A study published in Frontiers has proposed a series of challenges and recommendations relating to research using electronic health records, highlighting “five key themes” for the challenges associated with conducting research with EHRs, including developing the research proposal; access and ethical approval; data quality; analysis platform; and generalisability and research integrity.
The study notes that “a vast quantity of Real Word Data (RWD) are sitting in health providers servers, and harnessing these is recognised as vital to improving health systems and services, but access and usage is still difficult”.
The authors consider that “the use of EHR data for research needs a paradigm shift in the way research is conducted; moving away from a linear, pre-specified process to an iterative approach which is developed within multidisciplinary teams of researchers, clinicians and health informaticians”.
The article also makes a series of recommendations based on these challenges. For access and ethical approval, it emphasises the need for the involvement of practicing clinicians “who can verify the fields and modes of entry of clinical observations”.
In data quality, the research highlighted that it is important that “the expertise of clinicians, non-clinical researchers and health informaticians is collaborative so that a virtuous cycle of improvement in the quality, credibility and presentation of the data exist to ensure data quality and understanding increases, and facilitate future research projects”.
For analysis platforms, the researchers consider that appropriate hardware and training in using the platforms is essential, and that “the analysis environment must be professionally and actively maintained for performance for a range of users”.
Researchers also made recommendations for how to plan, approve and value EHR data-based research. These recommendations include adapting research design and associated approval processes to work effectively with EHR data; ensuring a strong research team with the right mix of skills and collaboration; and upholding research integrity – enabling research using EHRs “without compromising data management, confidentiality and intellectual property”.
Ultimately, the researchers recommend that every project must ask three key questions: is the research question clinically important and likely to lead to improved public or patient health; can the data available answer the question; and is the proposed methodology appropriate given the research questions and data available? “These questions can only be answered by a multidisciplinary team,” the authors note. “As such, patients, clinicians, statisticians, and health informaticians are all equally vital in planning, approving and performing high quality research.”
The article can be read in full here.
In other digital health research, a study also published in Frontiers journal has put forward a case study proposing an “omni-channel, outcomes-focused approach to scale digital health interventions in resource-limited populations”.
Another study from Sage Digital Health journal aimed to deliver a similar digital health intervention to improve health awareness for infection prevention, hygiene, and sanitation to assess its impact, and identify the risk of multimorbidity in women of reproductive years from low socio-economic background.
Citation: Honeyford K, Expert P, Mendelsohn EE, Post B, Faisal AA, Glampson B, Mayer EK and Costello CE (2022) Challenges and recommendations for high quality research using electronic health records. Front. Digit. Health 4. DOI: https://doi.org/10.3389/fdgth.2022.940330
