EMR Big Data and Clinical Research. -Distributed Research Network and Common Data Model-
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1 2016 Healthcare Innovation Forum EMR Big Data and Clinical Research -Distributed Research Network and Common Data Model- Rae Woong Park, MD, PhD Department of Biomedical Informatics Ajou University School of Medicine
2 Distributed Research Network with Common Data Model Source 1 Source 2 Source 3 Common Data Model Privacy Protection Multiple databases Reusuable analytic codes Analytic Method Results Analytic Method Results Analytic Method Quick and Fast Results Analytic Methods Analytic Methods Analytic Methods Aggregated Results 2
3 Examples of clinical researches using international multi-institutional big data 250M patients 12 database 5 countries 3
4 Prescription pattern analysis
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6 Population-level heterogeneity Type 2 Diabetes Mellitus CCAE Hypertension CUMC Depression MDCD CPRD INPC GE JMDC MDCR OPTUM
7 Distributed Research Network with Common Data Model 7
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9 OHDSI data network Database Data Type Country # of Patients (x1000) AltaMed Health Services EHR USA 638 ARS NYC-CDRN Claims Italy EHR 4,000 USA 6,000 AUSOM (Ajou Univ. School Of NYP/CUMC EHR Korea EHR2,610 USA 4,500 Optum ClinFormatics Claims USA 40,670 Medicine) Premier Hospital Billing USA BTRIS SAFTINet: EHR/CTDMS Bi- State Primary Care USA Association EHR-clinical 500 information system; USA 100 Clinical Practice Research Datalink (CPRD) EHR UK Medicaid 11,560claims CMSMedicare (Synthetic PUF) SAFTINet: Claims Cherokee Health Systems USA EHR-clinical 2,000 information system USA 111 DARTNet Institute: CER2 Study SAFTINet: Clinical Colorado 30 organizations Community Managed USA Care Network EHR-clinical 1,300 information system; USA 100 Medicaid claims Department of Veterans Affairs EHR USA 8,700 SAFTINet: Denver Health Hospital Authority EHR-clinical information system; USA 250 Flatiron EMR 53 databases USA Medicaid 732claims HCUP NIS San Claims Francisco General Hospital USA EHR91, Millions of patients USA 500 ICPI SEER EHRMedicare Netherlands Claims 2,000 + Cancer Registry USA 2,000 Stanford Clinical Data Warehouse (de-identified subset) EHR USA 2,011 IMS Ambulatory EMR EMR 12 countries USA 25,000 IMS Ambulatory EMR - Canada Taiwan EMR NHIRD Canada Claims 2,300 Taiwan 2,000 The Children s Clinic EHR USA 190 IMS Ambulatory EMR linked claims Claims + EMR USA 5,041 THIN EHR UK 10,000 IMS Disease Analyzer - France Truven Claims MarketScan Commercial Claims France and Encounters (CCA Claims 2,200 USA 121,850 IMS Disease Analyzer - Germany E) Claims Germany 8,875 IMS Oncology Analyzer - France Truven Survey MarketScan Medicare Supplemental France (MDCR) Claims 4.2 USA 9,250 IMS Oncology Analyzer - Germany Truven Survey MarketScan Multi-state Medicaid Germany(MDCD) Claims 6 USA 17,340 IMS Oncology Analyzer - Spain TUD Survey Spain EHR (Hospital) 4 Germany 4,000 IMS Oncology EMR University EMR of California, Davis US EHR 2,059 USA 2,200 University of California, Irvine EHR USA 1,400 IMS Pharmetrics Plus Claims USA 105,009 University of California, Los Angeles EHR USA 4,100 Indiana Network for Patient Care University HIE of California, San DiegoUSA EHR11,900 USA 2,200 Intermountain University EHR of California, San Francisco USA EHR 1,125 USA 3,000 Japan Medical Data Center (JMDC) University Claims of Pittsburgh Medical Center Japan Drug dispensing 2870 USA 4.7 MEPS University Survey of Texas USA EHR (Outpatient+Billing) USA 2,400 NHANES University Survey of Washington WPRN USA EHR 72 USA 23,327
10 OHDSI Open Innovation More than 75 software are developed/developing in Github Github: Open and collaborative software development platform Collaborative development Open Source Free!! 10
11 Open Innovation: open source software > 70 Study design to results: no dependency to data manager 11
12 Researchers can easily design and perform the study Including enroll and exclusion criteria, data extraction and analysis, independently from data manger. 12
13 Study summary, automatically generated 13
14 Graphic summary, automatically generated 14
15 Data Extraction code, automatically generated 15
16 The program automatically generates the SQL query extracting the cohort data. 16
17 AURORA: Analytic Code Managing and distributing unit bridging Research Organization and Associated Researchers
18 AURORA DEMO Comparison of gastrointestinal bleeding risk between Celecoxib and Diclofenac 18
19 Korean OHDSI data network 19
20 Are we ready for open innovation? -Ranking of Korea Github User Count GitHub: a web-based Git(Version control system) repository hosting service -VCS (Version Control System) -Easy collaboration -Social coding Top 50,
21 Github User count Top 50, How can we move into Open Innovative World? Rank: 31/170
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