Using EHRs to integrate research with patient care: Promises and challenges

Department of Biomedical Informatics, Columbia University, New York, New York 10032, USA.
Journal of the American Medical Informatics Association (Impact Factor: 3.5). 04/2012; 19(5):684-7. DOI: 10.1136/amiajnl-2012-000878
Source: PubMed


Clinical research is the foundation for advancing the practice of medicine. However, the lack of seamless integration between clinical research and patient care workflow impedes recruitment efficiency, escalates research costs, and hence threatens the entire clinical research enterprise. Increased use of electronic health records (EHRs) holds promise for facilitating this integration but must surmount regulatory obstacles. Among the unintended consequences of current research oversight are barriers to accessing patient information for prescreening and recruitment, coordinating scheduling of clinical and research visits, and reconciling information about clinical and research drugs. We conclude that the EHR alone cannot overcome barriers in conducting clinical trials and comparative effectiveness research. Patient privacy and human subject protection policies should be clarified at the local level to exploit optimally the full potential of EHRs, while continuing to ensure participant safety. Increased alignment of policies that regulate the clinical and research use of EHRs could help fulfill the vision of more efficiently obtaining clinical research evidence to improve human health.

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    • "All forms contain items corresponding to medical concepts. Some studies show the potential of reuse by identifying the same concepts in different forms [7] which implies that the variety is probably more based on formal aspects and layout information than on different concepts. This diversity of medical forms severely hampers semantic interoperability between different information systems: it is very difficult to transfer structured patient data between different EHR systems or between EHR and EDC systems in a research context, because the two involved systems do not use the same metadata. "
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    PLoS ONE 07/2013; 8(7):e67883. DOI:10.1371/journal.pone.0067883 · 3.23 Impact Factor
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