Journal article
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
Journal of the American Medical Informatics Association : JAMIA, Vol.29(4), pp.660-670
03/15/2022
DOI: 10.1093/jamia/ocab269
PMCID: PMC8922172
PMID: 34897506
Abstract
The 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.
EHR, 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.
GROUSE 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).
GROUSE 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.
Details
- Title: Subtitle
- 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
- Creators
- Lemuel R Waitman - University of MissouriXing Song - University of MissouriDammika Lakmal Walpitage - University of Kansas Medical CenterDaniel C Connolly - University of Kansas Medical CenterLav P Patel - University of Kansas Medical CenterMei Liu - University of Kansas Medical CenterMary C Schroeder - University of IowaJeffrey J VanWormer - Marshfield ClinicAbu Saleh Mosa - University of MissouriErnest T Anye - University of Missouri Health SystemAnn M Davis - Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Resource Type
- Journal article
- Publication Details
- Journal of the American Medical Informatics Association : JAMIA, Vol.29(4), pp.660-670
- DOI
- 10.1093/jamia/ocab269
- PMID
- 34897506
- PMCID
- PMC8922172
- ISSN
- 1527-974X
- eISSN
- 1527-974X
- Grant note
- UL1 TR002366 / NCATS NIH HHS UL1TR002366 / NIH HHS RI-CRN-2020-003-IC / Patient-Centered Outcomes Research Institute
- Language
- English
- Date published
- 03/15/2022
- Academic Unit
- Pharmacy Practice and Science
- Record Identifier
- 9984366027102771
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