HIT Innovation in Comparative Effectiveness Research across Institutions

Background: Population-based comparative effectiveness research (CER) requires large databases that combine complex clinical data from Electronic Medical Records (EMR). Numerous informatics challenges must be overcome when combining and sharing data across EMR systems and across care organizations. CER requires aggregation and analysis of disparate electronic clinical data sources held by different institutions, each with its own representations of relevant events and concerns for protecting data. The AHRQ-funded CER-HUB project aims to provide infrastructure for flexible, rapid, and efficient utilization of distributed, heterogeneous, electronic clinical data for CER analyses.

Methods: The CER-HUB is being used to conduct two CER studies addressing effectiveness of: (1) medication for controlling asthma and (2) smoking cessation counseling services, across 6 geographically-distributed and demographically-diverse health systems. Combining the data across these institutions provides the project with over 5 years of data for over 300,000 smokers and 100,000 asthmatics representing diverse socio-demographic and clinical populations.

Results: This presentation describes 18 months of progress toward CER-HUB study aims, including progress reports on the two CER studies. We briefly demonstrate the processes of using the CER-HUB including generating standardized study data from comprehensive electronic medical records of multiple health care systems while protecting patient confidentiality. We also report on using the CER-HUB to develop and validate measures of asthma control and smoking cessation and care delivery in the EMRs of the 6 participating health systems.

Conclusion: The CER-HUB provides a platform enabling the healthcare research community to use comprehensive, multi-institution EMR data to efficiently answer CER study questions in diverse populations.