ArticleJAMIA open2019
Heterogeneity introduced by EHR system implementation in a de-identified data resource from 100 non-affiliated organizations.
Article in JAMIA open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Article
- DBSCAN applied to EHRs data from patients with glioblastoma clusters patients based on cytosolic Hsp70 protein, sex, and brain subventricular zone.BioData mining · 2026Article
- Federated learning for heterogeneous electronic health record systems with cost effective participant selection.Scientific reports · 2026Article
- Reducing Information and Selection Bias in EHR-Linked Biobanks via Genetics-Informed Multiple Imputation and Sample Weighting.medRxiv : the preprint server for health sciences · 2024Article
- Leveraging multi-site electronic health data for characterization of subtypes: a pilot study of dementia in the N3C Clinical Tenant.JAMIA open · 2024Article
- A framework for understanding selection bias in real-world healthcare data.Journal of the Royal Statistical Society. Series A, (Statistics in Society) · 2024Article
- Characterizing the limitations of using diagnosis codes in the context of machine learning for healthcare.BMC medical informatics and decision making · 2024Article
- A neural network approach to predict opioid misuse among previously hospitalized patients using electronic health records.PloS one · 2024Article
- An open natural language processing (NLP) framework for EHR-based clinical research: a case demonstration using the National COVID Cohort Collaborative (N3C).Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Clinical encounter heterogeneity and methods for resolving in networked EHR data: a study from N3C and RECOVER programs.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Variation in antibiotic resistance patterns for children and adults treated at 166 non-affiliated US facilities using EHR data.JAC-antimicrobial resistance · 2023Article
- Contextual Variation of Clinical Notes induced by EHR Migration.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2023Article
- Multi-site medical record review for validation of intentional self-harm coding in emergency departments.Injury epidemiology · 2022Article
- Standardized Health data and Research Exchange (SHaRE): promoting a learning health system.JAMIA open · 2022Article
- Missing diagnoses of congenital cytomegalovirus infection in electronic health records for infants with laboratory-confirmed infection.Current medical research and opinion · 2022Article
- Healthcare System-to-System Cost Variability in the Care of Pediatric Abdominal Pain-Associated Functional Gastrointestinal Disorders.Children (Basel, Switzerland) · 2021Article
- Use of large scale EHR data to evaluate A1c utilization among sickle cell disease patients.BMC medical informatics and decision making · 2021Article
- Sex differences in postnatal weight gain trajectories of extremely preterm newborns.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Clinical data sharing improves quality measurement and patient safety.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Aligning EHR Data for Pediatric Leukemia With Standard Protocol Therapy.JCO clinical cancer informatics · 2021Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesElectronic health record (EHR) data aggregated from multiple, non-affiliated, sources provide an important resource for biomedical research, including digital phenotyping. Unlike work with EHR data from a single organization, aggregate EHR data introduces a number of analysis challenges. MATERIALS AND
methodsWe used the Cerner Health Facts data, a de-identified aggregate EHR data resource populated by data from 100 independent health systems, to investigate the impact of EHR implementation factors on the aggregate data. These included use of ancillary modules, data continuity, International Classification of Disease (ICD) version and prompts for clinical documentation. RESULTS AND DISCUSSION: Health Facts includes six categories of data from ancillary modules. We found of the 664 facilities in Health Facts, 49 use all six categories while 88 facilities were not using any. We evaluated data contribution over time and found considerable variation at the health system and facility levels. We analyzed the transition from ICD-9 to ICD-10 and found that some organizations completed the shift in 2014 while others remained on ICD-9 in 2017, well after the 2015 deadline. We investigated the utilization of "discharge disposition" to document death and found inconsistent use of this field. We evaluated clinical events used to document travel status implemented in response to Ebola, height and smoking history. Smoking history documentation increased dramatically after Meaningful Use, but dropped in some organizations. These observations highlight the need for any research involving aggregate EHR data to consider implementation factors that contribute to variability in the data before attributing gaps to "missing data."
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