Health care institutions’ info collection efforts drive patient care, research
Published on Thursday, November 8, 2018
By: Karen Bascom
We live in a time when advertisements follow people across the Internet and personalized grocery store coupons arrive in their mailboxes.
It’s the era of “Big Data:” groups ranging from start-up businesses to international organizations are harnessing insight from the information people volunteer.
But while companies primarily use Big Data to sell products, the University of Mississippi Medical Center and similar institutions are using it to improve health care.
The definitions of Big Data are as wide-ranging as the information collected itself. Dr. Richard Summers, UMMC associate vice chancellor for research, said it is “the capture of information on a broad, undifferentiated scale.”
“From big data, we are able to find associations that we didn’t know existed previously, and we can use that information to drive research questions and look for better ways to treat our patients,” Summers said.
At UMMC, these data include measurements, diagnoses, financial transactions and other records from encounters between patients and Medical Center clinicians.
Each piece of information becomes a fish in the Big Data sea: Since January 2013, that “sea” includes information from 750,000 unique patients and more than 24 million patient encounters. Most of UMMC’s data come from Epic, the institution’s electronic health record.
The Center for Analytics and Informatics, or CIA, is the steward of this “sea.” The center develops tools for managing the complex collection and applies analytics to aid UMMC’s mission areas.
“The goal of analytics is to answer why things happened and to determine if we can predict what happens next,” said Alexandra Castillo, executive director of the CIA.
For example, by looking at records of previous heart attack patients, the CIA and clinicians can determine which incoming patients are more likely to have complications during their hospital stays and can prepare to manage those patients more intensively.
Data from UMMC health records also fuel research tools like the patient cohort explorer, a resource that contains de-identified patient information that the CIA introduced in December 2017.
For example, Summers said he’s recently used the patient cohort explorer for exploratory research on risk factors associated with low birthweight and to gather information on emergency department admissions for gun-related injuries.
“Researchers can use it as a preparatory tool before applying for grants, and some complete retrospective studies can be done,” said Fremel Backus, intelligence program manager for research in the CIA. “There’s a huge difference between Epic and the patient cohort explorer.”
First, the users aren’t accessing Epic. Rather, they’re accessing the data in a separate environment known as the research data warehouse.
“The data warehouse serves as one source for all of the data collected across the institution,” said Ramona Sandlin, manager of enterprise informatics for the CIA. This practice, referred to as “single source of truth,” helps preserve the integrity of the data, Sandlin said.
In essence, the practice stems from the principle that the more people or offices information must pass through to reach the end user, the more opportunities there are for errors or misuse.
This leads to an important point. Patients aren’t just data; they are real people. UMMC has procedures to safeguard protected health information, or PHI, whenever data are used.
First, the CIA de-identifies the Epic data it makes available through the research data warehouse. The center removes PHI like names, birthdates and medical record numbers. This initial process takes several months, Castillo said.
UMMC’s Big Data resources also support health care efforts across the state. For example, Castillo said the Medical Center has a real-time data sharing agreement with the Mississippi Division of Medicaid – a first of its kind program – and an agreement with the Mississippi State Department of Health.
Furthermore, UMMC is a member of the Mississippi Health Information Network, an electronic exchange of patient information that allows providers quick, secure and reliable access to UMMC patient health records from other clinics and hospitals. It can provide a UMMC patient’s complete medical history at the point of care, so clinicians can know about conditions or past procedures that may affect the care plan.
“This also allows UMMC patients seen in other clinics to be followed longitudinally,” Castillo said. “We have never had that capability before,”
As of 2018, 60 Mississippi hospitals are active participants or preparing to join the MSHIN, representing about 73 percent of Mississippi residents.
The ability to access and use UMMC’s stores of data has come a long way, Summers said.
“Before electronic health records, if one wanted to analyze their practice or patients, it required pulling physical charts,” he said. “Now we are reaching the brink where data collections are of such a large size that it’s becoming more difficult to make sense of it without implementing machine learning.”