title: Utilizing an integrated infrastructure for outcomes research: a systematic review.
abstract: OBJECTIVE
  To explore the ability of an integrated health information infrastructure to support outcomes research.
  
  
  METHODS
  A systematic review of articles published from 1983 to 2012 by Regenstrief Institute investigators using data from an integrated electronic health record infrastructure involving multiple provider organisations was performed. Articles were independently assessed and classified by study design, disease and other metadata including bibliometrics.
  
  
  RESULTS
  A total of 190 articles were identified. Diseases included cognitive, (16) cardiovascular, (16) infectious, (15) chronic illness (14) and cancer (12). Publications grew steadily (26 in the first decade vs. 100 in the last) as did the number of investigators (from 15 in 1983 to 62 in 2012). The proportion of articles involving non-Regenstrief authors also expanded from 54% in the first decade to 72% in the last decade. During this period, the infrastructure grew from a single health system into a health information exchange network covering more than 6 million patients. Analysis of journal and article metrics reveals high impact for clinical trials and comparative effectiveness research studies that utilised data available in the integrated infrastructure.
  
  
  CONCLUSIONS
  Integrated information infrastructures support growth in high quality observational studies and diverse collaboration consistent with the goals for the learning health system. More recent publications demonstrate growing external collaborations facilitated by greater access to the infrastructure and improved opportunities to study broader disease and health outcomes.
  
  
  CONCLUSIONS
  Integrated information infrastructures can stimulate learning from electronic data captured during routine clinical care but require time and collaboration to reach full potential.
authors.affiliation: Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, IN, USA.|Regenstrief Institute, Inc., Indianapolis, IN, USA.|Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
authors.forename: Brian E
authors.identifier: http://orcid.org/0000-0002-1121-0607
authors.initials: BE
authors.lastname: Dixon
authors.affiliation: Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Whipple
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Lajiness
authors.affiliation: Regenstrief Institute and Purdue University, Indianapolis, IN, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Murray
mesh_terms: D035843:Biomedical Research / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D006801:Humans; D017063:Outcome Assessment, Health Care
keywords: bibliometrics; comparative study; effectiveness; informatics; information systems; medical; research networks