Mind the clinical-analytic gap: Electronic health records and COVID-19 pandemic response

J Biomed Inform. 2021 Apr:116:103715. doi: 10.1016/j.jbi.2021.103715. Epub 2021 Feb 19.

Abstract

Data quality is essential to the success of the most simple and the most complex analysis. In the context of the COVID-19 pandemic, large-scale data sharing across the US and around the world has played an important role in public health responses to the pandemic and has been crucial to understanding and predicting its likely course. In California, hospitals have been required to report a large volume of daily data related to COVID-19. In order to meet this need, electronic health records (EHRs) have played an important role, but the challenges of reporting high-quality data in real-time from EHR data sources have not been explored. We describe some of the challenges of utilizing EHR data for this purpose from the perspective of a large, integrated, mixed-payer health system in northern California, US. We emphasize some of the inadequacies inherent to EHR data using several specific examples, and explore the clinical-analytic gap that forms the basis for some of these inadequacies. We highlight the need for data and analytics to be incorporated into the early stages of clinical crisis planning in order to utilize EHR data to full advantage. We further propose that lessons learned from the COVID-19 pandemic can result in the formation of collaborative teams joining clinical operations, informatics, data analytics, and research, ultimately resulting in improved data quality to support effective crisis response.

Keywords: COVID-19; Data quality; Electronic health record; Real-world data.

MeSH terms

  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • COVID-19 / therapy
  • California / epidemiology
  • Data Accuracy
  • Delivery of Health Care, Integrated / statistics & numerical data
  • Electronic Health Records* / statistics & numerical data
  • Health Information Exchange / statistics & numerical data
  • Hospital Bed Capacity / statistics & numerical data
  • Humans
  • Information Dissemination / methods
  • Medical Informatics
  • Pandemics* / statistics & numerical data
  • SARS-CoV-2*