Cooper Sharon P, Heyer Nicholas, Shipp Eva M, Ryder E Roberta, Hendrikson Edward, Socias Christina M, Del Junco Deborah J, Valerio Melissa, Partida Sylvia
The University of Texas School of Public Health, San Antonio Regional Campus, San Antonio, TX.
Battelle, Seattle, WA.
Online J Public Health Inform. 2014 Oct 16;6(2):e190. doi: 10.5210/ojphi.v6i2.4903. eCollection 2014.
The lack of aggregated longitudinal health data on farmworkers has severely limited opportunities to conduct research to improve their health status. To correct this problem, we have created the infrastructure necessary to develop and maintain a national Research Data Repository of migrant and seasonal farmworker patients and other community members receiving medical care from Community and Migrant Health Centers (C/MHCs). Project specific research databases can be easily extracted from this repository.
The Community Based Research Network (CBRN) has securely imported and merged electronic health records (EHRs) data from five geographically dispersed C/MHCs. To demonstrate the effectiveness of our data aggregation methodologies, we also conducted a small pilot study using clinical, laboratory and demographic data from the CBRN Data Repository from two initial C/MHCs to evaluate HbA1c management.
Overall, there were 67,878 total patients (2,858 farmworkers) that were seen by two C/MHCs from January to August 2013. A total of 94,189 encounters were captured and all could be linked to a unique patient. HbA1c values decreased as the number of tests or intensity of testing increased.
This project will inform the foundation for an expanding collection of C/MHC data for use by clinicians for medical care coordination, by clinics to assess quality of care, by public health agencies for surveillance, and by researchers under Institutional Review Board (IRB) oversight to advance understanding of the needs and capacity of the migrant and seasonal farmworker population and the health centers that serve them. Approved researchers can request data that constitute a Limited Data Set from the CBRN Data Repository to establish a specific research database for their project.
缺乏关于农场工人的汇总纵向健康数据严重限制了开展研究以改善他们健康状况的机会。为纠正这一问题，我们创建了必要的基础设施，以开发和维护一个全国性的研究数据存储库，该存储库收录了接受社区和流动医疗中心（C/MHCs）医疗服务的流动和季节性农场工人患者及其他社区成员的数据。特定项目的研究数据库可轻松从此存储库中提取。
基于社区的研究网络（CBRN）已安全导入并合并了来自五个地理位置分散的C/MHCs的电子健康记录（EHRs）数据。为证明我们数据汇总方法的有效性，我们还使用来自两个初始C/MHCs的CBRN数据存储库中的临床、实验室和人口统计数据进行了一项小型试点研究，以评估糖化血红蛋白（HbA1c）管理情况。
总体而言，2013年1月至8月期间，两个C/MHCs共接待了67,878名患者（2,858名农场工人）。共记录了94,189次就诊情况，且所有就诊情况都可与唯一的患者相关联。随着检测次数或检测强度的增加，HbA1c值下降。
该项目将为扩大C/MHCs数据收集奠定基础，以供临床医生用于医疗协调、诊所用于评估医疗质量、公共卫生机构用于监测，以及研究人员在机构审查委员会（IRB）监督下用于增进对流动和季节性农场工人人口及其服务的健康中心的需求和能力的了解。经批准的研究人员可从CBRN数据存储库请求构成有限数据集的数据，以建立其项目的特定研究数据库。
