Background: The Distributed Ambulatory Research in Therapeutics Network (DARTNet) is a federated network of electronic health record (EHR) data, designed as a platform for next-generation comparative effectiveness research in real-world settings. DARTNet links information from nonintegrated primary care clinics that use EHRs to deliver ambulatory care to overcome limitations with traditional observational research.
Objective: Test the ability to conduct a remote, electronic point of care study in DARTNet practices by prompting clinic staff to obtain specific information during a patient encounter.
Research Design: Prospective survey of patients identified through queries of clinical data repositories in federated network organizations. On patient visit, survey is triggered and data are relinked to the EHR, de-identified, and copied for evaluation.
Subjects: Adult patients diagnosed with diabetes mellitus that scheduled a clinic visit for any reason in a 2-week period in DARTNet primary care practices.
Measures: Survey on hypoglycemic events (past month) and over-the-counter and herbal supplement use.
Results: DARTNet facilitated point of care data collection triggered by an electronic prompt for additional information at a patient visit. More than one-third of respondents (33% response rate) reported either mild (45%) or severe hypoglycemic events (5%) in the month before the survey; only 3 of those were also coded using the ICD-9 (a significant difference in detection rates 37% vs. 1%). Nearly one-quarter of patients reported taking an OTC/herbal, 4% specifically for the treatment of symptoms of diabetes.
Conclusions: Prospective data collection is feasible in DARTNet and can enable comparative effectiveness and safety research.
From the *University of Colorado School of Pharmacy, Denver, CO; †University of Colorado School of Medicine, Denver, CO; ‡American Academy of Family Physicians, Denver, CO; §Peak Statistical Services, Evergreen, CO; and ¶QED Clinical Inc., dba CINA, Dallas, TX.
Reprints: Anne M. Libby, PhD, 12631 E. 17th Ave., C238-L15, Academic Office 1, University of Colorado School of Pharmacy, Aurora, Colorado. E-mail: firstname.lastname@example.org.