NURSING RESEARCH SEMINAR SERIES

Using CTSA Resources for Big Data Research, Scholarship, and Teaching  

Presented byConnie White Delaney, PhD, RN, FAAN, FACMI

Bonnie L. Westra, PhD, RN, FAAN, FACMI   

Monday, February 2, 2015Noon to 1:00 pm ♦ 4-130 WDH (Benson Center)

Objectives•Connect Clinical and Translational Science Award (CTSA) resources to facilitate your teaching and scholarship

•Explore a powerful emerging nursing and other health data set for research and teaching

Clinical and Translational Science Institutehttp://www.ctsi.umn.edu/

Rank order the top 3 wordsEstimate how many times were words repeated in

the CTSA RFA?• Stakeholder• Innovation• Collaboration• Engage/Engagement• Enterprise• Integrate/Integration

… Answer …

• Stakeholder - 10• Innovation - 40• Collaboration - 14• Engage/Engagement - 43• Enterprise - 9• Integrate/Integration - 35

The CTSI Research Supported Pipeline

Intro/Exposureto Research

Foundational Training

in Research

Training AwardPreparedness

Career Development in Research

Pathways to Independence

SUC

CES

S

Career Establishment

URPARP

ARPTRDP

K to R01Pre-KKL2TL1

Researchers & Users

Data Education

ServicesTools Community

• AHC IE Clinical Data Repository• i2b2 cohort-discovery tool• MN Death IndexIn process:• Dental EHR• Imaging; Center for Magnetic

Resonance Research (CMRR); clinical images

• UMN Biospecimen Enterprise Storage initiative & data: Enterprise storage initiative, BioMedical Genomics Center

• Generalist • Specialist \Informaticians

• IHI – MHI, MS and PhD• SON – DNP-NI, PhD-NI• SPH – MPH-Informatics• UMII Biomedical Informatics

& Computational Biology Graduate degrees

Informatics meeting your needs for data, resources, and collaborators

• Informatics Consulting Service

• AHC IS• CTSI Portal• Front Door

• Greater Plains Collaborative (PCORI)

• Hennepin County Medical Center (NSF grant)

• CTSA Collaborations

• CTMS• Experts@Minnesota• ResearchMatch• Redcap• Analytical tools• Natural Language Processing

MN Supercomputer Institute (MSI) Tunnel

In process:• Genotype/phenotype mapping

Researchers & Users

Data Education

ServicesTools Community

• AHC IE Clinical Data Repository• i2b2 cohort-discovery tool• MN Death IndexIn process:• Dental EHR• Imaging; Center for Magnetic

Resonance Research (CMRR); clinical images

• UMN Biospecimen Enterprise Storage initiative & data: Enterprise storage initiative, BioMedical Genomics Center

• Generalist • Specialist \Informaticians

• IHI – MHI, MS and PhD• SON – DNP-NI, PhD-NI• SPH – MPH-Informatics• UMII Biomedical Informatics

& Computational Biology Graduate degrees

Informatics meeting your needs for data, resources, and collaborators

• Informatics Consulting Service

• AHC IS• CTSI Portal• Front Door

• Greater Plains Collaborative (PCORI)

• Hennepin County Medical Center (NSF grant)

• CTSA Collaborations

• CTMS• Experts@Minnesota• ResearchMatch• Redcap• Analytical tools• Natural Language Processing

MN Supercomputer Institute (MSI) Tunnel

In process:• Genotype/phenotype mapping

Our Infrastructure capacity for big data

• Minnesota Super Computer Institute (MSI)• Access to supercomputers that meet high-performance computing needs for

advanced computation and scientific visualization

• Minnesota Population Center• Access to U.S. census data back to 1790 for the U.S., as well as data from 75

other countries• Technical expertise to support strong empirical orientation for large-scale data

analysis, geospatial analysis, and policy-relevant research

• Optum Labs partnership

Inter-CTSA collaborations

• Greater Plains Collaborative (10 sites) for the Patient-Centered Outcomes Research Institute (PCORI) award

– Leader in applying and sharing LOINC mappings for Labs

– Developed a common data model for demographic data

– First site to get PopMedNet client installed and functioning; the tool allows multiple sites to submit and receive queries

• NCATS Accrual to Clinical Trials – NCATS ACT leverages i2b2 across 13 CTSA sites– Our governance model is driving the ACT model

Inter-CTSA collaborations

• Midwest Area Research Consortium for Health (MARCH)

– Established multi-site IRB agreement– MARCH leverages i2b2

• UMN/Mayo CTSA– UMN is a national leader on extended clinical data

space– Sharing experience and expertise in SHRINE and i2b2

with Mayo

Our partnerships

• Minnesota Department of Health• E-Health: Public-private collaborative that aims to accelerate the adoption and

use of health information technology• Death Index: Key researcher resource that offers improved data quality, and is

updated weekly

• National Center for Interprofessional Practice and Education• Data from the nation’s only coordinating center is part of the Academic Health

Center Information Exchange

Providing support throughout the research tools & process

Define question

Participants & logistics Collect data Findings Share and

output Translate

Front Door

Experts@ Minnesota

i2b2 cohort-discovery tool

Research-Match

REDcap

Clinical Data Repository

Biospecimen repository

OnCore Clinical Trials Management System

Informatics Consulting Service

Analytical Tools (JMP, R, SAS, SPSS)

NLP

Standards Knowledge

representationData cleaning

Researchers & Users

Data Education

ServicesTools Community

• AHC IE Clinical Data Repository• i2b2 cohort-discovery tool• MN Death IndexIn process:• Dental EHR• Imaging; Center for Magnetic

Resonance Research (CMRR); clinical images

• UMN Biospecimen Enterprise Storage initiative & data: Enterprise storage initiative, BioMedical Genomics Center

• Generalist • Specialist \Informaticians

• IHI – MHI, MS and PhD• SON – DNP-NI, PhD-NI• SPH – MPH-Informatics• UMII Biomedical Informatics

& Computational Biology Graduate degrees

How BMI adds value and meets researchers needs for data, resources, and collaborators

• Informatics Consulting Service

• AHC IS• CTSI Portal• Front Door

• Greater Plains Collaborative (PCORI)

• Hennepin County Medical Center (NSF grant)

• CTSA Collaborations

• CTMS• Experts@Minnesota• ResearchMatch• Redcap• Analytical tools• Natural Language Processing

MN Supercomputer Institute (MSI) Tunnel

In process:• Genotype/phenotype mapping

IMPORTANCE AND AVAILABILITY OF DATA FOR RESEARCH AND TEACHING

Bonnie L. Westra, PhD, RN, FAAN, FACMI

Use of Clinical Data Sets

• Facilitate cross-study comparison of results• Enable aggregation of data from multiple

studies / sources – greater statistical power, detect weaker signals

• Speed study start up by selecting from existing data

• Improve replication and reproducibility• Find patients for recruitment into studies

cwd 2012

U of Minnesota AHC Information Exchange (AHC IE)

University of Minnesota AHC IE Platform2.3 M Patients5.6 Billion lines of data8 hospitals and 40+ clinical settings

65,597,327 18,478,842

785,879,618

1,939,232,775

59,924,418

1,402,423,830

88,364,370

397,546,666

368,473,93

4

46,367,516

439,081,234

2,263,847 26,068,675

UMN CDR - Rows of data

Reference

Accounts / Coverage

Medications

Procedures and Labs

Diagnosis

Flowsheets

Encounter

Encounter Chart

Patient Chart

Episodes

Notes

Patient

Interventions

Flowsheets

Flowsheet Example - Falls

Flowsheet Data

• Nursing and interprofessional– OT, PT, ST, Nutrition, SW

• Collected across settings – varies in use– ED, Clinic, Hospital, Rehab– Hospital – ICU, Peds, NICU, OB, Adult (generic)

Initial Framework Flowsheet Data

Example Respiratory Data

Example Skin/ Pressure Ulcers

EXAMPLES RESEARCH QUESTIONSTEACHING STRATEGIES

AHC-IE Services/ Resources

• Access to data – identified/ deidentified• Linking AHC-IE data to other data sets• De-identification of data• Data storage• Access to data analytic tools

• SAS, SPSS, Stata, R and Rstudio, MatLab, Microsoft Office, JMP Pro, EpiInfo

Sepsis & Diabetes• Evaluate whether use of EBP guidelines make a difference in

development of complications• Discover new interventions which lead to improvement in outcomes

and add to EBP guidelines• Determine if there are differences in use of EBP guidelines and

outcomes for health disparities• HCMC Epic data – mapping data based on FHS data in AHC-IE• Data storage/ analytic tools• Interprofessional team – Faculty & Students

• Computer Science - Michael Steinbach, Vipin Kumar, Pranjul Yadav, Andrew Hangsleben, Sanjoy Dey, Katherine Hauwiller, Kevin Schiroo

– School of Nursing - Bonnie L. Westra, Connie W. Delaney, Lisiane Pruinelli– Institute for Health Informatics - György J. Simon

Predictive Models for CAUTI

• Jung In Park, PhD-C• Requesting AHC-IE services

– EHR data from the UMN-TIDE and add in UMMC’s NDNQI Data

– De-identify MRN after matching CAUTI to hospitalizations

– Link unit level nurse staff characteristics to patients with CAUTI i.e. education, experience

– Data storage and use analytic tools

Predictors Liver Transplant Survival

• Lisiane Pruinelli, PhD Student• Transplant Information System• Requesting AHC-IE services

– Use of secure workbench - assures data remain secure

– Potentially de-identify dates (date shifting)– Access to analytic tools

Unanticipated ICU Admissions After Surgery

• Jessica Peterson, PhD Student• Examine anesthesia variables and patient

characteristics that predict unanticipated admission to ICUs

• AHC-IE Services– Exploring availability of data from UMN TIDE– Data storage– Use of analytic tools in secure workbench

Teaching Preparation of EHR Data for Research

• Participating in a CTSA pilot project (Lisa Pulkrabek, DNP Student)

• Assisting with mapping flowsheets to concepts in a clinical data model

• Learning how to apply national data standards for comparing data across CTSA sites

Discussion – Your Use of CTSI Resources

• Potential courses– Evidence-based practice– Quality improvement– Research– Specialty courses – data projects i.e. gero, psych, etc.

• Your research topic and potential use of data and other CTSI resources

Find Information on Data Access

z.umn.edu/clinicaldata

Data Set Access

NURSING RESEARCH SEMINAR SERIES

Using CTSA Resources for Big Data Research, Scholarship, and Teaching  

Presented byConnie White Delaney, PhD, RN, FAAN, FACMI

Bonnie L. Westra, PhD, RN, FAAN, FACMI   

Thank you