Utilizing Electronic Medical Records to Improve Public Policy

How many fully vaccinated people still get COVID-19 infection? How will the 2020 surge in gun injuries affect minorities? How has the pandemic affected the hospitalization of teenagers with eating disorders?

Electronic Health Records (EHRs) are a repository of data to answer these questions. And one company, Epic, has made that information available to researchers across the country through Cosmos, a clinical and public health research platform.

Personal Information for the Public Interest

Epic launched Cosmos in 2017, but in the early days of the COVID-19 pandemic, Cosmos’ full opportunity was first realized, when clinicians eagerly wanted all the information they could find about treating this new disease. Realizing the need for solid data, Epic’s founder and CEO, Judy Faulkner, the unbearable Judy Faulkner, pressured her team to launch what was then called the Epic Health Research Network (hereafter simply renamed Epic Research).

As Faulkner said, “The network is intended to be a new kind of journal for rapidly filling the need for great, actionable insights.”

While not replacing the role of peer-reviewed clinical research, Epic Research uses Cosmos to provide public health officials with fast, accurate answers to critical health questions. Cosmos combines the electronic health record data of more than 140 million U.S. patients, refreshed every 14 days from more than 700 hospitals and more than 10,000 clinics, and approximately 4.5 billion, including 2.2 billion visits with healthcare providers. It is event based on the patient. Data includes healthcare, Medicare, and commercial health plans paid by individuals as well as patients in rural and urban areas. Data is de-identified into 16 categories to protect patient privacy before entering into Cosmos.

Indeed, the ramifications of clinical and public health information mined from such databases (where privacy is protected, normalized, recorded, consolidated, and representative) has long been a goal of EHR implementation. “The game-changer is the integration of artificial intelligence (AI) applied to these huge databases,” he explains. Walter Winners, consultants and EHR specialists. “Artificial intelligence provides new tools for analyzing clinical data to inform current policy-making and public health initiatives.”

The Epic Research team works with clinicians, data scientists, and public health professionals. For example, two years ago Epic Research establish The weekly volume of preventive cancer screenings for breast, colon, and cervical cancer fell by 90% from the US historical average in 2017-2019, probably due to the COVID-19 halt. If undetected, the cancer may be misdiagnosed or diagnosed at a later stage. Epic Research has published information to help individuals and health care providers schedule screening tests or find alternative testing options.

CDC and FDA use cases for COVID-19

Epic Research used Cosmos to help the Centers for Disease Control and Prevention (CDC) track the efficacy and side effects of a vaccine against COVID-19. The CDC has also submitted cosmos data to the FDA for myocarditis, a rare but serious inflammation of the heart. This data was used in the approval process for immunization against COVID-19 for children aged 5-11 years. The CDC teamed up with the Epic Research team using Cosmos to compare the efficacy of Moderna, Johnson & Johnson, and Pfizer COVID-19 vaccines against breakthrough infections and hospitalizations across age groups and to manage the decline in efficacy over time. Decide whether a booster vaccination is appropriate and for which population it is appropriate.

Epic and medical institutions providing data to Cosmos can use the platform to track, model and visualize the effects of disease over time. Study the clinical interventions that have worked best for similar patients. Examining Look-Alikes to help doctors connect with other doctors about the diagnosis and treatment of rare cases. The addition of the Cosmos Research Platform will be a key value proposition for Epic’s clients, including some of the nation’s top hospitals and medical research universities.

Epic’s paradoxical success story follows that of 78-year-old Faulkner, who avoided M&A with Wall Street for family-owned and in-house design of computer systems for humans. With Cosmos’ records of over 6 million cancer patients, Faulkner expects further improvements in prevention and treatment in this area, bringing a genomics perspective to healthcare, along with adequate privacy where appropriate. Faulkner touts Best Care for My Patient, Epic’s innovation to personalize clinical patient care to the next level. Best Care for My Patient allows providers to search Epic’s vast database to find other patients with the same symptoms or conditions as those currently being treated, and compare and modify treatment plans accordingly. For example, a clinician could investigate how other Epic users treat young adult women with Lyme disease and respiratory problems to find the best outcome for treating their patients.

Epic’s passion for health extends beyond patients to Epic’s employees and the planet. The 8.5 million square foot Epic campus in Verona, Wisconsin features 43 acres of green roofs, nature trails, ponds, biowetlands and rainwater structures. The company is nationally recognized for its sustainability and one of the largest green heating/cooling systems in the United States, with thousands of miles of underground geothermal pipes. The software giant also helps power the data center with six wind turbines and 18 acres of solar panels.

A lot of the media is touting healthcare startups and the politicization of medicine. Epic stands out as a legacy player at the forefront of innovation and is committed to making a positive impact on the world.


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