Get access

Electronic clinical laboratory test results data tables: lessons from Mini-Sentinel

Authors

  • Marsha A. Raebel,

    Corresponding author
    1. Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
    2. University of Colorado Skaggs, School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA
    • Correspondence to: M. A. Raebel, Institute for Health Research, Kaiser Permanente Colorado, PO Box 378066, Denver, CO 80237, USA. E-mail: Marsha.A.Raebel@kp.org

    Search for more papers by this author
  • Kevin Haynes,

    1. Center for Clinical Epidemiology and Biostatistics and Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
    Search for more papers by this author
  • Tiffany S. Woodworth,

    1. Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
    Search for more papers by this author
  • Gwyn Saylor,

    1. Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
    Search for more papers by this author
  • Elizabeth Cavagnaro,

    1. Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
    Search for more papers by this author
  • Kara O. Coughlin,

    1. Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
    Search for more papers by this author
  • Lesley H. Curtis,

    1. Duke Clinical Research Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
    Search for more papers by this author
  • Mark G. Weiner,

    1. Department of Clinical Sciences, Temple University School of Medicine, Philadelphia, PA, USA
    Search for more papers by this author
    • At the time of this work, Dr. Weiner was at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Patrick Archdeacon,

    1. Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
    Search for more papers by this author
  • Jeffrey S. Brown

    1. Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
    Search for more papers by this author

ABSTRACT

Purpose

Developing electronic clinical data into a common data model posed substantial challenges unique from those encountered with administrative data. We present here the design, implementation, and use of the Mini-Sentinel Distributed Database laboratory results table (LRT).

Methods

We developed the LRT and guided Mini-Sentinel data partners (DPs) in populating it from their source data. Data sources included electronic health records and internal and contracted clinical laboratory systems databases. We employed the Logical Observation Identifiers, Names, and Codes (LOINC®) results reporting standards. We evaluated transformed results data using data checks and an iterative, ongoing characterization and harmonization process.

Results

Key LRT variables included test name, subcategory, specimen source, LOINC, patient location, specimen date and time, result unit, and unique person identifier. Selected blood and urine chemistry, hematology, coagulation, and influenza tests were included. Twelve DPs with outpatient test results participated; four also contributed inpatient test results. As of September 2013, the LRT included 385,516,239 laboratory test results; data are refreshed at least quarterly. LOINC availability and use varied across DP. Multiple data quality and content issues were identified and addressed.

Conclusion

Developing the LRT brought together disparate data sources with no common coding structure. Clinical laboratory test results obtained during routine healthcare delivery are neither uniformly coded nor documented in a standardized manner. Applying a systematic approach with data harmonization efforts and ongoing oversight and management is necessary for a clinical laboratory results data table to remain valid and useful. Copyright © 2014 John Wiley & Sons, Ltd.

Ancillary