ABSTRACT
Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the primary data source is envisioned for observational studies, embedded pragmatic or post-marketing registry-based randomized studies, or comparative effectiveness studies. Advancing this approach to randomized clinical trials, electronic health records may potentially be used to assess study feasibility, to facilitate patient recruitment, and streamline data collection at baseline and follow-up. Ensuring data security and privacy, overcoming the challenges associated with linking diverse systems and maintaining infrastructure for repeat use of high quality data, are some of the challenges associated with using electronic health records in clinical research. Collaboration between academia, industry, regulatory bodies, policy makers, patients, and electronic health record vendors is critical for the greater use of electronic health records in clinical research. This manuscript identifies the key steps required to advance the role of electronic health records in cardiovascular clinical research.
Subject(s)
Cardiovascular Diseases , Clinical Trials as Topic/methods , Comparative Effectiveness Research/methods , Data Mining , Electronic Health Records , Research Design , Access to Information , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/therapy , Clinical Trials as Topic/ethics , Comparative Effectiveness Research/ethics , Confidentiality , Data Accuracy , Data Mining/ethics , Electronic Health Records/ethics , Humans , Medical Record Linkage , Systems IntegrationABSTRACT
The release in 2007 of the National Quality Forum (NQF) preferred practices is a significant advance in the field of palliative care. These NQF preferred practices build on the clinical practice guidelines for palliative care developed by the National Consensus Project (NCP). The NQF is dedicated to improving the quality of American health care, and their focus on palliative care recognizes its growing place within the broader scope of health care. This article reviews the work of both the NCP and NQF and presents the domains and preferred practices that should guide quality improvement efforts in hospice and palliative care.
