Table 2.
Reported challenges related to using EHR data in pragmatic trials
| Survey Question: (Yes/No) Did you experience any challenges related to: | # Projects reporting: n = 20 | New projects n = 2 (10%) | Early phase projectsa n = 4 (20%) | Middle phaseb projects n = 7 (35%) | Complete or near complete n = 7 (35%) |
|---|---|---|---|---|---|
| IT staff turnover | 11 (55%) | 1 (5%) | 1 (5%) | 3 (15%) | 6 (30%) |
| Integrating data from heterogeneous systems | 11 (55%) | 1 (5%) | 2 (10%) | 4 (20%) | 4 (20%) |
| Using EHRs to support intervention delivery or health system change | 10 (50%) | 2 (10%) | 1 (5%) | 3 (15%) | 4 (20%) |
| Missing data | 8 (40%) | 0 | 3 (15%) | 0 | 5 (25%) |
| Assessing the validity or accuracy of EHR data | 7 (35%) | 0 | 2 (10%) | 1 (5%) | 4 (20%) |
| Acquiring data | 7 (35%) | 1 (5%) | 2 (10%) | 2 (10%) | 2 (10%) |
| Use of free-text or narrative data from EHR | 6 (30%) | 0 | 0 | 2 (10%) | 4 (20%) |
| Data cleaning | 6 (30%) | 0 | 1 (5%) | 1 (5%) | 4 (20%) |
| Completeness of data across EHRs | 6 (30%) | 0 | 2 (10%) | 1 (5%) | 3 (15%) |
| Interoperability | 5 (25%) | 1 (5%) | 0 | 1 (5%) | 3 (15%) |
| Data quality assessment | 5 (25%) | 0 | 1 (5%) | 0 | 4 (20%) |
| Requesting data (ie, knowing which data are available) | 5 (25%) | 1 | 2 (10%) | 0 | 2 (10%) |
| Identification and use of clinical phenotype definitions | 4 (20%) | 0 | 1 (5%) | 1 (5%) | 2 (10%) |
| Determining or negotiating the frequency of data pulls | 4 (20%) | 0 | 0 | 1 (5%) | 3 (15%) |
| Gaining permission to use data | 2 (10%) | 0 | 1 (5%) | 0 | 1 (5%) |
| Need to upload data or write to EHRs | 1 (5%) | 0 | 1 (5%) | 0 | 0 |
a
Early-phase projects are just transiting from planning to implementing the trial.
b
Middle-phase projects are enrolling and collecting data but early; complete or near complete are nearly done with enrollment.
EHR: electronic health record.