Abstract
Background/Aims New source data systems almost always cause angst among programmers. Source data systems usually are built for user ease of use and are not built for ease of getting data out. A new Electronic Health Record (EHR) module designed specifically for Oncology treatment was no different. Having access to data that was previously unavailable caused excitement among researchers, so we conducted a project to explore extracting Oncology protocols, treatment plans and medications from this new module in order to:
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determine the process needed to identify protocols, treatment plans and medications from the EHR,
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validate the process with medical record review, and
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build VDW tables that could logically hold this data and accommodate data from other HMOs.
Methods The study team:
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identified EHR tables and fields that contained medication data, protocols and treatment plans specific to Oncology,
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completed multiple rounds of validation through chart review, and 3) identified the structure and key variables needed to construct VDW tables of Encounters, Treatment Plans, and Medications.
These three steps were then used to identify patients currently receiving cancer treatment in the Oncology department and data is being pulled to populate these VDW tables.
Results Multiple challenges were encountered and solutions identified. First, the EHR tables, fields and linkages required significant exploration to discern useful data elements and correct joins. For example, oral and infused medications are kept in separate tables and each table contains multiple and different date fields and status codes to determine if the drug was actually given to the patient. Other factors complicating identifying Oncology treatment included determining work flows and matching those work flows to data that was extractable from the EHR and poor documentation not specific to our HMO. An iterative process was used to validate each data pull.
Conclusion Identifying Oncology treatment data in the EHR was a process fraught with multiple challenges. We believe, however, that we have developed code that identifies protocols, treatment plans and medications used to treat cancer patients. This is an important first step in compiling data needed for future research on the treatment of various cancers.
