Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibility

Abstract Background Electronic health record (EHR) systems have been shown to represent a valuable source of data reuse in the design and conduct of clinical trials. Earlier work has mostly focused on institutional EHR systems. Shared EHR systems have been neglected so far, even though they are high...

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Main Authors: Georg Duftschmid, Florian Katsch, Gabriela Ciortuz, Dipak Kalra, Christoph Rinner
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Medical Informatics and Decision Making
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Online Access:https://doi.org/10.1186/s12911-025-02980-2
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author Georg Duftschmid
Florian Katsch
Gabriela Ciortuz
Dipak Kalra
Christoph Rinner
author_facet Georg Duftschmid
Florian Katsch
Gabriela Ciortuz
Dipak Kalra
Christoph Rinner
author_sort Georg Duftschmid
collection DOAJ
description Abstract Background Electronic health record (EHR) systems have been shown to represent a valuable source of data reuse in the design and conduct of clinical trials. Earlier work has mostly focused on institutional EHR systems. Shared EHR systems have been neglected so far, even though they are highly prevalent today and their characteristics (integrated data across a patient’s care providers, standardized information model) make them attractive for the task. However, as they typically focus on a limited data set for the most common care situations, it remains unclear, whether shared EHR systems actually cover the data elements required for clinical trial conduct. In this paper we present a method, which allows shared EHR systems to be analyzed in this regard. Methods We focus on shared EHR systems using HL7 CDA as this is currently the most-widely used content standard. For the data elements that are commonly used in clinical trials we refer to the EHR4CR reference list. The latter is semiautomatically mapped to the EHR system’s information model using the open source tool ART-DECOR. For the final automatic analysis of the mappings, another open source tool is provided. Results A stepwise approach was developed to analyze HL7 CDA-based shared EHR systems for their coverage of data elements that are relevant for clinical trials. All tools used in this work as well as all mappings are publicly accessible to make the method reusable and the results reproducible. We applied our approach to the Austrian nation-wide EHR system ELGA and showed that the latter allows the recording of 88% of all EHR4CR data elements, 77% in structured format. Conclusions Our method allows HL7 CDA-based shared EHR systems to be easily analyzed to what extent their content could be reused in the context of clinical trials. The results for ELGA indicate that it has a substantial corresponding potential. Clinical trial number Not applicable.
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spelling doaj-art-0c97f683ed324ebeacf8f7b55c286e842025-08-20T02:08:09ZengBMCBMC Medical Informatics and Decision Making1472-69472025-04-012511910.1186/s12911-025-02980-2Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibilityGeorg Duftschmid0Florian Katsch1Gabriela Ciortuz2Dipak Kalra3Christoph Rinner4Center for Medical Data Science (CEDAS), Medical University of ViennaCenter for Medical Data Science (CEDAS), Medical University of ViennaInstitute of Medical Informatics, University of LuebeckEuropean Institute for Innovation through Health Data (i~HD), University College of LondonCenter for Medical Data Science (CEDAS), Medical University of ViennaAbstract Background Electronic health record (EHR) systems have been shown to represent a valuable source of data reuse in the design and conduct of clinical trials. Earlier work has mostly focused on institutional EHR systems. Shared EHR systems have been neglected so far, even though they are highly prevalent today and their characteristics (integrated data across a patient’s care providers, standardized information model) make them attractive for the task. However, as they typically focus on a limited data set for the most common care situations, it remains unclear, whether shared EHR systems actually cover the data elements required for clinical trial conduct. In this paper we present a method, which allows shared EHR systems to be analyzed in this regard. Methods We focus on shared EHR systems using HL7 CDA as this is currently the most-widely used content standard. For the data elements that are commonly used in clinical trials we refer to the EHR4CR reference list. The latter is semiautomatically mapped to the EHR system’s information model using the open source tool ART-DECOR. For the final automatic analysis of the mappings, another open source tool is provided. Results A stepwise approach was developed to analyze HL7 CDA-based shared EHR systems for their coverage of data elements that are relevant for clinical trials. All tools used in this work as well as all mappings are publicly accessible to make the method reusable and the results reproducible. We applied our approach to the Austrian nation-wide EHR system ELGA and showed that the latter allows the recording of 88% of all EHR4CR data elements, 77% in structured format. Conclusions Our method allows HL7 CDA-based shared EHR systems to be easily analyzed to what extent their content could be reused in the context of clinical trials. The results for ELGA indicate that it has a substantial corresponding potential. Clinical trial number Not applicable.https://doi.org/10.1186/s12911-025-02980-2Electronic medical recordsClinical trialsData modelsData collection
spellingShingle Georg Duftschmid
Florian Katsch
Gabriela Ciortuz
Dipak Kalra
Christoph Rinner
Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibility
BMC Medical Informatics and Decision Making
Electronic medical records
Clinical trials
Data models
Data collection
title Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibility
title_full Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibility
title_fullStr Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibility
title_full_unstemmed Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibility
title_short Reusing data from HL7 CDA-based shared EHR systems for clinical trial conduct: a method for analyzing feasibility
title_sort reusing data from hl7 cda based shared ehr systems for clinical trial conduct a method for analyzing feasibility
topic Electronic medical records
Clinical trials
Data models
Data collection
url https://doi.org/10.1186/s12911-025-02980-2
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