How to Harness Clinical Neurology Data for the Greater Good

Electronic medical records from neurologists' offices are going into a practice-based research network in Evanston, Ill. It's part of an academic medical center's initiative to harness the data for scientific and clinical purposes. In a journal article researchers offer tips on replicating their system.

Researchers at North Shore University HealthSystem in Evanston, Ill. leveraged electronic medical records (EMR) to create a futuristic Neurology Practice-Based Research Network .

Reporting in October’s Neurology Clinical Practice, pre-published online Sept. 25, lead author Demetrius Maraganore, MD, medical director of NorthShore’s Neurological Institute, discusses, in practical terms, how to initiate similar efforts. The article is entitled “Quality improvement and practice-based research in neurology using the electronic medical record.”

The care transformation initiative targeted 10 neurologic disorders. Those are: brain tumors, epilepsy, migraine, memory disorders, mild traumatic brain injury, multiple sclerosis, neuropathy, Parkinson, restless leg syndrome and stroke. Informatics methods included building and implementing structured clinical documentation support (SCDS); electronic data capture; enrollment; data quality and reports; quality improvement projects; clinical decision support tools subgroup-based adaptive assignments and pragmatic trials; and DNA biobanking. A step-by-step description follows:

  • Structured clinical documentation support: Neurologists tested and revised SCDS tools to optimize EMR.
  • Enrollment reports: The team held bi-weekly meetings between neurologists and programmers and created project-specific data marts and--within a month of implementation--tracking reports.
  • Data quality reports: Programmers created data-quality reports to indicate where required information was missing.
  • Descriptive reports (cohorts): Satisticians created quarterly reports including frequencies, medians and ranges for data and score tests.
  • Quality improvement projects and dashboards: Neurologists envisioned three quality improvement projects using SCDS, data and reports.

Researchers regularly communicated the benefits of SCDS”to promote buy-in by physicians and staff.

Next steps include standardizing office visits with SCDS tools; subgroup adaptive assignments using EMR’s 10 neurologic disorders to compare treatments to outcomes; creating a neurology practice-based research network; biobanking and research informatics initiative, they add.