Enhancing Electronic Health Records to Support Clinical Research
This paper touches on the separation of research and patient care processes and how it is a major barrier to achieving the goals of the Learning Health System; the Learning Health System is described as an environment that strengthens research and innovation as a natural part of patient care. A model is proposed for enhancing EHRs to collect clinical research data during clinical patient encounters that promotes efficiency and reuse of quality for patient care and research. This model combines Common Data Elements (CDEs) for clinical research with existing clinical documentation workflows. 
The process and limitations of electronic documentation was discussed, including the 2011 AMIA Invitational Health Policy Meeting that focused on the current and future state of technology-enabled clinical data capture and documentation. It was also noted that clinical research data collection forms contain fields that are inadequately defined, and CDEs have been developed to reduce the time and effort spent on deciding what data to collect in a clinical trial, while increasing the interoperability of data collected.
This paper describes a clinical scenario that highlights the potential of an EHR system to enhance clinical research, while also elaborating on the challenges that may be overcome by implementation of the proposed model for enhancing EHR documentation to support clinical research. It was also noted that significant effort by institutions is necessary to effectively implement this model for improving EHR documentation.
Several arguments have been made regarding the integration of patient care and clinical research in terms of electronic systems and workflow processes. Advances in decision support were identified and categorized into four areas by a recent decision support panel. They include: “the state of the knowledge base...; necessary database elements to support decision support functions; operational features to promote usability and to measure performance; and organizational structures to help manage and govern current and new decision support interventions.”
Although the clinical research informatics field emphasizes on innovation of information technology to support research, it has become increasingly difficult to coordinate between the patient care and clinical research environments. A model is proposed for enhancing EHR that essentially bridges the gap between patient care and clinical research data. It is believed that this model will be useful in various clinical settings; however, further research needs to be conducted regarding its effectiveness.
EHR has increasingly become a vital part of the healthcare system. Documentation and care coordination among others are simplified with the use of EHR systems. It is also a necessary tool in clinical research; therefore, major steps must be taken in order to bridge the gap between the collection of, and access to patient care encounter data and clinical research data. I believe the proposed model in this paper addresses this issue.
- Vawdrey, D. K., Weng, C., Herion, D., & Cimino, J. J. (2014). Enhancing Electronic Health Records to Support Clinical Research. AMIA Summits on Translational Science Proceedings, 2014, 102.