DARTNet Institute Informing Practice Improving Care
image displayed if flash reader not installed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

:: Newsletters

2018 1st Quarter (Volume 7)

2017 3rd Quarter (Volume 6)

2017 2nd Quarter (Volume 5)

2017 1st Quarter (Volume 4)

2016 4th Quarter (Volume 3)

2016 3rd Quarter (Volume 2) 

2015 4th Quarter (Volume 1) 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home > About DI > News

News

DI Helps Recruit Patients for Study of Long COVID Among Children

June 21, 2022

The DARTNet Institute is a recruitment site for the RECOVER Initiative, which is an NIH-funded study examining lingering symptoms in children after they have recovered from COVID-19 infections.

Read more at https://www.medpagetoday.com/special-reports/exclusives/99264

Patient-Centered Intervention Improved Asthma Outcomes for Black and Latinx Adults

February 26, 2022

Black and Latinx patients who took inhaled corticosteroids when they used reliever medications, plus usual care, had fewer severe asthma exacerbations, improved asthma control, improved quality of life, and less days lost from work/school

A new approach to managing moderate-to-severe asthma among Black and Latinx adults shows great promise, according to a new study led by the Brigham and Women’s Hospital in which the DARTNet Institute managed patient data collection. The study found that inhaled corticosteroids (ICS) given as part of rescue therapy, medication taken to relive acute asthma symptoms, reduced exacerbations, long term asthma symptoms and lost days of school or work among Black and Latinx adults. No previous studies had focused on this treatment approach in African American/Black and Hispanic/Latinx populations that face a large burden of complications from asthma including higher rates of asthma-related emergency department visits, higher rates of hospitalizations and approximately double the asthma death rate compared to white individuals.

In the pragmatic PREPARE (PeRson EmPowered Asthma RElief) trial, African American/Black and Hispanic/Latinx patients with asthma received one-time instruction to use ICS when they used an asthma reliever/nebulizer in addition to their usual asthma medications. Study results, presented at the 2022 Annual Meeting of the American Academy of Allergy, Asthma & Immunology and simultaneously published in The New England Journal of Medicine, demonstrated that this intervention decreased the risk of severe asthma exacerbations by 15 percent and reduced asthma symptoms and days of impairment in 1,201 adults with moderate-to-severe asthma. PREPARE was conducted from November 2017 to April 2021 at 19 sites in the US and Puerto Rico. Participants were randomized to use ICS as needed (Patient-Activated Reliever-Triggered ICS, or PARTICS) in addition to usual care (UC) or to continue usual care (control). Participants were followed for 15 months.

“A disproportionate burden of asthma on underserved populations in the U.S. persists,” said Elliot Israel, MD, study leader. “Results of the PREPARE trial show us that we can reduce the impact of asthma through the simple, patient-centered intervention of having patients use ICS whenever they use their rescue inhaler or nebulizer. This intervention is effective — easy to implement, easy to use, and comes at a low cost.” Israel and colleagues designed the PREPARE trial to determine if taking an ICS whenever patients used their reliever inhalers or nebulizers — a patient- and provider-friendly approach that did not involve changing underlying medications — could help improve outcomes in populations who have been underrepresented in research but bear a disproportionate burden of disease. One of the unique aspects of the PREPARE trial was the degree of engagement and involvement of patients in the trial’s design and implementation. Investigators collaborated with African American/Black and Hispanic/Latinx adults with asthma as well as asthma caregivers on all phases of the study.

“What’s unique about this study is that we’ve focused exclusively on patient populations that face significant disparities in asthma outcomes and included them in optimizing the study,” said Juan Carlos Cardet, MD, of University of South Florida and a co-investigator of the study.

“Accurate and effective data collection and management are critical to effective patient engagement in treatment regimens that affect quality of life. In this study, with over 18,000 months of possible patient level data, we were able to collect data for 97+% of the months. This study and the data that underpin it prove once again that engaging patients directly in their health and care improve processes and outcomes,” said Wilson D. Pace, MD, Chief Medical and Technical Officer at the DARTNet Institute.

“I believe patient collaboration contributed to the success of this study,” said Israel. “We need to think about interventions that place the patient at the center of care and design our trials in ways that are inclusive of populations that bear a disproportionate burden of morbidity.”

Over 70 percent of participants reported at least one asthma exacerbation in the previous year and 67 percent used a nebulizer for quick-reliever treatment. The annualized rate of asthma exacerbations in the PARTICS group was 0.69 per patient; the rate was 0.82 for the control group. The PARTICS group also had improved scores for asthma symptoms and missed fewer days of school/work/usual activities at 13.4 days/year versus 16.8 days/year in controls.

PREPARE was funded by the Patient-Centered Outcomes Research Institute (PCORI). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its Board of Governors or Methodology Committee. QVAR® and QVAR Redihaler® inhalers and support for the AssistRx pharmacy (Orlando, FL) were generously provided by Teva Branded Pharmaceuticals Products R&D, Inc. (Malvern, PA).

Paper cited: Israel E et al. “Reliever-triggered inhaled steroid in Black and Latinx adults with asthma” New England Journal of Medicine DOI: 10.1056/NEJMoa2118813.

ONC funds project to achieve semantic interoperability between diverse health systems using the Layered Schemas Architecture

Sept. 22, 2021

Researchers are continually challenged when they try to assemble large amounts of health data from various organizations. Healthcare information – such as the type that resides in electronic medical records or wearable devices – is recorded mostly for individual use by a single provider, organization, or healthcare sector. Pooling that information from multiple organizations is difficult because there’s no standard meaning or arrangements across different information systems.

The DARTNet Institute and their technology partner Cloud Privacy Labs were recently selected to attack this challenge. They received the Office of the National Coordinator for Health Information Technology’s (ONC) highly competitive 2021 Leading Edge Acceleration Projects in Health Information Technology (LEAP) Award for accelerating the use of electronic health data for research and artificial intelligence applications.

The Semantic Interoperability for Electronic Health Data Using the Layered Schemas Architecture project focuses on the process of semantic harmonization, which involves collating data from different formats and institutions into a singular consistent logical view without losing the local context and nuance of data elements. DARTNet and Cloud Privacy Labs will build and evaluate a data processing framework that enables the standardization and harmonization of EHR data collected from healthcare organizations that use different EHR systems and coding conventions. They will build the framework using the Layered Schemas Architecture (LSA) - an open-source technology developed by Cloud Privacy Labs. The ultimate goal of this project is to build a person-centric system that generates high quality health data sets to be used in clinical care, artificial intelligence training, and research.

About DARTNet:

The DARTNet Institute is a not-for-profit 501c3 corporation headquartered in Denver, CO. DARTNet was created to support collaboration between networks of clinicians, health systems, academic health centers, researchers, and patients looking to improve the use of existing electronic health data across the health care and health services research areas. DARTNet helps these stakeholders use existing electronic data and collects patient or staff reported data for research, quality improvement, clinical care and safety. DARTNet currently collaborates with over 5,500 clinical organizations across the country across our portfolio of activities, including over 5,000 that contribute EHR data for a Practice Performance Registry through vendor agreements, EHR data self-pull, or DARTNet-operated data extraction systems. DARTNet has recent EHR data sets that cover over 30 million people. Dr. Wilson Pace, Chief Medical and Technology Officer for DARTNet notes, “We have standardized data from dozens of systems and thousands of locations over the past decade and each one requires significant hands-on review, adjustments and fine tuning to achieve reasonable data quality. If the Layered Schema Architecture approach is successful that kind of work can be captured and re-used by others expeditiously and with greater accuracy with multiple final data models.”

About Cloud Privacy Labs:

Cloud Privacy Labs, LLC is a technology company based in Colorado founded with the idea that human centric data management needs to be integrated into all business processes to ensure respectful use of personal data and to empower individuals. Cloud Privacy Labs develops both commercial privacy products as well as open-source platforms that can be used in health information technology settings. Their flagship product, ConsentGrid, is a commercial consent management and privacy-conscious data exchange platform geared towards health information exchange organizations. Layered Schemas is an open framework for semantic interoperability with both open-source and commercially supported components. Dr Berrin Serdar, Co-founder of Cloud Privacy Labs indicates, “Currently there are many challenges that prevent efficient use and sharing of health care data. Layered Schemas Architecture is a unique tool that will help overcome these challenges and enable true semantic interoperability among multiple systems.”

About ONC and LEAP:

The Office of the National Coordinator (ONC) for Health Information Technology is organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS). ONC is the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. Since 2018, ONC has sponsored the Leading Edge Acceleration Projects (LEAP) in Health IT funding opportunity, which addresses well-documented and fast emerging challenges that inhibit the development, use, and/or advancement of well-designed, interoperable health IT. ONC has funded two to three LEAP awards each year that address different focus areas. Awardees of LEAP are usually funded for two years of research and technical efforts, with up to an additional three years of supplemental funding, if determined appropriate by ONC.

This project is supported by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS) under grant number 90AX0034, Semantic Interoperability for Electronic Health Data Using the Layered Schemas Architecture, total award $999,990 with 100% financed with federal dollars and 0% financed with non-governmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, not should any endorsements be inferred by ONC, HHS, of the U.S. Government.

Read Our First Quarter 2018 Newsletter

(February, 2018) Read our DI Newsletter (PDF) for updates on:

  • Registry Contract Renewals
  • ABMS MOC IV Certification
  • MIPS Reporting Deadlines
  • Registry Metric Timeline
  • Able Health MIPS Demo
  • Study Participation Opportunity
  • Patient Safety Registry
  • DI Spotlight: Trijoon Pradhan

Recent Publication from DI Study Identifies Deep Phenotypes Among Patients with Chronic Kidney Disease

Identifying phenotypic subtypes for chronic kidney disease (CKD) is important for improving risk stratification and providing more targeted therapy. A recent paper reports the results of DI study that found that a large dataset of EHRs can be used to identify deep phenotypes retrospectively. Read the paper and abstract.

 

DARTNet to facilitate research examining how an individual's genetic makeup and clinical decision support can guide medication choices

(December, 2016) The DARTNet Institute is now participating in a new partnership to support research combining the use of an individual's genetic makeup with that of a unique clinical decision support system to help guide medication choices in primary care settings. DARTNet will capture data for a study from patient medical records and collect patient-reported outcomes through questionnaires.

The partnership includes the American College of Clinical Pharmacy Research Institute and Tabula Rasa HealthCare (TRHC), which provides health care organizations with patient-specific, data-driven technology to optimize medication choices to improve patient outcomes, reduce hospitalizations, lower health care costs, and manage risk. questionnaires.

"DARTNet will provide the ability to use embedded data transfer systems from electronic health records to present detailed patient information to Tabula Rasa HealthCare and back to the treating clinicians - both clinical pharmacists and medical clinicians. DARTNet is excited about working with the ACCP PBRN and Tabula Rasa HealthCare to create a system that will allow other practices to consider this approach to medication prescribing," said Dr. Wilson Pace, Chief Medical Officer for the DARTNet Institute.

Read more about the project (PDF).

Findings of study by the comparative effectiveness research through collaborative electronic reporting group published in Pediatrics, with commentary and media coverage

(November, 2016, Updated February, 2017) A study from DI and the CER2 (Comparative Effectiveness Research through Collaborative Electronic Reporting) group, "Diagnosis and Medication Treatment of Pediatric Hypertension: A Retrospective Cohort Study" by Kaelber and colleagues, was published in Pediatrics. A commentary (Hill KD and Li JS. "Childhood Hypertension: An Underappreciated Epidemic?") was also published.

The Philadelphia Inquirer published an article about the findings.  

The study was also highlighted by the Eunice Kennedy National Institute of Child Health and Human Development.

The AAP News Research Update featured the story as well.