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注意临床分析差距:电子健康记录与 COVID-19 大流行应对。

Mind the clinical-analytic gap: Electronic health records and COVID-19 pandemic response.

机构信息

Center for Health Systems Research, Division of Research, Development & Dissemination Sutter Health, Walnut Creek, CA, United States.

Center for Health Systems Research, Division of Research, Development & Dissemination Sutter Health, Walnut Creek, CA, United States.

出版信息

J Biomed Inform. 2021 Apr;116:103715. doi: 10.1016/j.jbi.2021.103715. Epub 2021 Feb 19.

Abstract

Data quality is essential to the success of the most simple and the most complex analysis. In the context of the COVID-19 pandemic, large-scale data sharing across the US and around the world has played an important role in public health responses to the pandemic and has been crucial to understanding and predicting its likely course. In California, hospitals have been required to report a large volume of daily data related to COVID-19. In order to meet this need, electronic health records (EHRs) have played an important role, but the challenges of reporting high-quality data in real-time from EHR data sources have not been explored. We describe some of the challenges of utilizing EHR data for this purpose from the perspective of a large, integrated, mixed-payer health system in northern California, US. We emphasize some of the inadequacies inherent to EHR data using several specific examples, and explore the clinical-analytic gap that forms the basis for some of these inadequacies. We highlight the need for data and analytics to be incorporated into the early stages of clinical crisis planning in order to utilize EHR data to full advantage. We further propose that lessons learned from the COVID-19 pandemic can result in the formation of collaborative teams joining clinical operations, informatics, data analytics, and research, ultimately resulting in improved data quality to support effective crisis response.

摘要

数据质量对于最简单和最复杂的分析都至关重要。在 COVID-19 大流行的背景下,美国和世界各地的大规模数据共享在公共卫生应对大流行方面发挥了重要作用,对于了解和预测其可能的进程至关重要。在加利福尼亚州,医院被要求报告与 COVID-19 相关的大量日常数据。为了满足这一需求,电子健康记录 (EHR) 发挥了重要作用,但尚未探索从 EHR 数据源实时报告高质量数据的挑战。我们从美国加利福尼亚州北部一个大型、综合、混合支付者健康系统的角度描述了为此目的利用 EHR 数据的一些挑战。我们使用几个具体示例强调了 EHR 数据中存在的一些不足之处,并探讨了构成这些不足之处基础的临床分析差距。我们强调需要将数据和分析纳入临床危机规划的早期阶段,以便充分利用 EHR 数据。我们进一步提出,从 COVID-19 大流行中吸取的经验教训可以促成临床运营、信息学、数据分析和研究的联合团队的形成,最终提高数据质量以支持有效的危机应对。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cf3/7892315/cf89ab876adc/ga1_lrg.jpg

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