Why Is the Electronic Health Record So Challenging for Research and Clinical Care?

BACKGROUND: The electronic health record (EHR) has become increasingly ubiquitous. At the same time, health professionals have been turning to this resource for access to data that is needed for the delivery of health care and for clinical research. There is little doubt that the EHR has made both of these functions easier than earlier days when we relied on paper-based clinical records. Coupled with modern database and data warehouse systems, high-speed networks, and the ability to share clinical data with others are large number of challenges that arguably limit the optimal use of the EHR OBJECTIVES: Our goal was to provide an exhaustive reference for those who use the EHR in clinical and research contexts, but also for health information systems professionals as they design, implement, and maintain EHR systems. METHODS: This study includes a panel of 24 biomedical informatics researchers, information technology professionals, and clinicians, all of whom have extensive experience in design, implementation, and maintenance of EHR systems, or in using the EHR as clinicians or researchers. All members of the panel are affiliated with Penn Medicine at the University of Pennsylvania and have experience with a variety of different EHR platforms and systems and how they have evolved over time. RESULTS: Each of the authors has shared their knowledge and experience in using the EHR in a suite of 20 short essays, each representing a specific challenge and classified according to a functional hierarchy of interlocking facets such as usability and usefulness, data quality, standards, governance, data integration, clinical care, and clinical research. CONCLUSION: We provide here a set of perspectives on the challenges posed by the EHR to clinical and research users.

Ideas for how informaticians can get involved with COVID-19 research

[...]there is a possibility that some of the observed genetic differences may be artifacts of this process. [...]the well-known CCR5-delta32 allele has a variation that protects individuals who have been exposed to the Human Immunodeficiency Virus (HIV);they are protected from developing AIDS (Acquired Immunodeficiency Syndrome) [10]. Because of this, researchers are gearing up to study the genomes of COVID-19 positive patients in comparison to controls (COVID-19-negative patients). Capacity and resource management tools can generate projects based on regional infection counts and current patient admissions to estimate the number of patients that will require hospitalization, intensive care unit beds, medications, and mechanical ventilation. Informaticians can support these efforts by 1) educating patients and care providers about data science resources and electronic health record (EHR) platforms for building point-of-care solutions, 2) joining the open-source community efforts to develop these technologies, and 3) volunteering with the information services divisions within their healthcare organizations to deploy telehealth tools and engage in patient management projects.