Integrating historical clinical and financial data for pharmacological research

Update item information
Publication Type pre-print
School or College School of Medicine
Department Biomedical Informatics
Creator Mitchell, Joyce A.
Other Author Deshmukh, Vikrant G.; Sower, N. Brett; Hunter, Cheri Y.
Title Integrating historical clinical and financial data for pharmacological research
Date 2011-01-01
Description Background: Retrospective research requires longitudinal data, and repositories derived from electronic health records (EHR) can be sources of such data. With Health Information Technology for Economic and Clinical Health (HITECH) Act meaningful use provisions, many institutions are expected to adopt EHRs, but may be left with large amounts of financial and historical clinical data, which can differ significantly from data obtained from newer systems, due to lack or inconsistent use of controlled medical terminologies (CMT) in older systems. We examined different approaches for semantic enrichment of financial data with CMT, and integration of clinical data from disparate historical and current sources for research. Methods: Snapshots of financial data from 1999, 2004 and 2009 were mapped automatically to the current inpatient pharmacy catalog, and enriched with RxNorm. Administrative metadata from financial and dispensing systems, RxNorm and two commercial pharmacy vocabularies were used to integrate data from current and historical inpatient pharmacy modules, and the outpatient EHR. Data integration approaches were compared using percentages of automated matches, and effects on cohort size of a retrospective study. Results: During 1999-2009, 71.52%-90.08% of items in use from the financial catalog were enriched using RxNorm; 64.95%-70.37% of items in use from the historical inpatient system were integrated using RxNorm, 85.96%-91.67% using a commercial vocabulary, 87.19%-94.23% using financial metadata, and 77.20%-94.68% using dispensing metadata. During 1999-2009, 48.01%-30.72% of items in use from the outpatient catalog were integrated using RxNorm, and 79.27%-48.60% using a commercial vocabulary. In a cohort of 16304 inpatients obtained from clinical systems, 4172 (25.58%) were found exclusively through integration of historical clinical data, while 15978 (98%) could be identified using semantically enriched financial data. Conclusions: Data integration using metadata from financial/dispensing systems and pharmacy vocabularies were comparable. Given the current state of EHR adoption, semantic enrichment of financial data and integration of historical clinical data would allow the repurposing of these data for research. With the push for HITECH meaningful use, institutions that are transitioning to newer EHRs will be able to use their older financial and clinical data for research using these methods.
Type Text
Publisher BioMed Central
Volume 11
Issue 1
First Page 151
Dissertation Institution University of Utah
Language eng
Bibliographic Citation Deshmukh, V. G., Sower, N. B., Hunter, C. Y., & Mitchell, J. A. (2011). Integrating historical clinical and financial data for pharmacological research. Medical Research Methodology, 11(1), 151.
Rights Management (c) Joyce A Mitchell. Creative Commons Attribution License http://creativecommons.org/licenses/by/2.0/
Format Medium application/pdf
Format Extent 2,699,396 bytes
Identifier uspace,17865
ARK ark:/87278/s602999c
Setname ir_uspace
Date Created 2012-09-28
Date Modified 2021-05-06
ID 708159
Reference URL https://collections.lib.utah.edu/ark:/87278/s602999c
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