title: Preparing Electronic Clinical Data for Quality Improvement and Comparative Effectiveness Research: The SCOAP CERTAIN Automation and Validation Project.
abstract: BACKGROUND
  The field of clinical research informatics includes creation of clinical data repositories (CDRs) used to conduct quality improvement (QI) activities and comparative effectiveness research (CER). Ideally, CDR data are accurately and directly abstracted from disparate electronic health records (EHRs), across diverse health-systems.
  
  
  OBJECTIVE
  Investigators from Washington State's Surgical Care Outcomes and Assessment Program (SCOAP) Comparative Effectiveness Research Translation Network (CERTAIN) are creating such a CDR. This manuscript describes the automation and validation methods used to create this digital infrastructure.
  
  
  METHODS
  SCOAP is a QI benchmarking initiative. Data are manually abstracted from EHRs and entered into a data management system. CERTAIN investigators are now deploying Caradigm's Amalga™ tool to facilitate automated abstraction of data from multiple, disparate EHRs. Concordance is calculated to compare data automatically to manually abstracted. Performance measures are calculated between Amalga and each parent EHR. Validation takes place in repeated loops, with improvements made over time. When automated abstraction reaches the current benchmark for abstraction accuracy - 95% - itwill 'go-live' at each site.
  A technical analysis was completed at 14 sites. Five sites are contributing; the remaining sites prioritized meeting Meaningful Use criteria. Participating sites are contributing 15-18 unique data feeds, totaling 13 surgical registry use cases. Common feeds are registration, laboratory, transcription/dictation, radiology, and medications. Approximately 50% of 1,320 designated data elements are being automatically abstracted-25% from structured data; 25% from text mining.
  
  
  CONCLUSIONS
  In semi-automating data abstraction and conducting a rigorous validation, CERTAIN investigators will semi-automate data collection to conduct QI and CER, while advancing the Learning Healthcare System.
authors.affiliation: University of Washington.
authors.forename: Emily Beth
authors.initials: EB
authors.lastname: Devine
authors.affiliation: University of Washington.
authors.forename: Daniel
authors.initials: D
authors.lastname: Capurro
authors.affiliation: University of Washington.
authors.forename: Erik
authors.initials: E
authors.lastname: van Eaton
authors.affiliation: University of Washington.
authors.forename: Rafael
authors.initials: R
authors.lastname: Alfonso-Cristancho
authors.affiliation: University of Washington.
authors.forename: Allison
authors.initials: A
authors.lastname: Devlin
authors.affiliation: University of Washington.
authors.forename: N David
authors.initials: ND
authors.lastname: Yanez
authors.affiliation: University of Washington.
authors.forename: Meliha
authors.initials: M
authors.lastname: Yetisgen-Yildiz
authors.affiliation: University of Washington.
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
authors.affiliation: University of Washington.
authors.forename: Peter
authors.initials: P
authors.lastname: Tarczy-Hornoch
keywords: CERTAIN; Comparative Effectiveness; Health Information Technology; Informatics; Quality Improvement
references.citation: Health Aff (Millwood). 2010 Oct;29(10):1761-7
references.pmid: 20921473
references.citation: Med Care. 2012 Jul;50 Suppl:S82-101
references.pmid: 22692265
references.citation: Med Care. 2012 Jul;50 Suppl:S19-20
references.pmid: 22692253
references.citation: J Am Med Inform Assoc. 1997 Sep-Oct;4(5):342-55
references.pmid: 9292840
references.citation: Med Care. 2012 Jul;50 Suppl:S11-8
references.pmid: 22692252
references.citation: J Am Med Inform Assoc. 2012 Jul-Aug;19(4):604-9
references.pmid: 22249967
references.citation: J Biomed Inform. 2007 Feb;40(1):5-16
references.pmid: 16574494
references.citation: J Am Med Inform Assoc. 2000 Jan-Feb;7(1):42-54
references.pmid: 10641962
references.citation: J Am Med Inform Assoc. 2012 Mar-Apr;19(2):219-24
references.pmid: 22249968
references.citation: Med Care. 2012 Jul;50 Suppl:S7-10
references.pmid: 22692262
references.citation: Ann Intern Med. 2009 Sep 1;151(5):359-60
references.pmid: 19638404
references.citation: Med Care. 2012 Jul;50 Suppl:S3-6
references.pmid: 22692255
references.citation: Surgery. 2005 Nov;138(5):821-8
references.pmid: 16291381
references.citation: Med Care. 2012 Jul;50 Suppl:S77-81
references.pmid: 22692264
references.citation: Med Care. 2012 Jul;50 Suppl:S21-9
references.pmid: 22692254
references.citation: N Engl J Med. 2009 Apr 9;360(15):1479-81
references.pmid: 19357402
references.citation: J Am Med Inform Assoc. 2013 Jun;20(e1):e21-5
references.pmid: 23538723
references.citation: AMIA Annu Symp Proc. 2010 Nov 13;2010:356-60
references.pmid: 21347000
references.citation: Med Care. 2012 Jul;50 Suppl:S49-59
references.pmid: 22692259
references.citation: J Clin Oncol. 2010 Sep 20;28(27):4268-74
references.pmid: 20585094
references.citation: Med Care. 2012 Jul;50 Suppl:S38-48
references.pmid: 22692258
references.citation: Med Care. 2012 Jul;50 Suppl:S74-6
references.pmid: 22692263
references.citation: Surgery. 2012 Feb;151(2):146-52
references.pmid: 22129638
references.citation: J Am Med Inform Assoc. 2000 Jan-Feb;7(1):55-65
references.pmid: 10641963
references.citation: J Am Med Inform Assoc. 2009 May-Jun;16(3):316-27
references.pmid: 19261934
references.citation: Am J Med. 2010 Dec;123(12 Suppl 1):e32-7
references.pmid: 21184865
references.citation: Med Care. 2012 Jul;50 Suppl:S30-5
references.pmid: 22692256