Electronic Health Record Improving Health Care with the Research-able EHR™
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Nurses
Integrated Clinical Research
Doctors
Benefits of the Research-able EHR™
The implementation of an Electronic Health Record (EHR) offers Healthcare Organisations several benefits in addition to those directly related to the care of an individual patient: support to clinical research, completion of retrospective analysis of clinical data, opportunities to benchmark performance, and the ability to quickly validate scientific hypothesis. Data collected in EHR archives provides unique opportunities to understand trends and outcomes of medical conditions and treatments. Cerner’s EHR supports the integration of research and clinical care, allowing for improved coordination between these sometimes artificially separated areas.
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Research-able EHR™ Making use of Real-world Data The clinical benefits of an Electronic Health Record (EHR) are already recognised by Physicians engaged in direct patient care 1 2. Researchers are also beginning to fully comprehend the value offered by integrating the EHR and research tools rather than keeping research databases separately. The primary use of an EHR is to improve patients’ care by implementing effective clinical pathways, evidence based medicine, and individualised treatment when appropriate. EHR data allows quality improvement initiatives and continuous or quasi-real time audit. The ability to analyse data promptly can afford better understanding of health trends and risks, and provides the ability to proactively manage health and deal with specific medical conditions by shifting from “evidence based practice” to “practice based evidence”3. An effective EHR solution can also provide support to research in important ways, for example identification of eligible candidates at the point of contact, data collection and transmission, and automatic reporting of adverse event. Interestingly this support may translate into clinical benefits. The system may reduce the time required to complete recruitment and completion of trials, and may shorten the time lag between completion of enrollment to analysis and publication of results. The most desirable EHR systems should offer high quality, relevant, and specific information at the point of care, and support clinicians and patients to identify evidence-based medical treatment for any medical condition 4.
The Cerner Research-able EHR Cerner’s commitment to research and belief in “closing the loop” from knowledge discovery to best practice implementation has resulted in the development of solutions which directly support research. These solutions bridge the clinical care space with the research care space creating an EHR that is ‘Research-able’. It is this bridging of the two care spaces that enables clinical medicine to drive discovery, and discovery to drive innovation in clinical medicine. An example of using data from the EHR is Cerner’s work with the U.S. Centers for Disease Control and Prevention to manage longitudinal de-identified health data collected on HIV-infected patients. Data were collected through two separate cohorts (research groups): HIV Outpatient Study (HOPS) and Study of the Natural History of HIV/AIDS in
the Era of Effective Therapy (SUN). Cerner has played a significant role in the HOPS study, collecting data using Discovere®, a clinical trial management platform utilised to manage participant sites, data
Key Benefits
Ability to analyse data promptly
Better understanding of health trends and risks
Data collection and transmission in real time
High quality, relevant, and specific information at the point of care
processing and quality assurance, and providing the ability to conduct data analysis. The data showed a higher risk of fractures in patients with HIV compared to the general population, and amongst those with HIV depending on their clinical status. It also showed an increase in the rates of fracture from 2000 onwards. As a result of these findings, the authors recommended that routine care of HIV-infected persons should include screening and intervention for causes of low mineral bone density and risk factors for falls. The study was published in Clinical Infectious Diseases, and the recommendations should be implemented into clinical practice – potentially having an impact on the care of people with HIV 5.
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EHR: Improving Clinical collaboration
EHRs are playing a key role in connecting and exchanging information across the entire health continuum, and contributing to more efficient and personalised medicine. Cerner is at the frontline of patient care in novation, offering EHR-integrated clinical research solutions, providing EHR screening capabilities, enabling predictive data modeling for evidence-base pathway decisions, and offering benchmarking tools to drive process improvement. The keys to unlock medicine best practice application and personalised care are available at the intersection between research and clinical care with a ‘Research-able’ EHR.
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Cerner Research
PowerTrials® PowerTrials®
PowerTrials facilitates clinical trials using a site’s EHR to enhance patient safety and connect clinical care with research care.
Discovere®: Site researchers use Discovere, Cerner’s web-based research system, to collect research data for their studies, removing the paperwork.
Discovere®
Health Facts®: Health Facts®
Health Facts is an anonymised data service that facilitates the collection of data for research.
References [1] Swindells M, de Lusignan S Lessons from the English National Programme for IT about Structure, Process and Utility. Stud Health Technol Inform. 2012; 174:17-22. [2] Sullivan F, Wyatt JC How computers help make efficient use of consultations. BMJ. 2005 Oct 29;331(7523):1010-2. [3] Frankovich J M.D. et al. Evidence-Based Medicine in the EMR Era. The New England Journal of Medicine. 2011 November. [4] Hoffman MA, Williams MS Electronic medical records and personalized medicine. Hum Genet. 2011 Jul;130(1):33-9. Epub 2011 Apr 26. [5] Young B, et al. the HIV Outpatient Study (HOPS) Investigators. Increased Rates of Bone Fracture among HIV-Infected Persons in the HIV Outpatient Study (HOPS) Compared with the US General Population, 2000-2006. Clinical Infectious Diseases 2011; doi: 10.1093/ 5 cid/ciq242
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Health Care is Too Important to Stay the Same.
For more than 30 years, Cerner has been a visionary leader in making health care safer and more efficient. We started with the foundation of digitising paper processes and replacing memory based care by linking research and evidence-based decision support at the point of care. Our clinical and health information system apps & services enhance the productivity, efficiency and effectiveness of health care delivery worldwide. Now, more than ever our focus is on developing the innovations that will integrate and help improve the entire health care system. Thus Cerner is:
Integrating the health system.
Working with organisations to manage change.
Changing the way people think about health
Join us as we work to make health care all it should be. For more information, please email: cerneruk@cerner.com Alternatively, visit our website: www.cerner.co.uk
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Cerner Limited / 6th Floor, The Point / 37 North Wharf Road / London W2 1AF / United Kingdom / Tel: +44 (0) 20 7432 8100 / www.cerner.co.uk / cerneruk@cerner.com