Personalized care, comparative effectiveness research and the electronic health record

2010 ◽  
Vol 10 (3) ◽  
pp. 168-170 ◽  
Author(s):  
Richard H Scheuermann ◽  
Henry Milgrom
Keyword(s):  
Electronic Health Record ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Health Record ◽  
Effectiveness Research ◽  
Personalized Care ◽  
Electronic Health

scholarly journals Caveats for the Use of Operational Electronic Health Record Data in Comparative Effectiveness Research

Medical Care ◽  
2013 ◽  
Vol 51 ◽  
pp. S30-S37 ◽  
Author(s):  
William R. Hersh ◽  
Mark G. Weiner ◽  
Peter J. Embi ◽  
Judith R. Logan ◽  
Philip R.O. Payne ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Health Record ◽  
Effectiveness Research ◽  
Electronic Health Record Data ◽  
Record Data ◽  
Electronic Health

scholarly journals The PCORnet Blood Pressure Control Laboratory

2020 ◽  
Vol 13 (3) ◽  
Author(s):  
Mark J. Pletcher ◽  
Valy Fontil ◽  
Thomas Carton ◽  
Kathryn M. Shaw ◽  
Myra Smith ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Electronic Health Record ◽  
Blood Pressure Control ◽  
Comparative Effectiveness ◽  
Pressure Control ◽  
Health Record ◽  
Control Laboratory ◽  
Electronic Health Record Data ◽  
Record Data ◽  
Electronic Health

Background: Uncontrolled blood pressure (BP) is a leading preventable cause of death that remains common in the US population despite the availability of effective medications. New technology and program innovation has high potential to improve BP but may be expensive and burdensome for patients, clinicians, health systems, and payers and may not produce desired results or reduce existing disparities in BP control. Methods and Results: The PCORnet Blood Pressure Control Laboratory is a platform designed to enable national surveillance and facilitate quality improvement and comparative effectiveness research. The platform uses PCORnet, the National Patient-Centered Clinical Research Network, for engagement of health systems and collection of electronic health record data, and the Eureka Research Platform for eConsent and collection of patient-reported outcomes and mHealth data from wearable devices and smartphones. Three demonstration projects are underway: BP track will conduct national surveillance of BP control and related clinical processes by measuring theory-derived pragmatic BP control metrics using electronic health record data, with a focus on tracking disparities over time; BP MAP will conduct a cluster-randomized trial comparing effectiveness of 2 versions of a BP control quality improvement program; BP Home will conduct an individual patient-level randomized trial comparing effectiveness of smartphone-linked versus standard home BP monitoring. Thus far, BP Track has collected electronic health record data from over 826 000 eligible patients with hypertension who completed ≈3.1 million ambulatory visits. Preliminary results demonstrate substantial room for improvement in BP control (<140/90 mm Hg), which was 58% overall, and in the clinical processes relevant for BP control. For example, only 12% of patients with hypertension with a high BP measurement during an ambulatory visit received an order for a new antihypertensive medication. Conclusions: The PCORnet Blood Pressure Control Laboratory is designed to be a reusable platform for efficient surveillance and comparative effectiveness research; results from demonstration projects are forthcoming.

scholarly journals The comparative effectiveness of fourth‐line drugs in resistant hypertension: An application in electronic health record data

2019 ◽  
Vol 28 (9) ◽  
pp. 1267-1277 ◽  
Author(s):  
Sarah‐Jo Sinnott ◽  
Liam Smeeth ◽  
Elizabeth Williamson ◽  
Pablo Perel ◽  
Dorothea Nitsch ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Resistant Hypertension ◽  
Comparative Effectiveness ◽  
Health Record ◽  
Electronic Health Record Data ◽  
Record Data ◽  
Electronic Health

Will Comparative Effectiveness Research Lead to Healthcare Rationing?

2011 ◽  
pp. 1-21
Author(s):  
Mary Brown
Keyword(s):  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Data Exchange ◽  
Health Data ◽  
Effectiveness Research ◽  
Advisory Committees ◽  
Healthcare Data ◽  
Practice Approach ◽  
Electronic Health ◽  
Healthcare Rationing

The Affordable Healthcare for America Bill that was signed into law in March 2010 includes support for activities that come under the heading of ‘comparative effectiveness’ research. The bill attempts to accelerate the conversion to electronic health records by all payers and providers who participate in the healthcare payment data stream. Conversion to electronic health data collection and storage solutions will create a large amount of treatment and payment data that is increasingly standardized by health standards organizations which reduces integration issues between technologies. There are federal advisory committees at work on designing the infrastructure needed to support a National Health Information Network (NHIN) that will support the healthcare data exchange required for comparative effectiveness research. The theory behind this work is that the availability of a large portion of existing health data will make it possible for researchers to identify therapies that lead to superior patient outcomes. It is assumed that the superior therapy would become the ‘best practice’ approach to treating a particular ailment. Supporters of comparative effectiveness see this as a strategy for making the system more effective both in terms of good medicine and also in terms of decreased cost. Opponents of comparative effectiveness see it as healthcare rationing and an inappropriate injection of government into the healthcare decision making process. Supporters and opponents have identified both positive and negative consequences to comparative effectiveness and this chapter will analyze the impact and propose some ways to optimize the results of this work.

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