VA unlocks records to improve health care

Thousands of veterans suffering with post-traumatic stress disorder or an aggressive, antibiotic-resistant staph infection will soon be on the radar screen for researchers looking to find the most effective treatments by "mining" the information contained in military medical records.

Utah physicians at Salt Lake's Veterans Medical Center will provide overall leadership and coordination for the new nationwide Veterans Affairs initiative to unlock information in the VA's electronic health records that have never before been available.

Dr. Matthew Samore, professor of internal medicine at the U. and chief of the Division of Clinical Epidemiology, is heading up Utah's part in the initiative, called the Consortium for Healthcare Informatics Research. Research teams of collaborating investigators are also located in Portland, Ore., Palo Alto, Calif., Indianapolis, Nashville, Tenn., Tampa, Fla., West Haven, Conn., Boston and Pittsburgh.

The initiative looks to use state-of-the-art language processing techniques to extract information from the health records that has been previously unavailable in easily searchable form.

It will allow researchers to "de-identify" the information so individual health information is not compromised and pool it in ways that will help doctors understand better which treatment regimens are most effective in the greatest number of patients.

"It used to be that if you wanted to know something like how many patients in your hospital were treated with penicillin, you couldn't find out. Those electronic records were designed to take care of one patient at a time," rather than allowing researchers to look at pools of information from patients throughout the hospital or around the country, Samore said.

Medical informatics has changed that in the past 20 years, creating "clinical data warehouses that have been transformational," in furthering medical research, he said.

The consortium will take that information warehousing function to a new level, he said, providing rich detail including outpatient pharmacy records; lab reports; notes made by nurses, physicians, physical therapists and pharmacists; radiology reports and electromagnetic images; family history; discharge summaries; physician orders; vital sign measurements; and other factors that were previously inaccessible.