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CC BY 4.0 · ACI open 2024; 08(01): e43-e48
DOI: 10.1055/s-0044-1782679
Research Article

Linking Patient Encounters across Primary and Ancillary Electronic Health Record Systems: A Comparison of Two Approaches

Marcos A. Davila III
1   Information Technologies & Services Department, Weill Cornell Medicine, New York, New York, United States
,
Evan T. Sholle
1   Information Technologies & Services Department, Weill Cornell Medicine, New York, New York, United States
2   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Xiaobo Fuld
1   Information Technologies & Services Department, Weill Cornell Medicine, New York, New York, United States
,
Mark L. Israel
3   Clinical IT Shared Services, NewYork-Presbyterian, New York, New York, United States
,
Curtis L. Cole
1   Information Technologies & Services Department, Weill Cornell Medicine, New York, New York, United States
2   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
3   Clinical IT Shared Services, NewYork-Presbyterian, New York, New York, United States
4   Department of Medicine, Weill Cornell Medicine, New York, New York, United States
5   Clinical and Translational Science Center, Weill Cornell Medicine, New York, New York, United States
,
Thomas R. Campion Jr.
1   Information Technologies & Services Department, Weill Cornell Medicine, New York, New York, United States
2   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
5   Clinical and Translational Science Center, Weill Cornell Medicine, New York, New York, United States
6   Department of Pediatrics, Weill Cornell Medicine, New York, New York, United States
› Author Affiliations Funding This work was supported by the U.S. Department of Health and Human Services > National Institutes of Health > National Center for Advancing Translational Sciences (UL1TR002384).
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Abstract

Background To achieve scientific goals, researchers often require integration of data from a primary electronic health record (EHR) system and one or more ancillary EHR systems used during the same patient care encounter. Although studies have demonstrated approaches for linking patient identity records across different EHR systems, little is known about linking patient encounter records across primary and ancillary EHR systems.

Objectives We compared a patients-first approach versus an encounters-first approach for linking patient encounter records across multiple EHR systems.

Methods We conducted a retrospective observational study of 348,904 patients with 533,283 encounters from 2010 to 2020 across our institution's primary EHR system and an ancillary EHR system used in perioperative settings. For the patients-first approach and the encounters-first approach, we measured the number of patient and encounter links created as well as runtime.

Results While the patients-first approach linked 43% of patients and 49% of encounters, the encounters-first approach linked 98% of patients and 100% of encounters. The encounters-first approach was 20 times faster than the patients-first approach for linking patients and 33% slower for linking encounters.

Conclusion Findings suggest that common patient and encounter identifiers shared among EHR systems via automated interfaces may be clinically useful but not “research-ready” and thus require an encounters-first linkage approach to enable secondary use for scientific purposes. Based on our search, this study is among the first to demonstrate approaches for linking patient encounters across multiple EHR systems. Enterprise data warehouse for research efforts elsewhere may benefit from an encounters-first approach.

Keywords

secondary use - encounters - record linkage - data warehouse - data mart

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Weill Cornell Medical College Institutional Review Board.


Supplementary Material



Publication History

Received: 30 October 2023

Accepted: 23 February 2024

Article published online:
10 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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