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EMRs are essential in modern healthcare. At the same time there has been the rapid development of clinical research systems (CRS) which offer specific tools to facilitate research protocol development, execution and management. However, examples of integrating a commercial EMR and CRS are rare. We describe our experience in the analysis, resolution of issues, design, and implementation of EMR/CR integration in a large academic medical center with affiliated hospitals. Our initial results suggest that (1) neither the EMR nor CRS system alone will suffice to facilitate clinical research, (2) there are important benefits to integration of the EMR and CRS systems and (3) this integration can be leveraged across multiple institutions.

Healthcare organizations across the country are searching for methods to address escalating healthcare costs. One strategy is to leverage resources across affiliated but independent organizations. This approach is common in other industries; yet, protecting confidential patient information is unique to the healthcare industry. Guaranteed protection of patient confidentiality is a critical step in any inter-organizational strategy. Because of the need to leverage resources, the University of Texas Southwestern Medical Center (UT Southwestern) and its affiliates initiated a cross-institutional effort to address information security and confidentiality issues.

ObjectivesTo examine whether individuals with low short-term risk of coronary heart disease but high lifetime predicted risk of cardiovascular disease (CVD) have greater prevalence of left ventricular (LV) hypertrophy and increased aortic wall thickness (AWT) than those with low short-term and low lifetime risk.BackgroundLifetime risk prediction can be used for stratifying individuals younger than 50 years of age into 2 groups: low short-term/high lifetime and low short-term/low lifetime predicted risk of CVD. Individuals with low short-term/high lifetime risk have a greater burden of subclinical atherosclerosis as measured by coronary artery calcium and carotid intima-media thickness. However, >75% of individuals with low short-term/high lifetime risk do not have detectable coronary artery calcium, suggesting the presence of alternative subclinical abnormalities.MethodsWe stratified 1,804 Dallas Heart Study subjects between the ages of 30 and 50 years who had cardiac magnetic resonance into 3 groups: low short-term ( 0.3). These associations persisted among participants without detectable coronary artery calcium.ConclusionsAmong individuals 30 to 50 years of age with low short-term risk, a high lifetime predicted risk of CVD is associated with concentric LV hypertrophy and increased AWT.