New research by the Regenstrief Institute suggests that the widespread use of electronic health records systems hold the keys to accelerate evidence-generating and evidence-based medicine.
EHR systems, now widely deployed and used by provider organizations, can enable broader development of learning health systems, the HIT research organization contends.
As a consequence of nearly universal adoption of EHRs, data-driven healthcare now is within reach, contends Peter J. Embi, an informaticst and president and CEO at Regenstrief.
However, despite unprecedented volumes of clinical data generated daily across the nation’s health system, the ability to leverage the data to increase knowledge of health and disease, and drive improvements, remain overwhelmingly unrealized, he says.
The research includes insights from multiple informaticists in such organizations as Duke University, Mount Sinai Health System, University of Michigan, Brown University, the American Medical Informatics Association and the Department of Health and Human Services.
Evidence-based medicine has become the bedrock of clinical decision-making and facilitated by use of EHRs. Similarly, evidence-generating medicine can be utilized to enable the generation of evidence from real-world practice. This offers the potential to transform a severely limited clinical research system that is expensive, inefficient and incapable of scaling to address the myriad unanswered questions of clinicians and patients, Embi and colleagues believe.
Evidence-generating medicine is the use of research and quality improvement considerations into the organization and practice of healthcare to advance biomedical science and improve the health of individuals and populations.
“Increasingly, all health stakeholders have the opportunity and obligation to leverage health information technology systems and the valuable data they contain for the development and delivery of new interventions,” Embi and colleagues contend. Examples include the All of Us Research Program, Cancer Moonshot Initiative, Health Care Systems Research Collaboratory and the development of a national system of real-world evidence.
The Regenstrief report includes a number of findings to bring research to physicians at the point of clinical care to where it can be included immediately. They include:
- Knowledge resources and standards can support research at the clinical level by enabling activities such as identifying clinical trials relevant to individual patients and collecting the research data. Results reporting via the ClinicalTrials.gov website is foundational for enabling outside stakeholders to benefit from research.
- Failure to report research results to ClinicalTrials.gov is a systemic problem that stifles national scientific advances as not all trials are published and not all outcomes measures for adverse events are published.
- However, a final rule published in September 2016 will enable better enforcement of requirements for depositing clinical trial information on ClinicalTrials.gov.
The full research report is available here.