University:
Boston University
Course:
SAR HP 151 | Introduction to Health Professions
Academic year:

2020
Views:

12

Pages:

22
Author:

Annalise Walters

Informatics Tools to Study Health and Healthcare in Boston Our “EcoSystem” • BMC is largest safety net provider in New England • Nearly all CHCs are FQHCs • EHR-based care • BMC since 1999 • CHCs since 2003 • Epic in use at nearly all sites since 2015 (three instances) Our Vision • • • • • Data are accessible - privacy is protected Broadest possible array of data available Researchers focus on questions more than queries Data and tools are standardized so they can be shared Advancing health equity is foundational Overview • • • • BMC Clinical Data Warehouse (CDW) Local de-identified data sources and tools National networks Looking forward BMC Clinical Data Warehouse (CDW) • Source data from: • Current electronic health records (e.g., Epic) • Legacy clinical systems (Centricity, SDK, Ibex,SCM, PICIS, others) • Dedicated research data analysts • Scientific Director, Heather Hsu, MD, MPH • Specialized expertise in ACO analytics and HSR • Fee-for-service model supports ongoing work and scalability i2b2 • “Informatics for Integrating Biology with the Bedside” • Open-source software based on the MGH Research Patient Data Repository (RPDR) • De-identified clinical data repository • Data linked to standardized vocabularies • Web-based query and analytic tools • Available at BMC/BUMC since 2009 EHR Data i2b2 Resources and Processes Staging Area Functions: • Master Patient Index • Data cleaning • Deidentification • Standardization (LOINC, CPT, RxNorm, ICD9/10,SNOMED CT) BMC-i2b2 • BMC only • Web accessible • Aggregate data queries • No additional IRB TriNetX • BMC data w/48+ HCOs • Query Builder (Counts) • Trial Connect (Trials) • TriNetX Research i2b2 Data: •Demographic •Insurances •Services •Medications •Problems •Labs •Clinical Observations Sites: • Boston Medical Center • Dorchester House MSC • Codman Square HC • Healthcare for the Homeless • Greater Roslindale MDC • Mattapan CHC • South End CHC • South Boston CHC • Uphams Corner CHC Limited Dataset • People • Facts • Concepts Health Disparities Repository • BMC + CHCs • RDP access (with SAS, STATA) • HOME Cell and data extracts • IRB approval required • Independent governance structure i2b2 Recent Additions Clinical Data Resources and Networks Faculty & Analysts BMC CDW Clinical Data Warehouse (Expert Consultation and Data Management) Research Networks Web-clients (Prep to research and data exploration) Data Extracts (HSR, CER, Analytics) Self-service Analytics (HSR, CER) Servers (Predictive Analytics, Machine Learning, Systems Modeling) OHDSI (N3C, AoU, HSR, CER, Analytics) i2b2 ACT Accrual to Clinical Trials Network AllofUs Precision Medicine Initiative TriNetX Global Health Research Network N3C National Covid Cohort Collaborative 2+ M patients 2+ B facts (1999-present) Diagnoses (ICD9/10) Medications (RxNorm) Lab Results (LOINC) Vital Signs (SNOMED-CT) DRG/LOS (MSDRG) Residential Zip Codes (USPS) Encounters (Local) Clinical Observations(Local) Social Determinants (LOINC) & � ��1, r,.�� Research-Ready Real-World Data On-Demand Real-World Evidence Generation Elegant UI with Research Workflow Global and Diverse Healthcare Databases Eliminates the cost, complexity, and lengthy timelines associated with licensing, mapping. normalizing. and hosting multiple third-party data sets. Quickly gain real-world insights into how patients аге treated and their health outcomes ог conduct full protocol-driven observational research studies in а fraction of the usual time. lntuitive interface for those without advanced data training and robust statistical analysis capabllities for experienced epidemiology and outcomes research professionals. Conduct region-specific studies compliant with local privacy regulations; studies using academic medical center ог cardiology specialty ЕМ Rs, HemOnc registries, or our Diamond Network. Participate in Sponsored Trial Site contacts receive trial requests from industry partners or new sponsors via “Trial Connect” and connect with local investigators. Explore Data and Discover Cohorts Find groups of eligible patients using “Query Builder” by adding terms for your inclusion and exclusion criteria using a simple easy to use interface. Pursue a grant or identify the patients for recruitment. Analytics: Replicate Trials and Develop Protocols Using “Analytics”, perform advanced analyses including analysis of risk factors and comparison of treatments. • Compare cohorts • Analyze outcomes • Compare outcomes • Treatment pathways Sample Query: Exploring the Cohort RESEARCH Network – ANALYTICS Our National Networks Sample ACT SHRINE Query Looking Forward… Social Determinants of Health | Healthy People 2020 Social Determinants of Health | Kaiser Family Foundation