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Enhancing PCORnet Clinical Research Network data completeness by integrating multistate insurance claims with electronic health records in a cloud environment aligned with CMS security and privacy requirements

Enhancing PCORnet Clinical Research Network data completeness by integrating multistate insurance... ObjectiveThe Greater Plains Collaborative (GPC) and other PCORnet Clinical Data Research Networks capture healthcare utilization within their health systems. Here, we describe a reusable environment (GPC Reusable Observable Unified Study Environment [GROUSE]) that integrates hospital and electronic health records (EHRs) data with state-wide Medicare and Medicaid claims and assess how claims and clinical data complement each other to identify obesity and related comorbidities in a patient sample.Materials and MethodsEHR, billing, and tumor registry data from 7 healthcare systems were integrated with Center for Medicare (2011–2016) and Medicaid (2011–2012) services insurance claims to create deidentified databases in Informatics for Integrating Biology & the Bedside and PCORnet Common Data Model formats. We describe technical details of how this federally compliant, cloud-based data environment was built. As a use case, trends in obesity rates for different age groups are reported, along with the relative contribution of claims and EHR data-to-data completeness and detecting common comorbidities.ResultsGROUSE contained 73 billion observations from 24 million unique patients (12.9 million Medicare; 13.9 million Medicaid; 6.6 million GPC patients) with 1 674 134 patients crosswalked and 983 450 patients with body mass index (BMI) linked to claims. Diagnosis codes from EHR and claims sources underreport obesity by 2.56 times compared with body mass index measures. However, common comorbidities such as diabetes and sleep apnea diagnoses were more often available from claims diagnoses codes (1.6 and 1.4 times, respectively).ConclusionGROUSE provides a unified EHR-claims environment to address health system and federal privacy concerns, which enables investigators to generalize analyses across health systems integrated with multistate insurance claims. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of the American Medical Informatics Association Oxford University Press

Enhancing PCORnet Clinical Research Network data completeness by integrating multistate insurance claims with electronic health records in a cloud environment aligned with CMS security and privacy requirements

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References (21)

Publisher
Oxford University Press
Copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com
ISSN
1067-5027
eISSN
1527-974X
DOI
10.1093/jamia/ocab269
Publisher site
See Article on Publisher Site

Abstract

ObjectiveThe Greater Plains Collaborative (GPC) and other PCORnet Clinical Data Research Networks capture healthcare utilization within their health systems. Here, we describe a reusable environment (GPC Reusable Observable Unified Study Environment [GROUSE]) that integrates hospital and electronic health records (EHRs) data with state-wide Medicare and Medicaid claims and assess how claims and clinical data complement each other to identify obesity and related comorbidities in a patient sample.Materials and MethodsEHR, billing, and tumor registry data from 7 healthcare systems were integrated with Center for Medicare (2011–2016) and Medicaid (2011–2012) services insurance claims to create deidentified databases in Informatics for Integrating Biology & the Bedside and PCORnet Common Data Model formats. We describe technical details of how this federally compliant, cloud-based data environment was built. As a use case, trends in obesity rates for different age groups are reported, along with the relative contribution of claims and EHR data-to-data completeness and detecting common comorbidities.ResultsGROUSE contained 73 billion observations from 24 million unique patients (12.9 million Medicare; 13.9 million Medicaid; 6.6 million GPC patients) with 1 674 134 patients crosswalked and 983 450 patients with body mass index (BMI) linked to claims. Diagnosis codes from EHR and claims sources underreport obesity by 2.56 times compared with body mass index measures. However, common comorbidities such as diabetes and sleep apnea diagnoses were more often available from claims diagnoses codes (1.6 and 1.4 times, respectively).ConclusionGROUSE provides a unified EHR-claims environment to address health system and federal privacy concerns, which enables investigators to generalize analyses across health systems integrated with multistate insurance claims.

Journal

Journal of the American Medical Informatics Association – Oxford University Press

Published: Dec 13, 2021

Keywords: obesity; electronic health records; Centers for Medicare and Medicaid Services; PCORnet; Patient-Centered Outcomes Research Institute; cloud computing; Amazon Web Services private cloud

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