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Applying the Sentinel Common Data Model to Electronic Medical Records: PCORnet® Experience
Lesley H Curtis, PhD Professor, Duke University, USA Lead, PCORnet Distributed Research Network Operations Center
European Medicines Agency, London, UK
11-12 December 2017
Today’s agenda
Brief overview of PCORnet
PCORnet data strategy
Our experience to date
PCORnet®: the National Patient-Centered Clinical Research Network
An innovative initiative funded by the Patient-Centered Outcomes Research Institute (PCORI), PCORnet is a large, highly representative, national patient-centered clinical research network.
Our vision is to support a learning U.S. healthcare system and to enable large-scale clinical research conducted with enhanced quality and efficiency.
Our mission is to enable people to make informed healthcare decisions by efficiently conducting clinical research relevant to their needs.
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PCORnet® embodies a “network of networks” that harnesses the power of partnerships
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20 Patient-Powered
Research Networks (PPRNs)
13 Clinical Data
Research Networks (CDRNs)
A national infrastructure for people-centered clinical research
+ = + 2
Health Plan Research Networks
(HPRNs) +
1 Coordinating
Center
With coverage in every state in the U.S. This map depicts the number of PCORI-funded Patient-Powered or Clinical Data Research Networks that have coverage in each state.
PCORnet data strategy
Standardize data into a common data model
Focus on data quality: data curation
Operate a secure distributed query infrastructure
Learn by doing and repeat
CDM guiding principles (abridged) CDM will contain data of general interest to PCORnet
CDM will be intuitive & easy to understand
Other CDMs exist – PCORnet will learn from them
CDM will reflect values found in source data
CDM will change over time
Not all networks are expected to populate all parts of CDM
Networks are free to add data/domains to their local CDMs
PATIDETC...PAT_PREFERRED_LANGUAGE
DEMOGRAPHIC
PATIDENR_START_DATEENR_BASISETC...
ENROLLMENT
ENCOUNTERIDPATIDADMIT_DATEENC_TYPEETC...PRIMARY_INSURANCE_TYPE
ENCOUNTER
VITALIDPATIDMEASURE_DATEVITAL_SOURCEETC...
VITAL
DIAGNOSISIDPATIDENCOUNTERIDDXDX_TYPEDX_SOURCEETC...DX_POA
DIAGNOSIS
PROCEDURESIDPATIDENCOUNTERIDPXPX_TYPEETC...PPX
PROCEDURES
DISPENSINGIDPATIDDISPENSE_DATENDCETC...DISPENSE_STRENGTH_ORDEREDDISPENSE_STRENGTH_ORDERED_UNITDISPENSE_STRENGTH_CALCULATEDDISPENSE_STRENGTH_CALCULATED_UNITDISPENSE_ROUTE
DISPENSING
LAB_RESULT_CM_IDPATIDRESULT_DATEETC...
LAB_RESULT_CM
CONDITIONIDPATIDCONDITIONCONDITION_TYPECONDITION_SOURCEETC...
CONDITION
PRO_CM_IDPATIDPRO_ITEMPRO_DATEPRO_RESPONSEETC...
PRO_CM
PRESCRIBINGIDPATIDETC...RX_STRENGTH_ORDEREDRX_STRENGTH_ORDERED_UNITRX_STRENGTH_CALCULATEDRX_STRENGTH_CALCULATED_UNITRX_ROUTE
PRESCRIBING
PATIDDEATH_SOURCEETC...
DEATHPATIDTRIALIDPARTICIPANTIDETC...
PCORNET_TRIAL
NETWORKIDDATAMARTIDETC...
HARVEST
PATIDDEATH_CAUSEDEATH_CAUSE_CODEDEATH_CAUSE_TYPEDEATH_CAUSE_SOURCEDEATH_CAUSE_CONFIDENCE
DEATH_CAUSE
Bold font indicates fields that cannot be null due to primary key definitions or record-level constraints.http://www.pcornet.org/pcornet-common-data-model/
PCORnet Common Data Model v4.0 New to v4.0
OBSGENIDPATIDENCOUNTERIDOBSGEN_PROVIDERIDOBSGEN_DATEOBSGEN_TIMEOBSGEN_TYPEOBSGEN_CODEOBSGEN_RESULT_QUALOBSGEN_RESULT_NUMOBSGEN_RESULT_MODIFIEROBSGEN_RESULT_UNITOBSGEN_TABLE_MODIFIEDOBSGEN_ID_MODIFIED
OBS_GEN
OBSCLINIDPATIDENCOUNTERIDOBSCLIN_PROVIDERIDOBSCLIN_DATEOBSCLIN_TIMEOBSCLIN_LOINCOBSCLIN_RESULT_QUALOBSCLIN_RESULT_NUMOBSCLIN_RESULT_MODIFIEROBSCLIN_RESULT_UNITOBSCLIN_RESULT_SNOMED
OBS_CLIN
MEDADMINIDPATIDENCOUNTERIDMEDADMIN_PROVIDERIDMEDADMIN_DATEMEDADMIN_TIMEMEDADMIN_TYPEMEDADMIN_CODEMEDADMIN_STRENGTH_ORDEREDMEDADMIN_STRENGTH_ORDERED_UNITMEDADMIN_STRENGTH_CALCULATEDMEDADMIN_STRENGTH_CALCULATED_UNITMEDADMIN_ROUTEMEDADMIN_ORIGIN
MED_ADMIN
PROVIDERIDPROVIDER_NPIPROVIDER_PRIMARY_SPECIALTYPROVIDER_SEXPROVIDER_RACEPROVIDER_ETHNICITY
PROVIDER
The data curation cycle
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Learning within PCORnet®
Load Data into CDM
Prep to Research Queries
Assess Foundational Quality
Assess Study- Specific Data
Quality Run Analysis
Interpret Results
Community Input (Funders, Network
Partners, Other Stakeholders, etc.)
Areas of study
Data domains
Data quality
Tool development &
study designs
PCORnet experience
EHR are highly heterogeneous and source data are dynamic Implementation guidance is necessary Active data curation is essential
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PCORnet experience
Tools and processes make the data model usable and useful Data curation Analytical
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PCORnet experience
Evolution of the common data model is guaranteed Adaptations to meet new needs of the network Refinements based on data curation
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Downstream impact of CDM evolution
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Downstream impact of CDM evolution
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