1. Using EPR2020 for Clinical Research Diana Gumas, Director of Clinical and Clinical Research IT 1

2. Migration of clinical data to EPR2020 (powered by Amalga) 2 EPR- JHH & JHBMC Discharge summaries Operative notes Clinic Notes Problems, Allergies, Meds Lab Results Radiology Results EPR2020 Read-Only Data Discovery for Clinical Care Research Quality Improvement JHCP External Labs Additional Hospitals Clinical Research Management System Patient Portal HDM/Casemix Inpatient & Outpatient Diagnoses/Procedures Other JHH/JHBMC Clinical Systems

3. 3 Multiple Applications – Including Research Support

4. 4 Research App View: Patients on “My Studies”

5. 5 Now drill down to see Clinical Data for the Research Participant Clinical detail for the Patient: Problems, Allergies, Immunizations, Medications Labs Documents Active Research Study enrollment

6. 6 Research App View: Research Lab Results

7. 7 Exporting Lab Results Saves Significant Researcher Hours!

8. Researcher App View: Diagnosis “Find my patients who had a cardiac diagnosis in the 1 st quarter of 2010” Provides assistance gathering: Preliminary, anonymous data for feasibility, grant applications and statistical sample-size estimates IRB-approved case-finding--for study enrollment (mailings, phone solicitation), chart review, and cohort/case-control studies Research data extracts - monthly/quarterly integrated extracts from EPR, POE, ORMIS, lab/PDS, billing systems, vaccination/transfusion/culture data, etc. 8

9. Electronic Patient Record (EPR) and Research 9 One major source of clinical data for JHH/JHBMC Research documentation New EPR clinical research note just for researchers Access to scanned consents & Can look at statistics for race, gender, age, diagnosis description

10. 10 Diag Seq 1 - the primary for this encounter. Notice patient has a pacemaker… so…

11. 11 Search patient’s documents for pacemaker

12. 12 Future Plans My Research Patients’ Outpatient Diagnosis My Research Patients’ Procedures Alerts for significant events –Participant admission –Lab value out of range Evaluate Microsoft cohort discovery tool Evaluate use of i2b2 with data from EPR2020 Provide result data to Case Report Forms in Research System Interface to Specimen Tracking Tool (caTissue) Natural Language Processing to mine documents

13. EPR2020 Data Contents 13 Available today from EPR for JHH & JHBMC - *view-only* 4.4M Patients, 32.6M Visits 16.2M Documents, 8.5M Radiology Reports 78M Lab Tests, 402M Lab Results 1.7M Problems, 2.5M Medications, 159K Allergies, 475K Immunizations 5.8M Inpatient Diagnoses (409K distinct) In progress: Community physician visits and summary documents Outpatient diagnosis codes & procedures Images Improve speed of display Additional clinical research tools