Data to Knowledge Analysis
University of Maryland
April 26, 2015
Data to Knowledge Analysis
It is estimated that at least 94% of the U. S. population have at least one cardiovascular/stroke risk factor, with major risk factors (diabetes, hypertension, hyperlipidemia, smoking, obesity) in at least 38% (Roger, et al., 2012). The presence of peripheral arterial or carotid disease detected during community cardiovascular screening changes risk stratification. Evidence-based treatment guidelines, such as aspirin and statin use can be implemented in those with risk factors to minimize the risk of a life threatening or debilitating health event such as myocardial infarction ...view middle of the document...
The DTC program owns the data and volunteers enter the data as the patient is being screened. The screening data is reviewed by a health care provider (MD, NP or PA), risk stratification category is assigned and recommendations are provided for risk reduction or further testing. The data will be analyzed to determine: those who were found to have risk factors and not on evidence-based interventions (aspirin and statins); and to identify those who do not have significant cardiovascular risk factors but are found to have subclinical carotid disease by ultrasound and not on aspirin/statins.
Centricity EHR and EPIC EHR are office-based and hospital-based systems, respectively that may be helpful in researching missing data, identifying medications prescribed by outpatient physicians and assessing risk factor self-report accuracy. Centricity is owned by MedStar Health and EPIC is owned by Anne Arundel Medical Center. The data is entered by a multitude of health care providers across both systems involved in both direct and indirect patient care, billing and diagnostic testing. These data systems would be utilized as supplemental data sources.
The DTC database contains personal and health data that are not initially de-identified, therefore, the data should be treated as subject HIPPA privacy rules, which “provides individuals with certain rights about how their health information is used and disclosed as well as how they can gain access to health records and information about when their PHI was released without their permission” (National Institute of Health, 2015). Partial de-identification of the data will be possible but complete de-indentification will not be conducive to the project as there may be a need to contact subjects after screening. Providing a clear, concise explanation of how the data will be used to answer the research question provides informed consent and protects subjects’ rights to allow data to be used and protects their right of withdrawal of that consent at anytime. Determination of need for an Institutional Review Board (IRB) review of the project would be necessary to ensure compliance with all federal, institutional and ethical guidelines of human research.
Social implications of data access both internally (DTC) and externally (MedStar and AAMC) would include potential identification of social determinants of health based upon data analysis. There is great potential of identifying at risk subjects and the relationships of their social and economic situation to their current health and potential barriers to risk factor modification in the future. This information has potential to impact the population health of communities.
It is imperative to adopt a data protection plan, which will include: identification of who will have access to data, who is maintaining confidentiality of data, describing measures to protect the physical security and software security of the data, providing authentication and...