A Longitudinal Analysis of Institutional Adoption, Use, and Dissemination of an EHR Vendor-Based Data Sharing Program

While health systems increasingly participate in real-world data sharing collaboratives, little is known about their empiric use. To examine one proprietary research collaborative in detail, administrative data from Cosmos research collaborative (Epic Corporation) was analyzed over 27 months through the end of 2023. An increasing number of organizations participated in Cosmos across geographic regions and organization types between Quarter 4 2021 and end of 2023 (152 to 229 total organizations "live" on Cosmos). While distinct users increased 3-fold over this time period, user engagement remained low, with between 0.25 to 0.21 projects on average per user per quarter. There was a trend toward increased number of logins and time using the platform over the study period. Through 2024 there have been 54 total publications referencing Cosmos. Although adoption is increasing for Cosmos, opportunities remain to improve cross-organizational data collaborative engagement for this and similar platforms.