Creating a Learning Health System in a Cancer Center: Generalizability of an Electronic Health Record Phenotype for Advanced Solid Cancer

Anne M Walling ^1,2,3, Karl A Lorenz ^3,4,5, Anita Yuan ¹

⁰VA Greater Los Angeles Health System, Los Angeles, CA.

Jco Oncology Practice +

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October 10, 2024

View abstract on PubMed

Summary

An electronic health record (EHR) phenotype accurately identifies advanced cancer patients across different healthcare settings. This tool can enhance palliative care quality for cancer patients.

Area Of Science

Oncology
Health Informatics
Palliative Care Research

Background

Electronic Health Records (EHRs) are crucial for patient data management.
Developing accurate methods to identify patients with advanced cancer is essential for targeted care.
Previous EHR phenotypes for advanced cancer were validated in single institutions.

Purpose Of The Study

To assess the generalizability of a previously developed EHR phenotype for advanced solid cancer patients.
To validate the EHR phenotype in diverse healthcare settings, including the Veterans Health Administration (VA) and an academic cancer center.

Main Methods

A comparative study was conducted between January 1, 2016, and December 31, 2019.
An EHR algorithm for identifying advanced solid cancer patients was compared against a human-coded reference standard.
The study included a random sample of patients with active cancer from the VA and an academic cancer center.

Main Results

The EHR algorithm demonstrated high specificity (93% in VA, 97% in academic center) and reasonable sensitivity (85% in VA, 87% in academic center).
Patients with advanced cancer exhibited significantly higher 6-month mortality rates (29.2% in VA, 17.0% in academic center) compared to non-advanced cancer patients (6.8% in VA, 3.5% in academic center).

Conclusions

The validated EHR phenotype is effective for identifying advanced cancer patients across different healthcare systems.
This EHR phenotype can be utilized to measure and enhance the quality of palliative care for advanced cancer patients.
The findings support the use of EHR data for improving cancer care quality in various healthcare settings.

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