A guide to optimizing real-world data: Electronic medical records

The healthcare industry has moved away from paper charts and file folders in favor of electronic record keeping since 2009 with the passage of the American Recovery and Reinvestment Act (ARRA) and accompanying Health Information Technology for Economic and Clinical Health Act (HITECH). These acts incentivize the use of electronic medical records (EMRs), also referred to as an electronic health record (EHR), and allow for a reduction in Medicare reimbursements for failure to make the switch to electronic.¹ 

The purpose of this was to make health records more accurate and accessible, but it has the added benefit of providing a wealth of insights into the patient journey for the life sciences industry. In this first of a series on real-world data (RWD) sources, we will review the benefits and considerations of this valuable data type, as well as use cases. 

Key benefits of EMR data

Unlike medical claims, EMRs provide data on both insured and uninsured patients. EMRs provide insights on the patient’s demographics, such as age and gender, and their medical history, including diagnoses, prescribed medications, orders for lab tests and procedures, and tests conducted in the office, such as flu, strep and COVID. It is also one of the only RWD sources where you can get patient vitals that can be indicative of a patient’s overall health or how they are managing a chronic condition, including:

• Height
• Weight
• Temperature
• Blood pressure
• Body mass index (BMI)
  

Important considerations

There are a number of different EMR systems, which are highly flexible, and each healthcare provider (HCP) or health system has their own processes for recording data. As an example, there are no standards for describing the reason for a visit. Also, an encounter with an EMR could be simply to update a record or call a patient with results and not for an actual patient visit, making it difficult to ascertain the reason for the encounter. 

Additionally, when multiple options are available, some healthcare providers might favor using certain codes, whether for diagnosis, NDC or LOINC. That means the information provided could vary by HCP and greater analysis might be necessary to uncover the desired insights. 

While one of the benefits of EMR data is seeing what medications were prescribed and what tests were ordered, the key is you only see that it was prescribed or ordered, not necessarily if the patient took any action after the encounter. 

Lab and imaging results are separate reports that are attachments to EMR records. The information from these reports might be recorded in the EMR, captured in the system electronically or manually entered, but it still may not provide comprehensive insights.    

Lastly, unlike some data types, such as labs where you can have results in a matter of days, EMR data has a latency of one to three months, depending on the source.

EMR use cases

EMR data can be used to track the patient journey and provider prescribing preferences. This valuable data type also offers a view into how chronic conditions, such as diabetes, cardiac disease or respiratory conditions are being managed over time, as demonstrated in the following example:

EMR data is the only RWD source where you can get the results of pulmonary tests for a patient’s forced expiratory volume (FEV1 to FVC), which is indicative of if a patient has chronic obstructive pulmonary disease (COPD) and used to track disease progression. These insights can be used to discover patients with the condition or monitor the effectiveness of treatments over time.

Advance the science with EMR data

With the nation’s largest healthcare and consumer data ecosystem, HealthVerity offers EMR data from a multitude of sources, representing nearly 140 million patient journeys that are fully interoperable, HIPAA compliant and in a common data model. Our single EMR data model means that clients only have to navigate one data layout and one data ingestion routine, even if multiple EMR sources are leveraged. This EMR data can be seamlessly synchronized with other sources, such as medical claims and lab results, for the most comprehensive view of the patient journey.