Increasing Capacity to Conduct Research with Electronic Health Records (EHR) across Diverse Sites in a Practice Based Research Network

Abstract

Background: Electronic health records (EHRs) have been widely adopted in clinical settings for patient care and billing purposes, creating a large repository of patient data. However, many clinical organizations and clinicians are unable to access this data for quality improvement or research purposes. The WWAMI region Practice and Research Network (WPRN), a collaborative Practice Based Research Network (PBRN), developed a successful process to use EHRs to answer a research and quality improvement question Methods: The WPRN used a collaborative process to develop the study. Project steps included: topic selection, parameter development, participant training, data collection, analysis, and results dissemination. Sites used EHR data to calculate the number of adult patients who were prescribed sleep medications in 4 medication groups in a 1-year time period. Data was reported in aggregate which eliminated the need for Human Subjects review Results: Seven sites in three states, with over 44,000 adult patients, participated in the primary data collection. The WPRN was able to demonstrate wide variation in prescribing practices across sites. The proportion of adult patients receiving a prescription for sleep medications containing Zolpidem ranged from 0.25% to 5.81% across practices. Discussion: The use of tools, clear processes, collaborative study development enable diverse practices with varying levels of EHR sophistication and utilization capacity to participate in studies using EHRs for quality improvement and research purposes. Participating in such projects helps build site confidence and capacity for using the EHR for future research projects.