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Conducting Research Using the Electronic Health Record Across MultiHospital Systems: Semantic Harmonization Implications for Administrators

Bowles, Kathryn H. PhD, RN, FACMI, FAAN; Potashnik, Sheryl PhD; Ratcliffe, Sarah J. PhD; Rosenberg, Melissa BSN, RN; Shih, Nai-Wei MPhil, IMBA; Topaz, Maxim MA, RN; Holmes, John H. PhD, FACMI; Naylor, Mary D. PhD, RN, FAAN

Journal of Nursing Administration:
doi: 10.1097/NNA.0b013e3182942c3c

Administrators play a major role in choosing and managing the use of the electronic health record (EHR). The documentation policies and EHR changes enacted or approved by administrators affect the ability to use clinical data for research. This article illustrates the challenges that can be avoided through awareness of the consequences of customization, variations in documentation policies and quality, and user interface features. Solutions are posed that assist administrators in avoiding these challenges and promoting data harmonization for research and quality improvement.

Author Information

Author Affiliations: Professor and Ralston House Endowed Term Chair in Gerontological Nursing and Director of the Center for Integrative Science in Aging (Dr Bowles), Marian S. Ware Professor in Gerontology and Director of the NewCourtland Center for Transitions and Health (Dr Naylor), Research Project Manager (Dr Potashnik), Research Assistant (Ms Rosenberg), Research Administrative Coordinator (Ms Shih), and Doctoral Student (Mr Topaz), School of Nursing, University of Pennsylvania, Philadelphia; and Associate Professor of Medical Informatics in Epidemiology, Senior Scholar Center for Clinical Epidemiology and Biostatistics (Dr Holmes), and Associate Professor of Biostatistics and Epidemiology, Senior Scholar, Clinical Epidemiology and Biostatistics (Dr Ratcliffe), Perelman School of Medicine, University of Pennsylvania, Philadelphia.

The project described was supported by the National Institute of Nursing Research (award R01NR007674).

The authors declare no conflicts of interest.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.

Correspondence: Dr Bowles, University of Pennsylvania School of Nursing, Room 340, Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104 (

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