Use of Epic Electronic Health Record System for Health Care Research: Scoping Review (Preprint)

Abstract

BACKGROUND Electronic health records (EHR) enable health data exchange across interconnected systems from varied settings. Epic is among the five leading EHR providers, and the highest adopted EHR across the globe. Despite its global reach, there is a gap in the literature detailing how it has been used for research. The objective of this systematic scoping review is to synthesize available literature on the use of the EHR for research in areas of clinical and health sciences. OBJECTIVE The objective for this systematic scoping review is to synthesize available literature on use cases of the Epic EHR for research in various areas of clinical and health sciences. METHODS We used established scoping review methods, searching nine major information repositories, including databases and grey literature sources. For categorizing the research data, we developed detailed criteria with major research domains for presenting our results. RESULTS A total of 4669 articles were screened by two independent reviewers at each stage, and 206 articles were abstracted. Most studies were from the USA, with a sharp increase from 2015 onwards. Most studies were from clinical, health services research, and clinical decision support. The majority employed longitudinal designs, followed by interventional studies implemented at single sites with an adult population. Important facilitators and barriers to the use of EPIC and EHRs in general were also identified. CONCLUSIONS EHRs are a new source of health data, with an ever-expanding repertoire of functions. This places them as a unique tool for primary and secondary research. The Epic EHR is a globally known, well established and growing EHR. This review attempts at filling a critical gap in the literature on the use of EHRs for research, outlining the current state of science in this realm. We additionally offer opportunities, key considerations and recommendations for future use of the Epic EHR and other EHRs in general. While the Epic system provides a wide variety of functions, important considerations for researchers include architecture, data access, and data quality issues. Significant recommendations relate to training, creating clinician buy-in, and creating trans-institutional collaborations for effective research. While this review was limited to Epic systems, the larger lessons are generalizable to other EHRs. CLINICALTRIAL Not applicable.