Evidence map›Paper›PMID 37873390›Full record

ArticlemedRxiv : the preprint server for health sciences2023

Real World Performance of the 21st Century Cures Act Population Level Application Programming Interface.

James R Jones, Daniel Gottlieb, Andrew J McMurry, Ashish Atreja, Pankaja M Desai, Brian E Dixon, Philip R O Payne, Anil J Saldanha, Prabhu Shankar, Yauheni Solad and 10 more

Open access · greenAbstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 4 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 5 institutions in 1 country.

James R JonesComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Daniel GottliebComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Andrew J McMurryComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Ashish AtrejaDepartment of Health Innovation Technology, UC Davis Health, Rancho Cardova, CA.
Pankaja M DesaiDepartment of Internal Medicine, Rush University Medical Center, Chicago IL.
Brian E DixonDepartment of Health Policy & Management, Fairbanks School of Public Health, Indiana University, Indianapolis, IN.
Philip R O PayneDepartment of Medicine, Washington University in St Louis, St Louis, MO.
Anil J SaldanhaDepartment of Health Innovation, Rush University Medical Center, Chicago IL.
Prabhu ShankarDepartment of Health Innovation Technology, UC Davis Health, Rancho Cardova, CA.
Yauheni SoladDepartment of Health Innovation Technology, UC Davis Health, Rancho Cardova, CA.
Adam B WilcoxDepartment of Medicine, Washington University in St Louis, St Louis, MO.
Momeena S AliDepartment of Health Innovation Technology, UC Davis Health, Rancho Cardova, CA.
Eugene KangDepartment of Health Innovation Technology, UC Davis Health, Rancho Cardova, CA.
Andrew M MartinDepartment of Technical Services, Regenstrief Institute, Indianapolis, IN.
Elizabeth SprouseDouble Lantern Informatics, Atlanta, GA.
David TaylorDepartment of Technical Services, Regenstrief Institute, Indianapolis, IN.
Michael TerryComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Vladimir IgnatovComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
SMART Cumulus Network
Kenneth D MandlComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Boston Children's Hospital · USUniversity of California, Davis · USRegenstrief Institute · USRush University Medical Center · USWashington University in St. Louis · US

Funding

Instrumenting the Delivery System for a Genomics Research Information CommonsU01TR002623 · NCATS · BOSTON CHILDREN'S HOSPITAL · PI MANDL, KENNETH D. · 2019 to 2024
$8.6M
Leveraging Electronic Health Data to Assess the Burden of Diabetes among Young AdultsU18DP006500 · DP · INDIANA UNIVERSITY INDIANAPOLIS · PI DIXON, BRIAN E., MENDONCA, ENEIDA A · 2020 to 2024
$1.4M
ACL HHS U18DP006500NCATS NIH HHS U01 TR002623NCCDPHP CDC HHS U18 DP006500OSTLTS CDC HHS NU38OT000286
6 · The paper itself

Abstract

Objective: To evaluate the real-world performance in delivering patient data on populations, of the SMART/HL7 Bulk FHIR Access API, required in Electronic Health Records (EHRs) under the 21st Century Cures Act Rule. Materials and Methods: We used an open-source Bulk FHIR Testing Suite at five healthcare sites from April to September 2023, including four hospitals using EHRs certified for interoperability, and one Health Information Exchange (HIE) using a custom, standards-compliant API build. We measured export speeds, data sizes, and completeness across six types of FHIR resources. Results: Among the certified platforms, Oracle Cerner led in speed, managing 5-16 million resources at over 8,000 resources/min. Three Epic sites exported a FHIR data subset, achieving 1-12 million resources at 1,555-2,500 resources/min. Notably, the HIE's custom API outperformed, generating over 141 million resources at 12,000 resources/min. Discussion: The HIE's custom API showcased superior performance, endorsing the effectiveness of SMART/HL7 Bulk FHIR in enabling large-scale data exchange while underlining the need for optimization in existing EHR platforms. Agility and scalability are essential for diverse health, research, and public health use cases. Conclusion: To fully realize the interoperability goals of the 21st Century Cures Act, addressing the performance limitations of Bulk FHIR API is critical. It would be beneficial to include performance metrics in both certification and reporting processes.

Identifiers

PMID37873390
PMCPMC10593080
OpenAlexW4387358683

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.