1. A Brief Tour of UCSF’s Clinical
Data Sources and Resources
June 10, 2014
Informatics Day
Douglas Berman
Deputy Director Academic Research Systems

2. Informatics Day
• Tools and technology support researchers
in their work
• EHR data is available to support our
discovery mission
• Ensure our use of data is accurate,
understandable, secure, and protects
patient privacy
2

3. Overview
• What information resources are available?
• How can researchers use these
resources?
• Where you can learn about them today?
3

4. APeX
• Now in its third year as our primary clinical
documentation tool
• Data for over 440,000 patients
• Over 7 Million encounters (Epic
encounters are interactions between
patients and UCSF)
4

5. Integration of Systems
• APeX is highly integrated and will continue to
become more integrated
• 100 interfaces were built at go-live
• Additional integration in progress
• OnCore CTMS
• SalesForce
• Integration of clinical systems
• Supports patient care
• Improves business
• Creates rich data sets that are can support research
activities
• EDW
• Will create an environment to support analysis
5

6. Tools and data access
• APeX for researchers
• IDR and UC-ReX
• Research Data Browser
• APeX Reports
• Data Consultation Requests
• Sensei Program
6

7. Caché
Epic
Production
Server
Clarity
Microsoft
SQL Server
APeX
Reports

8. APeX Reports
• For users of APeX often linked to workflow
• Operational reports
• Radar Dashboards
• Reporting Workbench
• Crystal Reports
8

9. 9
Caché
Epic
Production
Server
Clarity
Microsoft
SQL Server
IDR
SQL Server
HIPAA LDSAPeX
Reports
MyResearch

10. IDR
10
• De-identified repository
allows identification and
sizing of cohorts
• Easy to use
• Embeds standard
ontologies (ICD, CPT,
RX-Norm)
• IDR
• 7 dimensions
• APeX data
• School of Dentistry data
Improved

11. 11
Caché
Epic
Production
Server
Clarity
Microsoft
SQL Server
IDR
UC ReX
SQL Server
HIPAA LDS
SHRINE
HIPAA LDS
APeX
Reports
UCSF UCSD
UCD UCI
UCLA
MyResearch

12. UC-ReX
12
• De-identified repository
allows identification and
sizing of cohorts
• Easy to use
• Embeds standard
ontologies (ICD, CPT, RX-
Norm) uniform across 5 UC
Medical Campuses
• UC-Rex
• 4-dimensions with consistent
meaning
• over 13-Million patients
• Trust and rely at IRB’s

13. 13
Caché
Epic
Production
Server
Clarity
Microsoft
SQL Server
IDR
UC ReX
SQL Server
HIPAA LDS
SHRINE
HIPAA LDS
APeX
Reports
Data
Extract
Request
UCSF UCSD
UCD UCI
UCLA
MyResearch

14. Data Consultation Requests
• Data is retrieved by an analyst through a
request.
• De-identified or identifiable with CHR-approved
Protocol
• SFGH Or APeX data
• The analyst assists in finding data and
providing an extract
• Often an interactive process
• Supports CTSI - Data Consultation Services &
SF Coordinating Center
• Data extracts, data analysis, study design,
participant recruiting, etc.
14

15. 15
Caché
Epic
Production
Server
Clarity
Microsoft
SQL Server
IDR
UC ReX
Cogito
Clinical Data
Warehouse
SQL Server
Research
Data
Browser
SQL Server
HIPAA LDS
SHRINE
HIPAA LDS
APeX
Reports
Data
Extract
Request
UCSF UCSD
UCD UCI
UCLA
MyResearch

16. Research Data Browser
• De-identified view of
APeX displayed
graphically
• Identify and characterize
populations of patients
• Based on Epic CDW
uses native APeX
terminology
• Web-based
• More information and
more complexity than
IDR or ReX
16
NEW!

17. 17
Caché
Epic
Production
Server
Clarity
Microsoft
SQL Server
IDR
UC ReX
Cogito
Clinical Data
Warehouse
SQL Server
Research
Data
Browser
SQL Server
HIPAA LDS
SHRINE
HIPAA LDS
APeX
Reports
Data
Extract
RequestSensei
Program
UCSF UCSD
UCD UCI
UCLA
MyResearch

18. Sensei Program
• Our Sensei are a community of data and
reporting experts who develop a deep
understanding of APeX and how our
workflows are reflected in data
• Program components:
• UCSF-specific training
• Regular learning sessions
• UCSF Data Wiki /
• Replaces Epic training – for select users
18

19. 19
Caché
Epic
Production
Server
Clarity
Microsoft
SQL Server
IDR
UC ReX
Cogito
Clinical Data
Warehouse
SQL Server
Research
Data
Browser
SQL Server
HIPAA LDS
SHRINE
HIPAA LDS
APeX
Reports
Data
Extract
RequestSensei
Program
UCSF UCSD
UCD UCI
UCLA
MyResearch

20. Methods compared
Method Ease of
use
Depth
of Data
UsesStandard
Terminology
Scope of
Data
Use Restrictions
IDR
▲▲ ▼ ▲▲
APeXandSchool
ofDentistry
Few (Data is
deidentified)
UC-ReX ▲▲ ▼ ▲▲
EHRfor5UC
MedCampuses
Few (Data is
deidentified)
Research
Browser
▲ ▲▼ ▲
APeXOnly Few (Data is
deidentified)
APeX
Reports
▲▲ ▲▼ ▲▼
APeXOperations As appropriate to
role
Data Extract
Service
▲ ▲▲
▲▼ EHRdata
APeX andSFGH
Identifiable with
approved protocol
Sensei
Program ▼ ▲▲▲ ▲▼
APeXOnly As appropriate to
role or w/ approved
protocol
20

21. The beginning…
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