Current Implementation of Electronic Health Record System

The past decade has seen a dramatically increased propagation of electronic health records (EHRs) in the United States. This phenomenon was largely promoted through large US government-initiated programs to encourage the adoption of EHRs in routine practice (eg, Meaningful Use, Certification Commission for Health Information Technology; inducements in the Affordable Care Act; Health Information Technology for Economic and Clinical Health Act in 2009; and the mandatory submission of quality measures electronically). Although certain benefits of EHRs are undeniable, they are most often designed and implemented with the administrative end-user in mind. In most cases, a system with a focus on administration, with streamlined billing and coding features, is not adapted for the assimilation of research data. Coincidentally, this same system contains a plethora of social, demographic, and medical information on thousands of patients in one location and is quite possibly one of the largest underutilized resources in modern medical research. However, at the time of the cusp of the COVID-19 pandemic, many health care facilities, including our own, lacked EHR add-ons that would allow for a rapid assimilation of research datasets. As the COVID-19 pandemic ensued, our research infrastructure faced an unprecedented need for validated datasets to support clinical trials and observational studies. Hence, to support research activities based on EHR, the RRTF decided to set up the Houston Methodist CURATOR. The goal of CURATOR is to serve as a unified, longitudinal, cross-institutional registry for COVID-19 data, to fulfill ongoing and long-term observational research data needs and enable availability of data for planning of prospective clinical trials.