Electronic Medical Records (EMRs), Epidemiology, and Epistemology: Reflections on EMRs and Future Pediatric Clinical Research

doi:10.1016/j.acap.2011.02.007

Academic Pediatrics

Volume 11, Issue 4, July–August 2011, Pages 280-287

https://doi.org/10.1016/j.acap.2011.02.007 Get rights and content

Abstract

Electronic medical records (EMRs) are increasingly common in pediatric patient care. EMR data represent a relatively novel and rich resource for clinical research. The fact, however, that pediatric EMR data are collected for the purposes of clinical documentation and billing rather than research creates obstacles to their use in scientific investigation. Particular issues include accuracy, completeness, comparability between settings, ease of extraction, and context of recording. Although these problems can be addressed through standard strategies for dealing with partially accurate and incomplete data, a longer-term solution will involve work with pediatric clinicians to improve data quality. As research becomes one of the explicit purposes for which pediatricians collect EMR data, the pediatric clinician will play a central role in future pediatric clinical research.

Section snippets

Data Sets Available For Pediatric Research

As has been noted elsewhere, a proliferation of existing data sets currently are available to pediatric researchers.²⁵ They include the Kids’ Inpatient Database (KID),²⁶ National Health Interview Survey (NHIS),²⁷ the National Health and Nutrition Examination Survey (NHANES),²⁸ National Ambulatory Medical Care Survey (NAMCS),²⁹ Youth Risk Behavior Surveillance System (YRBSS),³⁰ Medical Expenditure Panel Survey (MEPS),³¹ and others. These data sources have some distinct advantages for research,

Acknowledgment

The author thanks the dozen-plus individuals from multiple institutions who identified resources, answered questions, and critiqued drafts of the manuscript. This work was supported by Health Resources and Services Administration Maternal and Child Health Bureau awards UA6MC15585 and UB5MC20286, National Eye Institute grant R13EY019972, the American Academy of Pediatrics, and the Children’s Hospital of Philadelphia.

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: The author has no conflicts of interest to disclose.

View full text

PerspectiveElectronic Medical Records (EMRs), Epidemiology, and Epistemology: Reflections on EMRs and Future Pediatric Clinical Research

Abstract

Section snippets

Data Sets Available For Pediatric Research

Acknowledgment

Am J Med

Int J Med Inform

Ambul Pediatr

J Am Med Inform Assoc

Int J Med Inform

J Am Med Inform Assoc

Int J Med Inform

The Computer-Based Patient Record: An Essential Technology for Health Care

The clinical record in medicine, part 1: learning from cases

Ann Intern Med

Which physicians and practices are using electronic medical records?

Health Aff

Adoption of electronic health records in primary care pediatric practices

Pediatrics

Electronic health records in ambulatory care—a national survey of physicians

N Engl J Med

Medicare and Medicaid Programs; Electronic Health Record Incentive Program

Fed Reg

Stimulating the adoption of health information technology

N Engl J Med

Toward reuse of clinical data for research and quality improvement: the end of the beginning?

Ann Intern Med

A Rapid-Learning Health System

Health Aff

Use of claims data systems to evaluate health care outcomes: mortality and reoperation following prostatectomy

JAMA

Using claims data for epidemiologic research: the concordance of claims-based criteria with the medical record and patient survey for identifying a hypertensive population

Med Care

Measuring quality of care—part two of six

N Engl J Med

Clinical research databases—a historical review

J Med Syst

Linking automated databases for research in managed care settings

Ann Intern Med

Charting the use of electronic health records and other information technologies among child health providers

BMC Pediatr

Clinical Epidemiology: The Architecture of Clinical Research

Perspective
Electronic Medical Records (EMRs), Epidemiology, and Epistemology: Reflections on EMRs and Future Pediatric Clinical Research