EHR research: We're entering uncharted, exciting territory

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No doubt, electronic health records still are in need of improvement.

That said, there's no denying the inroads they're making in research. Recent reports we highlight this week really highlight EHRs' potential to delve into new, and frankly incredible, areas of education.

For starters, consider this study about diabetes screening. The researchers created an algorithm to more accurately and cheaply pinpoint people who may be at risk of having Type 2 diabetes by combing through their EHRs to look for risk factors for the disease.

It worked. The researchers are so confident in their screening tool that they predict using it would identify an additional 400,000 people with active, untreated diabetes. And since 25 percent of Type 2 diabetes patients in this country are undiagnosed due to inadequate screening, this development can have a huge impact on treatment, population health and the cost of healthcare. We've known that EHRs help support the treatment of diabetes; this breakthrough takes such involvement one step further.

What's more, the screening algorithm that the researchers developed also uncovered several previously unknown risk factors for diabetes, many of which seem pretty random, such as a history of sexual and gender identity disorders, Colitis and Chicken Pox. And some of these newly identified risk factors are better risk factors than a few of the ones for diabetes that we're familiar with, such as body mass index or high cholesterol.

Then, there's this study in Science. It actually used EHR phenotype data of 28,000 adults of European ancestry to identify the surviving DNA of Neanderthals in modern humans. The Neanderthal alleles were associated with neurological, psychological, immunological and dermatological phenotypes, including those for conditions such as depression, skin problems stemming from sun exposure, hypercoagulation, tobacco use and mood disorders.

The research not only confirms that that inbreeding between Neanderthals and anatomically modern humans occurred, but also that the inbreeding influenced the anatomically modern humans brain phenotype. Perhaps most significantly, it demonstrates that EHRs can be used to research evolution and history.  

And what may be called a study-in-training, an article published in the journal LGBT Health praised the rule implementing Stage 3 of Meaningful Use because it requires certified EHR technology to include sexual orientation and gender identity fields. The authors called the rule a "historic" advance in health for lesbian, gay, bisexual and transgender (LGBT) people.

That is, in and of itself, a big step forward in addressing a burgeoning and misunderstood health issue. The authors noted that such data collection will help reduce health disparities--as this population has higher rates of sexually transmitted infections, HIV and behavioral health issues--but said that if providers don't know about a patient's sexual orientation and gender identity, they won't necessarily be on the lookout for such particular health needs.

The authors also said that collecting this data will facilitate research and analysis of this particular population, something that can't really be accomplished at present.

I can only imagine how much more can be discovered, what secrets of science and medicine can be revealed.

Yes, EHRs can improve individual patient care. But perhaps it's this far-reaching secondary use that will be their greatest contribution. - Marla (@MarlaHirsch and @FierceHealthIT)

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