NURSING RESEARCH SEMINAR SERIES Using CTSA Resources for Big Data Research, Scholarship, and Teaching Presented by Connie White Delaney, PhD, RN, FAAN, FACMI Bonnie L. Westra, PhD, RN, FAAN, FACMI Monday, February 2, 2015 Noon to 1:00 pm ♦ WDH (Benson Center)

Sponsored by the Office of Nursing Research and Scholarship 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 Institute

Rank order the top 3 words Estimate 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/Exposure to Research Foundational Training in Research Training Award Preparedness Career Development in Research Pathways to Independence SUCCESS Career Establishment

Researchers & Users DataEducationServicesToolsCommunity AHC IE Clinical Data Repository i2b2 cohort-discovery tool MN Death Index In process: Dental EHR Imaging; Center for Magnetic Resonance Research (CMRR); clinical images UMN Biospecimen Enterprise Storage initiative & data: Enterprise storage initiative, BioMedical Genomics Center AHC IE Clinical Data Repository i2b2 cohort-discovery tool MN Death Index In 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 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 Informatics Consulting Service AHC IS CTSI Portal Front Door Greater Plains Collaborative (PCORI) Hennepin County Medical Center (NSF grant) CTSA Collaborations Greater Plains Collaborative (PCORI) Hennepin County Medical Center (NSF grant) CTSA Collaborations CTMS ResearchMatch Redcap Analytical tools Natural Language Processing MN Supercomputer Institute (MSI) Tunnel In process: Genotype/phenotype mapping CTMS ResearchMatch Redcap Analytical tools Natural Language Processing MN Supercomputer Institute (MSI) Tunnel In process: Genotype/phenotype mapping

Researchers & Users DataEducationServicesToolsCommunity AHC IE Clinical Data Repository i2b2 cohort-discovery tool MN Death Index In process: Dental EHR Imaging; Center for Magnetic Resonance Research (CMRR); clinical images UMN Biospecimen Enterprise Storage initiative & data: Enterprise storage initiative, BioMedical Genomics Center AHC IE Clinical Data Repository i2b2 cohort-discovery tool MN Death Index In 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 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 Informatics Consulting Service AHC IS CTSI Portal Front Door Greater Plains Collaborative (PCORI) Hennepin County Medical Center (NSF grant) CTSA Collaborations Greater Plains Collaborative (PCORI) Hennepin County Medical Center (NSF grant) CTSA Collaborations CTMS ResearchMatch Redcap Analytical tools Natural Language Processing MN Supercomputer Institute (MSI) Tunnel In process: Genotype/phenotype mapping CTMS 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 dataFindings Share and output Translate Front Door Minnesota i2b2 cohort- discovery tool Front Door Minnesota i2b2 cohort- discovery tool Research- Match REDcap Research- Match REDcap Clinical Data Repository Biospecimen repository Clinical Data Repository Biospecimen repository OnCore Clinical Trials Management System Informatics Consulting Service Analytical Tools (JMP, R, SAS, SPSS) NLP Analytical Tools (JMP, R, SAS, SPSS) NLP Standards Knowledge representation Data cleaning Standards Knowledge representation Data cleaning

Researchers & Users DataEducationServicesToolsCommunity AHC IE Clinical Data Repository i2b2 cohort-discovery tool MN Death Index In process: Dental EHR Imaging; Center for Magnetic Resonance Research (CMRR); clinical images UMN Biospecimen Enterprise Storage initiative & data: Enterprise storage initiative, BioMedical Genomics Center AHC IE Clinical Data Repository i2b2 cohort-discovery tool MN Death Index In 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 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 Informatics Consulting Service AHC IS CTSI Portal Front Door Greater Plains Collaborative (PCORI) Hennepin County Medical Center (NSF grant) CTSA Collaborations Greater Plains Collaborative (PCORI) Hennepin County Medical Center (NSF grant) CTSA Collaborations CTMS ResearchMatch Redcap Analytical tools Natural Language Processing MN Supercomputer Institute (MSI) Tunnel In process: Genotype/phenotype mapping CTMS 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 Platform 2.3 M Patients 5.6 Billion lines of data 8 hospitals and 40+ clinical settings 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 QUESTIONS TEACHING 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 by Connie White Delaney, PhD, RN, FAAN, FACMI Bonnie L. Westra, PhD, RN, FAAN, FACMI