Project Title

Washington Heights/Inwood Informatics Infrastructure for Community-Centered Comparative Effectiveness Research (WICER)

Shortened Title

WICER

Publication Date

2013

Author Information

Suzanne Bakken RN, PhD, FAAN, FACMI
The Alumni Professor of Nursing and Professor of Biomedical Informatics
Columbia University.

Abstract

The WICER project advances comparative effectiveness research (CER) through creating a robust community-focused data infrastructure that supports innovative studies of public health problems. WICER is built on an existing institution-focused data foundation at Columbia University. WICER contains a research data warehouse that integrates patient-level data, including clinical data from multiple facilities, settings and sites of care, with person-level self-reported information collected via community survey. It maps the linked data to variables that support CER studies. WICER also includes tools to support researchers in accessing WICER data resources to perform retrospective analyses and recruit patients for research studies. Three CER studies demonstrating the WICER infrastructure and methods are prospectively studying the diagnosis, treatment and management of hypertension.

Objective

Create a robust community-focused data infra­structure including a research data warehouse that integrates patient-level data with person-level self-reported information from a community based survey in a predominantly low-income, minority neighborhood in New York City, a Research Data Explorer (RedX) tool to support data queries, and EHR “plug-ins” to facilitate research tasks in the context of clinical care processes. CER studies focus on hypertension diagnosis, treatment, and management.


Infrastructure Aims

This project will create the following four elements:

1. De-identified research warehouse, which will integrate health care data from mul­tiple disparate data sources, plus com­munity survey data, together in a research data warehouse (RDW) have the option to incorporate additional data during the course of the project if appropriate IRB applications are completed (e.g. dental/ oral health information);

2. Research Data Explorer (RedX), a front-end viewer to the de-identified data in the RDW. This allows researchers to browse patient data to look for specific data elements that can be used to generate research queries (identified as a critical component of query creation through years of experience providing mediated queries);

3. Agile, portable, ready to implement research decision support tools (i.e., EHR “plug-ins”) that can flexibly work with EHRs to facilitate research tasks in the context of clinical care processes;

4. Data governance policies and procedures

Healthcare Settings

Primary care or ambulatory clinics, Inpatient facilities, Academic medical centers, Community health centers, Long-term care facilities, Community households

Data Types

Electronic Health/Medical Records (EHR or EMR), Patient-Reported Outcomes

Geographic scope type

Local

Locations of Focus

Washington Heights and Inwood neighborhoods in the northern part of Manhattan, above 155th street, specifically the zip codes: 10031, 10032, 10033, 10034, 10040 in New York

Population Network Size

270,677

Informatics Platform/Tools

Research Data Explorer (RedX); EHR Plug-in; Research Data Warehouse (RDW)

Grant Type

PROSPECT Studies

Major Partners

Columbia University Departments of: Biomedical Informatics, Cardiology; Schools of: Public Health, Nursing; Columbia Doctors; New York Presbyterian Hospital; Columbia Community Partnership for Health; Visiting Nurse Service of New York; Isabella Geriatric Center ; Mount Sinai School of Medicine; Community-Based Organizations and residents of Washington Heights/Inwood

CER/PCOR Study Priority Populations

Low-income groups, Minority groups, Women, The elderly, Individuals with disabilities, Individuals who live in inner-city areas

Outcome(s) of Interest

Detection, management, and adherence mea­sures for hypertension control

Acknowledgement of Funders

Funding was provided by R01 HS019853 from the Agency for Healthcare Research and Quality, one of the ARRA-funded PROSPECT studies.

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