Using Electronic Medical Records to Improve Public Policy

How many fully vaccinated people still get COVID-19? How will the 2020 surge in gunshot wounds affect minorities? What is the impact of the pandemic on hospitalization of teens with eating disorders?

Electronic health records (EHRs) are a treasure trove of data to answer such questions. One company — Epic — made this information available to researchers across the country through the clinical and public health research platform Cosmos.

Private data used for public interest

Epic launched Cosmos in 2017, but its full opportunity first materialized early in the COVID-19 pandemic, when clinicians were desperate for any information they could find about treating the novel disease. Seeing the need for reliable data, the irrepressible Judy Faulkner, founder and CEO of Epic, pushed her team to launch what was then known as the Epic Health Research Network (later renamed Epic Research).

“The network is designed to be a new type of journal to quickly meet the need for good, actionable insights,” Faulkner said.

While Epic Research cannot replace peer-reviewed clinical research, Epic Research uses Cosmos to provide public health officials with fast, accurate answers to important health questions. Cosmos combines electronic health record data from more than 140 million U.S. patients, updated every 14 days, from more than 700 hospitals and 10,000 clinics, a repository of approximately 4.5 billion patient visits, including 2.2 billion A visit to a health care provider. The data covers patients in rural and urban areas as well as personally paid healthcare, Medicare and commercial health plans. Before data enters Cosmos, it is de-identified in 16 categories to protect patient privacy.

In fact, the spillover benefits of clinical and public health information mined from these databases—as long as it is privacy-preserving, normalized, historic, comprehensive, and representative—has long been the goal of EHR implementation. “The game changer is the application of artificial intelligence (AI) to these giant databases,” explains Walter Venus, consultants and EHR specialists. “Artificial intelligence provides new tools for analyzing clinical data to inform current policy decisions and public health planning.”

The Epic Research team collaborates with clinicians, data scientists and public health experts. For example, Epic Research two years ago established The weekly number of preventive cancer screenings for breast, colon, and cervical cancer decreased by 90% compared to the 2017-2019 historical average in the United States, likely due to disruptions due to COVID-19. If not found, cancer can be misdiagnosed or diagnosed at a later stage. Epic Research publishes this information so that individuals and healthcare providers can schedule screenings or seek alternative testing options.

COVID-19 Use Cases for CDC and FDA

Epic Research uses Cosmos to help the Centers for Disease Control (CDC) track adverse events and the efficacy of COVID-19 vaccines. The CDC also submitted Cosmos data to the FDA on myocarditis, a rare but serious inflammation of the heart. This data is used in the approval process for COVID-19 vaccination for children aged 5-11. The CDC collaborated with the Epic research team who used Cosmos to compare the efficacy of Moderna, Johnson & Johnson and Pfizer COVID-19 vaccines against breakthrough infections and hospitalizations across age groups, and to manage the decline in efficacy over time, an important factor: Determining Whether booster injections are suitable and for whom.

Epic and healthcare organizations contributing data to Cosmos can use the platform to track, model, and visualize the impact of disease over time; study the most effective clinical interventions for similar patients; and examine Look-Alikes, which help physicians interact with Other doctors make connections about the diagnosis and care of rare cases. The addition of the Cosmos research platform could be a key value proposition for Epic’s customers, which include top US hospitals and medical research universities.

Epic’s bucking the trend’s success story complements the lessons of Faulkner, 78, who eschewed Wall Street and mergers and acquisitions in search of home ownership and the in-house design of human computer systems. With Cosmos’ records of more than 6 million cancer patients, Faulkner expects to make more improvements in prevention and treatment in the field, and when appropriate, bring a genomic perspective to healthcare, with appropriate privacy protections, naturally. Faulkner touted Epic’s upcoming innovation, Best Care for My Patient, which takes clinical patient care to a new level of personalization. Best Care for My Patient enables providers to search Epic’s vast database to find other patients with symptoms or diseases, such as those they are currently treating, and to compare and revise treatment plans. For example, clinicians might study how other Epic users treat young adult women with Lyme and respiratory conditions to find the best outcomes for treating patients.

Epic’s passion for health extends beyond patients to include Epic employees and the planet. Epic’s 8.5 million-square-foot campus in Verona, Wisconsin, includes 43 acres of green roofs, nature trails, ponds, bioswales and stormwater structures. The company is nationally recognized for its sustainability and for having one of the largest green heating/cooling systems in the U.S. with thousands of miles of underground geothermal pipes. The software giant also powers its data center with six wind turbines and 18 acres of solar panels.

With many media outlets touting healthcare startups and the politicization of medicine, Epic stands out as a traditional player on the cutting edge of innovation and committed to making a positive impact on the world.