Finding Value in Volume: An Exploration of Data Access and Quality Challenges

Aware of the potential benefits of health information technology (health IT), many early adopting health systems have leveraged electronic health records (EHRs) for far more than point-of-care documentation. Many rely on these electronic data to conduct quality assurance, quality improvement (QI) and reporting; surveillance; operations research; and clinical and health services research. However, as these health systems have generated more electronic data—and from an increasingly diverse array of IT systems and sources—they have encountered challenges associated with accurately recording, reconciling, and contextualizing these data in a way that supports a multitude of potential uses. Through AcademyHealth’s Health IT for Actionable Knowledge project, six participating health system partners—Denver Health, Geisinger Health System, Kaiser Permanente, the New York City Department of Health’s Primary Care Information Project (PCIP), the Palo Alto Medical Foundation Research Institute (PAMFRI), and the Veterans Health Administration (VHA)—raised a number of issues and challenges associated with using health IT to support other critical functions, focusing primarily on quality improvement and health services research. This report describes some of the key challenges to capturing and then extracting “research grade” data from health IT systems, and elaborates on the experiences of these six health system partners that, recognizing the value of using EHR data to support research, have devised approaches to mitigate these challenges. Their collective experience offers lessons from which others can learn.