The TriNetX Linked EHR and Administrative Claims Network

OBJECTIVES: Data resources that combine the clinical richness of Electronic Health Records (EHR) with administrative claims data have long been considered the gold standard for health economics and outcomes research (HEOR) and other real-world data research. However, there are very few integrated EHR and claims systems generally available for research. TriNetX seeks to fill that void with the creation of the TriNetX Linked EHR and Claims Network.

METHODS: TriNetX is a federated global research network, that has 61 US-based HealthCare Organizations (HCOs), contributing EHR data for over 105 million patients. The de-identified EHR data is sourced directly from the HCOs and mapped to standardized terminologies. A subset of HCOs permit linking to external data sources through tokenization. The EHR data has been linked to closed claims and mortality data to create the TriNetX Linked Network.

RESULTS: As of January 2024, the Network includes 13.2 million patients with 22 million unique medical enrollment periods across 21 HCOs. The Network is 51% female, 90% with a known race (62% white, 19% Black, 3% Asian, 6% other), 61% with a known ethnicity (51% not Hispanic or Latino, 10% Hispanic or Latino), and the average age is 41. Insurance types are Medicaid only (31%), Medicare only (6%), commercial insurance only (48%), and mixed coverage (15%). There are 14.8 million unique medical enrollment periods 1+ years in length, 10.1 million are 2+ years, and 6.9 million are 3+ years (54%, 61%, and 67%, respectively, contain at least one EHR encounter). In addition to the depth of EHR data, the claims data provides complementary data to the patient records including enrollment, claim type, payment amounts, provider specialty, medication dispensed (NDC), quantity dispensed, and days supply.

CONCLUSIONS: The TriNetX Linked Network combines EHR data with administrative claims providing a clinically rich, longitudinal, data network ideal for conducting HEOR research.