Supporting reuse of EHR data in healthcare organizations: The CARED research infrastructure framework

Abstract

Healthcare organizations have in recent years started assembling their Electronic Health Record (EHR) data in data repositories to unlock their value using data analysis techniques. There are however a number of technical, organizational and ethical challenges that should be considered when reusing EHR data, which infrastructure technology consisting of appropriate software and hardware components can address. In a case study in the University Medical Center Utrecht (UMCU) in the Netherlands, we identified nine requirements of a modern technical infrastructure for reusing EHR data: (1) integrate data sources, (2) preprocess data, (3) store data, (4) support collaboration and documentation, (5) support various software and tooling packages, (6) enhance repeatability, (7) enhance privacy and security, (8) automate data process and (9) support analysis applications. We propose the CApable Reuse of EHR Data (CARED) framework for infrastructure that addresses these requirements, which consists of five consecutive data processing layers, and a control layer that governs the data processing. We then evaluate the framework with respect to the requirements, and finally describe its successful implementation in the Psychiatry Department of the UMCU along with three analysis cases. Our CARED research infrastructure framework can support healthcare organizations that aim to successfully reuse their EHR data.