理质量。与PHIS+数据库进行的研究将改善住院儿童的健康状况，包括那些在AHRQ确定的优先人群，如少数民族，患有多种共病的人，以及社会经济地位较低的人。

DESCRIPTION (provided by applicant): The objective of the PHIS+ project is to build on the existing infrastructure provided by Child Health Corporation of America (CHCA)--a business alliance networking 42 of North America's leading children's hospitals--to augment its existing database with laboratory and radiology data for children seen in the ambulatory and inpatient departments of 6 large children's hospitals. The existing database, called the Pediatric Health Information System (PHIS), is a comprehensive pediatric database containing clinical and financial details of more than six million patient cases. The enhanced database, called PHIS+, will provide a rich data source for academic clinicians to answer in real time the comparative effectiveness questions that affect hospitalized children, thereby significantly enhancing the quality and scope of pediatric comparative effectiveness research. The specific aims are: 1. To develop the infrastructure for accurately and reliably performing quarterly downloads of laboratory results and radiology reports from 6 CHCA-member children's hospitals into the existing Pediatric Health Information System (PHIS). 2. To demonstrate the utility of the PHIS+ database in the performance of multiple comparative effectiveness research studies The hospitals collaborating on this proposal are national leaders in the use of electronic medical records and will provide highly accurate and complete clinical data collected as a routine part of clinical care. The outlined proposal will build the data platform needed to make advances in the following 4 areas: (1) Make the most efficient use of our diagnostic armamentarium (i.e. laboratory testing and imaging studies) to predict outcomes, select appropriate interventions, and improve the health status of hospitalized children; (2) Apply state-of-the- art observational study design and analysis to existing data in administrative and clinical databases in to evaluate therapeutic, prognostic, and diagnostic strategies for conditions for which randomized controlled trials are not feasible; (3) Perform economic evaluations of inpatient management strategies to inform resource allocation and, coupled with outcomes measurement, better understand value; and (4) Develop quality measures and severity adjustment tools to study inpatient quality (comparing hospitals, providers, systems) across multiple institutions using large administrative and clinical databases. The PHIS+ project will use an existing robust computational infrastructure-The Federated Utah Research and Translation Health electronic Repository (FURTHeR)-to link data from 6 children's hospitals (with the potential to expand to more) and sites of care (inpatient, outpatient, Emergency Department, Day Surgery) and conduct meaningful comparative effectiveness research in several AHRQ priority areas for several AHRQ priority populations, including children, children with multiple co-morbidities, minorities, and those from lower socioeconomic status. PUBLIC HEALTH RELEVANCE: The construction of the PHIS+ database proposed in this application will provide academic clinicians with a rich data source to study large proportions of the pediatric population and answer in real time the comparative effectiveness questions that affect hospitalized children. With this enhanced database, researchers will be able to predict outcomes, evaluate treatment strategies, select appropriate interventions, evaluate cost effectiveness, and measure quality of care. The research conducted with the PHIS+ database will improve the health status of hospitalized children including those in AHRQ identified priority populations such as minorities, those with multiple co-morbidities, and those from lower socioeconomic status.