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Led by AcademyHealth, the ABIM Foundation, and the Donaghue Foundation, the Research Community on Low-Value Care has been examining how to leverage electronic health data in addressing low-value care. The Research Community is a professional network for research producers and users focused on improving health care value across settings, and a key area of interest has been the potential for using electronic health data to better inform research on low-value care and the reduction of low-value health care services.

Through a series of webinars, we have explored the use of data from electronic health records (EHRs) in low-value care research, opportunities to leverage data linkages, as well as using EHRs in the de-implementation of unnecessary health services.

As highlighted in a webinar focused on electronic health data, Dr. Philip Payne from Washington University in St. Louis illustrated how data from EHRs can be used to address research questions about cost, quality, safety, and outcomes. Key issues explored included those related to accessing, integrating, and ensuring quality of data. Challenges were also raised, such as linking data sets that vary across a number of dimensions, e.g., clinical features, cost and utilization, and outcomes.

In another webinar on data linkages, Dr. Thomas Carton from the Louisiana Public Health Institute, Dr. Keith Marsolo from Duke University, and Dr. Daniella Meeker from the University of Southern California, showcased work on linking diverse data sets, with a focus on PCORnet, The National Patient-Centered Outcomes Research Network. A network of networks, PCORnet includes a combination of clinical research networks and health plan research networks, and has a common data model that incorporates locally-stored data from these varied networks in a standardized format. Examples of within and across network data linkages were demonstrated, along with the potential for using linked data sets in studying and addressing low-value care. The importance of longitudinal data and more complete data sets was emphasized as key components in providing appropriate and high value care.

Use of EHR data for research on low-value care within the context of emergency medicine has also been explored. Dr. Daniella Meeker from the University of Southern California provided a focus on how decision fatigue impacts the quality and value of care, including widening disparities in care delivery across patients of varying socio-economic status. Additionally, opportunities for utilizing EHRs to measure how health care services are delivered were noted—with the goal of optimizing care delivery.

EHRs have also successfully been used to support the de-implementaion of certain health services, as illustrated in another webinar by Dr. Shireen Atabaki from Children’s National Medical Center. Specifically, the use of clinical decision support helped in the reduction of unnecessary CT scans in children with traumatic brain injury. A clinical decision rule in the EHR was used to assess a patient’s risk level and determine whether a CT scan would indeed be necessary. In addition to reducing radiation exposure through de-implementation of CT scans, the new EHR process has also led to reductions in costs.

The Research Community continues to work on these and related issues in addressing low-value care. If you are interested in this network, and learning about future webinars and thematic working groups, hearing about funding opportunities, and participating in a community deeply engaged with the topic, consider joining today.

For a broader look at health data, consider a submission to AcademyHealth’s 2020 Health Datapalooza, which will be co-located with the 2020 National Health Policy Conference this year. Submit a proposal for a panel, rapid fire, or poster presentation on transforming patient care, ensuring data privacy and security, or advancing data analytics and application. The deadline for submissions is Tuesday, September 24, 2019 at 5:00 pm ET.


Marya Khan, M.P.H.

Senior Manager - AcademyHealth

Marya Khan is a Senior Manager at AcademyHealth. She is responsible for managing projects under grants from th... Read Bio

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