Challenges Associated With Using Large Data Sets for Quality Assessment and Research in Clinical Settings.
The rapidly expanding use of electronic records in health-care settings is generating unprecedented quantities of data available for clinical, epidemiological, and cost-effectiveness research. Several challenges are associated with using these data for clinical research, including issues surrounding access and information security, poor data quality, inconsistency of data within and across institutions, and a paucity of staff with expertise to manage and manipulate large clinical data sets. In this article, we describe our experience with assembling a data-mart and conducting clinical research using electronic data from four facilities within a single hospital network in New York City. We culled data from several electronic sources, including the institution's admission-discharge-transfer system, cost accounting system, electronic health record, clinical data warehouse, and departmental records. The final data-mart contained information for more than 760,000 discharges occurring from 2006 through 2012. Using categories identified by the National Institutes of Health Big Data to Knowledge initiative as a framework, we outlined challenges encountered during the development and use of a domain-specific data-mart and recommend approaches to overcome these challenges.
Columbia University School of Nursing, New York, NY, USA bac2116@columbia.edu.
Bevin
B
Cohen
Department of Biomedical Informatics, Columbia University, New York, NY, USA.
David K
DK
Vawdrey
Columbia University School of Nursing, New York, NY, USA.
Jianfang
J
Liu
Department of Information Services, New York-Presbyterian Hospital, New York, NY, USA.
David
D
Caplan
Department of Medicine, Columbia University, New York, NY, USA.
E Yoko
EY
Furuya
Department of Information Services, New York-Presbyterian Hospital, New York, NY, USA.
Frederick W
FW
Mis
Columbia University School of Nursing, New York, NY, USA.
Elaine
E
Larson
D015400:Clinical Nursing Research; D016208:Databases, Factual / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D008297:Male; D008490:Medical Informatics; D017063:Outcome Assessment, Health Care; D011786:Quality Control; D012107:Research Design / Q000592:standards / Q000639:trends*; D018570:Risk Assessment; D014481:United States
informatics; outcomes measurement; research methodology