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

Autor:	Richesson RL; Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA., Marsolo KS; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA., 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., Staman K; Duke Clinical Research Institute, Durham, North Carolina, USA., Ho PM; Department of Medicine, University of Colorado Medicine, Denver, Colorado, USA., 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., Boyd AD; Department of Biomedical and Health Information Sciences University of Illinois Chicago, Chicago, Illinois, USA., McTigue KM; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Ezenwa MO; Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, Gainesville, Florida, USA., Schlaeger JM; Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois, USA., Patil CL; Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois, USA., Faurot KR; Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Tuzzio L; Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA., Larson EB; Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA., O'Brien EC; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA., Zigler CK; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA., Lakin JR; Palliative Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Pressman AR; Center for Health Systems Research, Sutter Health Center for Health Systems Research, Walnut Creek, California, USA., Braciszewski JM; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA., Grudzen C; Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA., Fiol GD; Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Informatics Association : JAMIA [J Am Med Inform Assoc] 2021 Nov 25; Vol. 28 (12), pp. 2626-2640.
DOI:	10.1093/jamia/ocab202
Abstrakt:	Objective: We identified challenges and solutions to using electronic health record (EHR) systems for the design and conduct of pragmatic research. Materials and Methods: 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. Results: 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. Discussion: 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. Conclusion: 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. (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association.)
Databáze:	MEDLINE
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