Health Services/Population Health

36. Enhancing PCORnet Clinical Research Network Data Completeness by Integrating Multistate Insurance Claims with Electronic Health Records

Introduction: The Greater Plains Collaborative (GPC) and PCORnet Clinical Data Research Networks capture healthcare use within their health systems but may lack information on care received elsewhere in the community. Here, we describe are usable environment (GPC Reusable Observable Unified Study Environment [GROUSE]) that integrates hospital and electronic health records data in the PCORnet common data model with state-wide Medicare and Medicaid claims and assess how claims and clinical data complement each other to identify obesity and related diseases.  

Methods: GROUSE also allows investigators to use multiple analysis tools including SAS, R, python and natural language processing pipelines. Initially, EHR, billing, and tumor registry data from 7 healthcare  systems were integrated with Center for Medicare (2011-2016) and  Medicaid (2011-2012) services insurance claims to create deidentified databases in PCORnet Common Data Model formats. Trends in obesity rates for different age groups are reported, along with the relative contribution of claims and EHR data-to-data completeness and detecting common comorbidities.  For PCORnet’s Third Phase starting in 2022, we have refreshed the linkages for all thirteen partner health systems (including WashU/BJC) and have requested 2018-2022 Medicare insurance claims.  We are also linking hospital tumor registries from our partner health systems. 

Results: GROUSE contained 73 billion observations from 24 million unique  patients (12.9 million Medicare; 13.9 million Medicaid; 6.6 million GPC patients with 1,674,134 patients cross-walked, 983,450 patients  with body mass index (BMI) linked to claims.    

Impact: GROUSE provides a unified EHR-claims environment to address health system and federal privacy concerns, which enables investigators to generalize analyses across health systems integrated with multistate insurance claims.

Organization: University of Missouri – Columbia

Waitman LR, Song X