Sample of numerous features written for several of AMN's publications.

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Using Electronic Medical Records to Enhance Genetic Research and Public Health

There has been increasing focus on the usefulness of the data aggregated by electronic medical records (EMRs), and how this data might be applied to improve healthcare options and research in the US.

This growing 'braintrust' of critical information is being tapped by researchers and those in public health to see how having real-time access to this data might advance efforts in these areas.

Since 2007, a consortium comprised of Northwestern University, several other leading universities, and the Mayo Clinic, has been working to mine EMR data to track genetic patterns linked to disease.

The project, called eMERGE (Electronic Medical Records and Genomics), has been producing consistent, and positive, results.

Genetic studies often require very large samples sizes to achieve statistical significance. By culling information from multiple sites in the nation's EMR database, research teams can have access to greater amounts of data more quickly—which, in future, will shorten the time needed to get results, and help researchers move more quickly toward clinical trials.

Pinpointing these patterns with written paper records would have been almost impossible. Northwestern is looking at factors related to diabetes and asthma, and each consortium participant has its own focus, including peripheral arterial disease, cataracts, and dementia. Mayo Clinic is already realizing "palpable success" from their cancer/EMR projects, and applying enhanced information about patient options for clinical trials.

Collectively, the group has completed 14 algorithms describing different conditions using the information gathered from the electronic medical records.

The data analyzed so far have provided information to correctly identify known disease phenotypes with enough positive and negative predictive value for use in genome-wide association studies. To address privacy concerns, patients have to agree to allow their information to be used by researchers.

EMRs capture key information about diagnoses, medications, and lab tests, which the teams are using to define phenotypes. Information about race, ethnicity, smoking, and family history has been sporadically collected, a level of detail that will lead to even more detailed analyses and predictive research as it is aggregated.

What these researchers have done so far, and with success, is demonstrate an innovative application of EMRs.

The next steps are to apply this approach to an expanded list of diseases, and to make the information easily accessible to others, including providers.

There is momentum in getting the US healthcare system digitized. The most recent federal studies show that about 63% of hospital-based ambulatory surgery centers, 46% of hospital emergency departments, and 30% of office-based physicians are using EMRs; those numbers have increased substantially in the last few years. In addition to research, EMR data is helping public health departments respond more quickly to outbreaks and potential epidemics, speeding up the process of issuing media alerts and saving more lives.

Having off-site data also protects health centers, hospitals and public health departments from losing documentation in the event of a natural disaster.

Locally, The Metropolitan Chicago Healthcare Council (MCHC) has announced its goal of constructing the largest urban health information exchange (HIE) in the country.

This HIE will allow clinicians to share the digitized medical records of more than 9.4 million patients, linking them with hospital labs at more than 66 Chicago region hospitals and major outpatient care organizations.

Authorized users will be able to see a consolidated view of a patient's medical history, test results, and medication information from other providers throughout the region.

The Centers for Disease Control and Prevention (CDC) has been playing an active role in promoting healthcare information technology throughout the country, with training programs, resources for state and local health departments, and project grants.

They are tasked with helping the US healthcare system implement EMRs with a phased approach, achieving universal compliance in next two years.