Figure 1.

Data flows and processes for the GEMINI database. The following steps are involved in preparing the GEMINI database: 1. Data are extracted from hospitals and deidentified. 2. Data are securely transferred to the central site. 3. Data are processed, including standardization and reformatting of variables. 4. Data undergo computational data quality checks, which are manually reviewed by a data analyst to flag potential issues. Data processing issues are resolved within the central site by addressing the problematic processing step. Data extraction/transfer issues are addressed at the hospital sites and may require data re-extraction. 5. Data are sampled from the central repository and sent back to the hospital site for reidentification. 6. Manual data validation is performed using the reidentified sample. Data quality issues are investigated and resolved as possible. 7. Finally, data are added to the GEMINI database with all data quality issues either resolved or clearly documented to inform future use. GeMQIN: General Medicine Quality Improvement Network.