title: Scalable Collaborative Infrastructure for a Learning Healthcare System (SCILHS): architecture.
abstract: We describe the architecture of the Patient Centered Outcomes Research Institute (PCORI) funded Scalable Collaborative Infrastructure for a Learning Healthcare System (SCILHS, http://www.SCILHS.org) clinical data research network, which leverages the $48 billion dollar federal investment in health information technology (IT) to enable a queryable semantic data model across 10 health systems covering more than 8 million patients, plugging universally into the point of care, generating evidence and discovery, and thereby enabling clinician and patient participation in research during the patient encounter. Central to the success of SCILHS is development of innovative 'apps' to improve PCOR research methods and capacitate point of care functions such as consent, enrollment, randomization, and outreach for patient-reported outcomes. SCILHS adapts and extends an existing national research network formed on an advanced IT infrastructure built with open source, free, modular components.
authors.affiliation: Children's Hospital Informatics Program at Harvard-MIT Health Sciences and Technology, Boston, Massachusetts, USA Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA Harvard Catalyst, Harvard Medical School, Boston, Massachusetts, USA Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Mandl
authors.affiliation: Children's Hospital Informatics Program at Harvard-MIT Health Sciences and Technology, Boston, Massachusetts, USA Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA Harvard Catalyst, Harvard Medical School, Boston, Massachusetts, USA Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Isaac S
authors.initials: IS
authors.lastname: Kohane
authors.affiliation: Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA Harvard Catalyst, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: McFadden
authors.affiliation: Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA Biomedical Research Informatics Core, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Griffin M
authors.initials: GM
authors.lastname: Weber
authors.affiliation: Children's Hospital Informatics Program at Harvard-MIT Health Sciences and Technology, Boston, Massachusetts, USA Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Natter
authors.affiliation: Children's Hospital Informatics Program at Harvard-MIT Health Sciences and Technology, Boston, Massachusetts, USA Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Mandel
authors.affiliation: Division of Pharmacoepidemiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schneeweiss
authors.affiliation: Harvard Catalyst, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Weiler
authors.affiliation: Laboratory of Computer Science, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Klann
authors.affiliation: Children's Hospital Informatics Program at Harvard-MIT Health Sciences and Technology, Boston, Massachusetts, USA Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA Information Services Department, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bickel
authors.affiliation: Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, USA Boston University Clinical and Translational Sciences Institute, Boston, Massachusetts, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Adams
authors.affiliation: College of Computing and Informatics, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.
authors.forename: Yaorong
authors.initials: Y
authors.lastname: Ge
authors.affiliation: Department of Radiology, Center for Bioinformatics & Systems Biology, Wake Forest University Health Science, Winston-Salem, North Carolina, USA.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Clark Atlanta University, Atlanta, Georgia, USA Research Centers in Minority Institutions Translational Research Network, Data Coordinating Center, Jackson State University, Jackson, Mississippi, USA.
authors.forename: James
authors.initials: J
authors.lastname: Perkins
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Marsolo
authors.affiliation: Division of Biomedical Informatics, Biomedical Informatics and Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Elmer
authors.initials: E
authors.lastname: Bernstam
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi, USA.
authors.forename: John
authors.initials: J
authors.lastname: Showalter
authors.affiliation: Department of Internal Medicine, Community Health and Preventive Medicine and Clinical Research Center, Morehouse School of Medicine, Atlanta, Georgia, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Quarshie
authors.affiliation: Department of Internal Medicine, Clinical Research Center, Morehouse School of Medicine, Atlanta, Georgia, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ofili
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York,  New York, USA.
authors.forename: George
authors.initials: G
authors.lastname: Hripcsak
authors.affiliation: Laboratory of Computer Science, Massachusetts General Hospital, Boston, Massachusetts, USA Partners HealthCare Systems, Information Systems, Charlestown, Massachusetts, USA.
authors.forename: Shawn N
authors.initials: SN
authors.lastname: Murphy
mesh_terms: D003195:Computer Communication Networks; D057286:Electronic Health Records / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination; D009938:Organizations; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D018802:Patient-Centered Care; D014481:United States
keywords: Clinical Trials; Distributed Computing; Electronic Health Record; Learning Health System; Patient Engagement