title: Taking advantage of continuity of care documents to populate a research repository.
abstract: OBJECTIVE
  Clinical data warehouses have accelerated clinical research, but even with available open source tools, there is a high barrier to entry due to the complexity of normalizing and importing data. The Office of the National Coordinator for Health Information Technology's Meaningful Use Incentive Program now requires that electronic health record systems produce standardized consolidated clinical document architecture (C-CDA) documents. Here, we leverage this data source to create a low volume standards based import pipeline for the Informatics for Integrating Biology and the Bedside (i2b2) clinical research platform. We validate this approach by creating a small repository at Partners Healthcare automatically from C-CDA documents.
  
  
  METHODS
  We designed an i2b2 extension to import C-CDAs into i2b2. It is extensible to other sites with variances in C-CDA format without requiring custom code. We also designed new ontology structures for querying the imported data.
  
  
  RESULTS
  We implemented our methodology at Partners Healthcare, where we developed an adapter to retrieve C-CDAs from Enterprise Services. Our current implementation supports demographics, encounters, problems, and medications. We imported approximately 17 000 clinical observations on 145 patients into i2b2 in about 24 min. We were able to perform i2b2 cohort finding queries and view patient information through SMART apps on the imported data.
  
  
  CONCLUSIONS
  This low volume import approach can serve small practices with local access to C-CDAs and will allow patient registries to import patient supplied C-CDAs. These components will soon be available open source on the i2b2 wiki.
  
  
  CONCLUSIONS
  Our approach will lower barriers to entry in implementing i2b2 where informatics expertise or data access are limited.
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Klann
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mendis
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA.
authors.forename: Lori C
authors.initials: LC
authors.lastname: Phillips
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA.
authors.forename: Alyssa P
authors.initials: AP
authors.lastname: Goodson
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Beatriz H
authors.initials: BH
authors.lastname: Rocha
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Howard S
authors.initials: HS
authors.lastname: Goldberg
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA.
authors.forename: Nich
authors.initials: N
authors.lastname: Wattanasin
authors.affiliation: Partners Healthcare, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Shawn N
authors.initials: SN
authors.lastname: Murphy
mesh_terms: D035843:Biomedical Research; D003266:Continuity of Patient Care; D003628:Database Management Systems; D019992:Databases as Topic / Q000458:organization & administration; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods; D062527:Meaningful Use; D018511:Systems Integration
keywords: Database Management Systems; Information Storage and Retrieval; Meaningful Use; Medical Informatics; Systems Integration