When most people think of medical research, they envision sterile labs where scientists in white coats peer through microscopes. True, that is how some medical research is done. However, knowledge can also be gleaned from simply compiling and analyzing patient data, which is what the team at Washington University’s Institute for Informatics (I2) does. And they’re about to take a step that will make gathering and searching patient data much simpler and more efficient.
With the launch of BJC HealthCare and Washington University School of Medicine’s new Epic electronic health record system, I2 will have access to more and better data than ever before. Epic is the platform that clinicians will use to collect, manage and store patient data across the system’s hospitals, physician groups and specialty departments. Epic will then feed a research data core (RDC) that researchers and data brokers can access to get the information they need to conduct studies, identify patients for clinical trials and track patient outcomes.
“Think of Epic as the front end — where data comes in at the point of care and from patient care encounters,” says Philip R.O. Payne, PhD, FACMI, director of the Institute for Informatics at Washington University. “On the back end, the RDC helps organize that data in a way that we can look at to ask and answer research questions.”
Currently, mining patient data for research purposes is an arduous task. Records are housed in different systems depending on which hospital, physician group or specialty office a patient visits. Some records are even still paper-based. Once Epic launches fully in summer 2018, the RDC will be able to access all patient records across the health system.
How the Data Will Be Used
Once patient data is collected, researchers will be able to use it in a number of ways. One way is to track the effectiveness of treatment. Another is to identify trends in chronic and infectious disease development. But those are just two examples.
“We’re opening the door to be able to start collecting patient outcomes,” Dr. Payne says. “We’ll be able to conduct research that not only studies health or disease, but we can also look at functional and patient-reported indicators that tell us how those patients are feeling, how they are able to engage in activities of daily life and how they feel about the outcomes of their treatment. Because that’s actually one of the most important issues when we get into the sort of broader space of population health when we’re trying to focus on how we keep our patients well.”
Another important aspect in evaluating care is tracking cost.
“Now that the data will all be in one system, we should be able to have a much better picture of a person’s healthcare, including their total cost of care,” says Albert M. Lai, PhD, chief research information officer for I2. “Cost often correlates with patients getting more care than needed, which has a negative impact on outcomes, safety and quality of life. If we’re able to know the total cost of care, we will then be able to optimize how we provide that care in the future.”
The RDC will also make identifying patients for clinical trials much faster and more efficient.
“Right now, identifying and recruiting patients for clinical trials is a very manual and labor-intensive process. It really involves people being in the right place at the right time,” Dr. Payne says. “But soon we will be able to use the data in the RDC, as well as decision support tools within Epic, to identify patients who are eligible for clinical trials, and help the clinical trial investigators connect with patients and their care providers to make those opportunities known.”
Attracting Top Talent
The RDC’s benefits are circular. Creating efficiency in research saves time and allows grant dollars to stretch farther. That, in turn, will attract top researchers from across the country. And the more talented scientists at Washington University, the better the care and outcomes will be.
“It’s a really important strategic asset for attracting the best and brightest researchers to Wash U, because this type of data is central to their ability to be impactful with their research,” Dr. Payne says. “Another big benefit is it’s going to make researchers that are already members of our faculty more competitive when securing extramural funding.”
Additional benefits are still to be seen, but Dr. Payne is certain there will be many.
“The more we use data, the better we understand it, so by making that data more readily available through the research data core, we’re helping to build a culture where we become a much more data-driven organization,” he says. “There are all sorts of research, academic and operational benefits afforded by being a data-driven organization, something that’s not always easy to achieve right now. But RDC makes that possible.”
“The more we use data, the better we understand it, so by making that data more readily available through the research data core, we’re helping to build a culture where we become a much more data-driven organization,” Dr. Payne says.