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. 2020 Jul 10;15(1):24.
doi: 10.1186/s13722-020-00198-3.

Assessing the readiness of digital data infrastructure for opioid use disorder research

Arjun Venkatesh  1   2 , Caitlin Malicki  3 , Kathryn Hawk  3 , Gail D'Onofrio  3 , Jeremiah Kinsman  3 , Andrew Taylor  3
Affiliations

Assessing the readiness of digital data infrastructure for opioid use disorder research

Arjun Venkatesh et al. Addict Sci Clin Pract. .

Abstract

Background: Gaps in electronic health record (EHR) data collection and the paucity of standardized clinical data elements (CDEs) captured from electronic and digital data sources have impeded research efforts aimed at understanding the epidemiology and quality of care for opioid use disorder (OUD). We identified existing CDEs and evaluated their validity and usability, which is required prior to infrastructure implementation within EHRs.

Methods: We conducted (a) a systematic literature review of publications in Medline, Embase and the Web of Science using a combination of at least one term related to OUD and EHR and (b) an environmental scan of publicly available data systems and dictionaries used in national informatics and quality measurement of policy initiatives. Opioid-related data elements identified within the environmental scan were compared with related data elements contained within nine common health data code systems and each element was graded for alignment with match results categorized as "exact", "partial", or "none."

Results: The literature review identified 5186 articles for title search, of which 75 abstracts were included for review and 38 articles were selected for full-text review. Full-text articles yielded 237 CDEs, only 12 (5.06%) of which were opioid-specific. The environmental scan identified 379 potential data elements and value sets across 9 data systems and libraries, among which only 84 (22%) were opioid-specific. We found substantial variability in the types of clinical data elements with limited overlap and no single data system included CDEs across all major data element types such as substance use disorder, OUD, medication and mental health. Relative to common health data code systems, few data elements had an exact match (< 1%), while 61% had a partial match and 38% had no matches.

Conclusions: Despite the increasing ubiquity of EHR data standards and national attention placed on the opioid epidemic, we found substantial fragmentation in the design and construction of OUD related CDEs and little OUD specific CDEs in existing data dictionaries, systems and literature. Given the significant gaps in data collection and reporting, future work should leverage existing structured data elements to create standard workflow processes to improve OUD data capture in EHR systems.

Keywords: Common data elements; Electronic health records; Emergency medicine; Opioid-related disorders.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of literature review
Fig. 2
Fig. 2
Distribution of clinical data element type by data system
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention NCfHSMCoD-oCWOD, released December 2018. Accessed 11 Nov 2019.
    1. Miclette MA, Leff JA, Cuan I, Samet JH, Saloner B, Mendell G, et al. Closing the gaps in opioid use disorder research, policy and practice: conference proceedings. Addict Sci Clin Pract. 2018;13(1):22. doi: 10.1186/s13722-018-0123-3. - DOI - PMC - PubMed
    1. H.R.6—SUPPORT for Patients and Communities Act. https://www.congress.gov/bill/115th-congress/house-bill/6.
    1. U.S. Department of Health and Human Services. National Institutes of Health. U.S. National Library of Medicine. Common Data Element Resource Portal. https://www.nlm.nih.gov/cde/.
    1. Opmeer BC. Electronic health records as sources of research data. JAMA. 2016;315(2):201–202. doi: 10.1001/jama.2015.15419. - DOI - PubMed

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