UNIVERSITY OF WASHINGTON

The Surgical Care and Outcomes Assessment Program (SCOAP) is a voluntary, clinical data-based surveillance, sharing and feedback platform aimed at improving quality and performing "real world" studies of comparative effectiveness. Over the initial three years acting as a Regional Health Information Organization (RHIO), deployment of SCOAP across nearly all Washington State hospitals has been effective for comparing the safety and effectiveness of surgical and other interventions and in quality improvement. SCOAP has demonstrated the capability to integrate records from ambulatory surgical centers, statewide payer billing and pharmacy systems, the states vital status registry, and a post-discharge patient-reported outcome survey assessment center in distinct projects, but current methods for manual abstraction of SCOAP data are workforce intensive and burdensome. To address these limitations, in partnership with Microsoft, we propose deploying the Amalga Unified Intelligence SystemTM(Amalga UIS) across the SCOAP RHIO. While there are several commercially available and homegrown electronic medical record systems, they do not readily "talk with one another" or allow linkages to other data streams. Drawing information out of these different systems and linking them to other data sources for comparative effectiveness research requires an information technology solution that can interact with all available data systems and all types of data. While Microsoft does not have an electronic medical record product, it is a leader in creating software solutions that enable relational databases, create interoperability, and facilitate data repository management. Amalga UISTM is a revolutionary, proven software solution that employs automated data retrieval from all types of electronic medical records and data systems to create common data platforms. Amalga UISTM deployment within the SCOAP RHIO creates automated data retrieval from each participating hospitals varied electronic sources and on-going linkage to other relevant statewide data sources-including data from other hospitals and ambulatory surgical facilities, medication and outpatient records from selected insurers, the states vital status records, and the patient reported outcomes survey system. The resulting network of real-world clinical outcome information- the Comparative Effectiveness Research Tranalstional Network (CERTN) will facilitate efficient surgical and interventional comparative effectiveness research and be a gateway to a broader array of clinical disciplines. We will demonstrate the usability of the CERTN network through a comparative study of vascular interventions for life limiting claudication. The comparative evidence about treatment options for claudication compared to best medical treatment is limited and there has been very limited evidence to describe these treatments in the general community. This project will highlight the capability of the CERTN network to systematically collect longitudinal data on healthcare encounters by performing ongoing linkages of multiple automated data streams across disparate electronic medical records and within different healthcare environments.

Clarification of Codes