Clinical Data Services



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Clinical Data Services Data Storage, Data Collection Data Management Human Research Academy October 2014 CTS Research Development Services 706.721.6247 www.ctsrds@gru.edu

Objectives Participants will: Have an overview of several data research applications available at GRU. Review advantages and best use of several data mining tools. Be made aware of the need to request IRB approval for data mining and processes. Review the need for the R Drive; secure storage application.

Several questions to ask before you request or search for data: Do you need de-identified data as a feasibility tool? Do you need identified data to contact patients or review their chart? Do you have the identifiers that would assist the search for patient information? Can you list them? What is your final goal? Do you need IRB Approval before your data search? If you are searching for PHI do you have R Drive permission for your IRB approved study?

A Few Data Search Tools at GRU I2b2 for de-identified results I2b2 for identified results PowerChart (the Electronic Health Record for GRU)

What is i2b2? i2b2 (Informatics for Integrating Biology & the Bedside) is: an informatics framework created through NIH funding to leverage existing data for research cohort discovery. i2b2 was designed to support cohort identification, retrospective data analysis, and hypothesis generation. i2b2 consists of a workbench and a web client. a tool to manage data pulled from GRU sources.

i2b2 Web Client The i2b2 web client: is designed with a user-friendly, drag-and-drop interface. enables users to perform these tasks without extensive training or technical expertise.

The i2b2 workbench The i2b2 workbench: Is a desktop-based application that can also interface with i2b2 data. Is designed to accommodate more frequent i2b2 users.

How is i2b2 populated and how will patients be identified? i2b2 is populated using Cerner s Architecture: leveraging a nightly extraction process, our institution sends data from the Cerner Millennium EMR, along with associated data, for mapping into a data mart that feeds the GRU i2b2. this daily extraction pulls data from not only PowerChart but other applications as well including HealthQuest. GRU has access to two i2b2 instances: De-identified project and Identified project.

GRU supports two versions of i2b2 A de-identified search tool This is a feasibility tool; it results only numerical information. An example is a search for the 250.0 diagnosis code for females under the age of 25. These parameters would net a numerical value. The data from i2b2 is developed from mixed applications including billing and Electronic Health Record (PowerChart) files. No IRB approval is required. An online tutorial requires a brief test and proof of Citi training for access to use this version of i2b2.

i2b2 at GRU An identified search tool: In this tool PHI can be extracted from the results/findings. Potential PHI includes patient names, addresses, birth days, and Medical Record numbers. From the example we had earlier: females under the age of 25 with a diagnosis of 250.0 the same patient count is available; a second set of parameters are added to show MRNs, addresses, names, and more detail. IRB approval is required for identified searches in i2b2 and storage is on the R Drive only.

The i2b2 Screen The basic i2b2 screen; previous queries and query tool are visible.

Examples of Data The data found in i2b2 includes: Age Gender Race Addresses Diagnosis Codes Medications (that are on formulary) Many Lab test Updates will be coming soon including CPT codes.

Chart Reviews: Data From PowerChart Chart reviews require IRB approval and access to PowerChart. In each patient chart menus show lab results, radiology documentation, medication lists, clinical notes, encounter listings, and all results. The chart is the cumulative information of each patient s medical care at GRU. PowerChart access is role based and is created by a security administrator.

A View of the PowerChart Menu The menu listings open to pages with chart detail.

Data From PowerChart Visit/Provider/Patient listings: PowerChart offers a listing of visits. The visits, encounters are created in IDX and flow to PowerChart. You can search by provider, location, or patient. This can be helpful to determine the number of patients who have visited a MD or a clinic. It will also list all visits for a patient.

An Example of a Listing by Clinic in PowerChart: 1. Select Scheduling Appointment Book 2. Select the Eye 3. Define the dates, source, provider, or patient. 4. The listing is displayed (names have been blocked for this example) The final listing can show patient names, dates, and appointment information. The search can be a patient, or a MD, or a clinic; this reflects encounters created in IDX.

The R Drive All PHI data from i2b2 is added to the appropriate study folder on the R Drive. The R Drive offers a secure data storage site for PHI. R Drive Storage space is requested through the Service Now web site.

Requests? To request an identified i2b2 search include: your IRB approval for data mining search criteria age, gender, diagnosis codes, or other definition. brief overview of your goal data is saved to your study R Drive; confirm your access. For de-identified i2b2 access and/or information? For PowerChart or PowerTrials training? Email: jhayman@gru.edu

Questions, Ideas, Suggestions? Thank you for participating in this workshop series! CTS Research Development Services 19