IDR Snapshot:Quantitative Assessment Methodology Evaluating Size and Comprehensiveness of an Integrated Data Repository

Vojtech Huser, MD PhDJames J Cimino, MD

Laboratory for Informatics DevelopmentNIH Clinical Center

NLM

http://code.google.com/p/idrsnapshot/ 2

Research question

• How can you evaluate an IDR?• What makes a good IDR ? (for research)?

• IDR A(in 2007) vs. IDR A (in 2012)• IDR A vs. IDR B

Vojtech Huser

http://code.google.com/p/idrsnapshot/ 3Vojtech Huser

http://code.google.com/p/idrsnapshot/ 4

Motivation/Assumptions

• Improving IDR– while acknowledging the a-priori limitations

• Ideal IDR for a researcher – versus existing data

• General measure on whole-IDR level– Not research project specific

• Build on CTSA IDR surveys from 2007, 2008 and 2010

Vojtech Huser

http://code.google.com/p/idrsnapshot/ 5

Examples

• Academic medical center • with limited number of outpatient clinics

– University of Utah

• Integrated delivery network• Outpatient and inpatient records

– Partners Healthcare

• HMO• Health Plan component

– Kaiser Permanente South California

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http://code.google.com/p/idrsnapshot/ 6

Target level (researcher-facing schema)

• Level 1: Epic Clarity (6000+ tables)

• Level 2: Clinical Data Repository (add data from GE Centricity (outpatient) (plus other sources)

• Level 3: subset of CDR for health plan members only

• Level 4: i2b2, or VDW, or OMOP, or XYZ (Deduce, Further, BTRIS)

Vojtech Huser

http://code.google.com/p/idrsnapshot/ 7

Beyond core data sources

– Diagnoses, Procedures, Labs– ADT data (admission, ICU)– Visit data

• Less-common data sources– Insurance history data– Over the counter drug data– Death certificate data

– Link to other sources

– Pharmacy dispensing data– Out of network claims data

• Health Plan data» Heath Assessment questionnaire data» Out of network pharmacy refills data

Vojtech Huser

http://code.google.com/p/idrsnapshot/ 8

Measures

• Glasgow comma scale of 10 vs. 5• Apgar score of 7 vs. 5•

• Good measure:– Intuitive to interpret (count of patients)– facilitates monitoring and improvement– does not place any arbitrary value on individual measure

components – (e.g., value of 10 years of medication history vs. 10 years of weight/height

history).

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http://code.google.com/p/idrsnapshot/ 9

“Consortia made easy(ier)”

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Vojtech Huser, IDR Snapshot http://code.google.com/p/idrsnapshot

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Results (site A, site B)

http://code.google.com/p/idrsnapshot/ 11Vojtech Huser