The ISPOR BOOK:
Reliability and Validity of Data Sources for Disease and Health Management:

Section 2: Electronic Medical Records & Medical Charts
Section Co-editors:Ryung Suh MD, MPH, MBA and Carla Zema PhD

• Chapter 1:  Electronic Medical Records and Medical Charts:  This chapter will lay the foundation, starting off with definitions of EMRs, EHRs, PHRs, EMR systems, etc. and the roles of each in disease management; discussing data characteristics and scope (what type if information is available); and their broad current uses.  It will cover how and where other components may fit, e.g. CPOE, CDSS, and what types of data are available, i.e. inpatient, outpatient, pharmacy, etc.  This will provide a broad overview to introduce the remaining chapters.  AUTHORS:  Ryung Suh, Carla Zema

• Chapter 2:  Methodological Issues:  This chapter will focus on the methodological strengths and weaknesses of medical record reviews and EMRs and any methodological challenges that are raised.  It will compare the validity and reliability of EMRs vs paper medical records and cite applications in disease and health management.  It will provide a review of analytic approaches, methodological issues for each, and, where possible, prescriptions or recommendations.  It will compare scope, types of available data, generalizability, and potential biases.  AUTHORS:  Carla Zema, TBD

• Chapter 3:  Innovative Approaches Using EMRs and Medical Charts:  This chapter will focus on innovative or new approaches to utilizing EMR and medical chart data, with the goal of covering the broad landscape of use within disease management.  It will cover strategies for real-time monitoring of health outcomes, dealing with unstructured text in medical records, new models for structuring EMRs and medical data scrubbing, new risk-adjustment concepts, and other potential directions for leveraging the potential of EMRs.  AUTHORS:  Farrokh Alemi, Brent Gibson, Brian Sisk

• Chapter 4:  Researcher Perspectives on EMRs and Medical Charts:  The chapter will focus on the promises and pitfalls of adapting EMR systems as research tools, to include review (and examples) of existing and available EMR systems.  This chapter should also address the reliability and validity issues associated with each of the available EMR systems.  AUTHORS:  Carl Asche, TBD

• Chapter 5:  Practitioner Perspectives on EMRs and Medical Charts:  This chapter will focus on the uses of medical records and EMRs in DM clinical practice, to include perspectives on the current and potential value to practitioners, its clinical informatics applications, practitioner competencies with EMR systems and network infrastructure, and the implications of potential data biases on patient care.  AUTHORS:  Edward Kim, Jaspal Ahluwalia

• Chapter 6:  Purchaser Perspectives on EMRs and Medical Charts:  This chapter will focus on evaluating your current EMR system for DM, to include strategies for using an existing EMR for DM, proposed evaluation frameworks for EMRs and medical chart reviews from a purchaser’s perspective, considerations if you are just beginning to implement an EMR system, the cost-effectiveness/ROI of using EMR for DM, and other associated issues.  AUTHORS:  Cesar Abicalaffe, TBD

• Chapter 7:  Policymaker Perspectives on EMRs and Medical Charts:  This chapter will focus broadly on federal and state level EMR evaluation initiatives, barriers to EMR adoption and implementation, current trends and industry developments, and issues on the horizon with respect to EMR utilization in DM evaluation (e.g. health information exchange networks, integrated decision analytic platforms, etc.).  It will review current perceptions on data source reliability and validity among federal agencies (e.g. CBO, AHRQ, CMS) through a review of public reports and outline important directions for future research and policy action.  AUTHORS:  Ryung Suh, Shivaani Prakash, Sarah Johnson