EHRs must evolve as big data use grows

As big data use continues to increase in healthcare, electronic health records will need to evolve simultaneously, researchers from Northwestern University, Geisinger Health System and Mount Sinai School of Medicine write in a viewpoint recently published in the Journal of the American Medical Association. Current EHRs, the authors say, are not built to handle the capacity of data created by current electronic medical tools, a problem that will only continue to grow as data access becomes easier.

"EHRs are designed to facilitate day-to-day patient care," co-study author Justin Starren, chief of the division of health and biomedical informatics in the department of preventive medicine at Northwestern's Feinberg School of Medicine, says in an announcement. "EHRs are not designed to store large blocks of data that do not require rapid access, nor are they currently capable of integrating genomics clinical decision support."

As a temporary solution until more advanced EHRs are developed, Starren and his colleagues suggest using auxiliary systems for the storage of data culled from what they call increasing 'omics' research efforts--studies focusing on genomics, epigenomics, proteomics and metabolomics. Groups like the Electronic Medical Records and Genomics (eMERGE) consortium, they say, already are "bridging the chasm" by creating interoperable systems with the ability to integrate large-scale genomic data with clinical workflow.

"Omic data are different," the authors write. "An individual's germline genetic sequence changes little over a lifetime, but understanding of that sequence is changing rapidly. The 1000 Genomes project has identified tens of millions of different genomic variants; the clinical significance of these variants is mostly unknown, but current understanding is rapidly changing. … This necessitates systems that dynamically reanalyze and reinterpret stored static genomic results in the context of evolving knowledge."

Research published online in the Journal of the American Medical Informatics Association last week examines the use of EHRs within the eMERGE network, concluding those EHRs are helpful for identifying phenotypes for genetic and other research.

To learn more:
- read the JAMA viewpoint (subscription required)
- here's the accompanying announcement