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. 2021 Sep:121:103871.
doi: 10.1016/j.jbi.2021.103871. Epub 2021 Jul 21.

REDCap on FHIR: Clinical Data Interoperability Services

A C Cheng  1 , S N Duda  2 , R Taylor  3 , F Delacqua  4 , A A Lewis  5 , T Bosler  6 , K B Johnson  7 , P A Harris  8
Affiliations

REDCap on FHIR: Clinical Data Interoperability Services

A C Cheng et al. J Biomed Inform. 2021 Sep.

Abstract

Background: Despite widespread use of electronic data capture (EDC) systems for research and electronic health records (EHR), most transfer of data between EHR and EDC systems is manual and error prone. Increased adoption of Health Level Seven Fast Healthcare Interoperability Resource (FHIR) application programming interfaces (APIs) in recent years by EHR systems has increased the availability of patient data for external applications such as REDCap.

Objective: Describe the development of the REDCap Clinical Data Interoperability Services (CDIS) module that provides seamless data exchange between the REDCap research EDC and any EHR system with a FHIR API. CDIS enables end users to independently set up their data collection projects, map EHR data to fields, and adjudicate data transfer without project-by-project involvement from Health Information Technology staff.

Methods: We identified two use cases for EHR data transfer into REDCap. Clinical Data Pull (CDP) automatically pulls EHR data into user-defined REDCap fields and replaces the workflow of having to transcribe or copy and paste data from the EHR. Clinical Data Mart (CDM) collects all specified data for a patient over a given time period and replaces the process of importing EHR data for registries from research databases. With an iterative process, we designed our access control, authentication, variable selection, and mapping interfaces in such a way that end users could easily set up and use CDIS.

Results: Since its release, the REDCap CDIS has been used to pull over 19.5 million data points for 82 projects at Vanderbilt University Medical Center. Software and documentation are available through the REDCap Consortium.

Conclusions: The new REDCap Clinical Data and Interoperability Services (CDIS) module leverages the FHIR standard to enable real-time and direct data extraction from the EHR. Researchers can self-service the mapping and adjudication of EHR data into REDCap. The uptake of CDIS at VUMC and other REDCap consortium sites is improving the accuracy and efficiency of EHR data collection by reducing the need for manual transcription and flat file uploads.

Keywords: Clinical research; Electronic data capture; Electronic health record; Fast Healthcare Interoperability Resources.

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Figures

Figure 1:
Figure 1:
Traditional workflow for creating a registry from EHR data in REDCap (greyed out) compared to new CDIS workflow
Figure 2:
Figure 2:
Variable selection screen with keyword search
Figure 3:
Figure 3:
Mapping helper
Figure 4:
Figure 4:
REDCap CDP project mapping with examples of non-temporal, one-to-one, many-to-one, and many-to-many scenarios.
Figure 5:
Figure 5:
REDCap CRF Data Adjudication Process
Figure 6:
Figure 6:
Adjudication of labs with multiple values and most recent value preselected
Figure 7:
Figure 7:
Data representation in CDM
Figure 8:
Figure 8:
Real-time algorithm for establishing CDIS connection between REDCap and EHR at VUMC.
Figure 9:
Figure 9:
Numbers of projects, patients, and data points collected from the EHR at VUMC by CDIS by month
Figure 10:
Figure 10:
Numbers of projects, patients, and data points collected from the EHR at UT Southwestern by CDIS by month
Figure 11:
Figure 11:
Institutions with the Epic EHR that requested and implemented CDIS cumulatively by month since requests on the App Orchard began in February 2019.
Figure 12:
Figure 12:
Proportion of data values collected in CDIS at VUMC and UTSW by FHIR resource.
See this image and copyright information in PMC

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