Research Action for Health Network (REACHnet)* is based on a partnership between a fully operational Greater New Orleans Health Information Exchange (GNOHIE) run by the Louisiana Public Health Institute (LPHI), Pennington Biomedical Research Center's (PBRC) HarmonIQ data warehouse, and Tulane University clinical researchers. GNOHIE maintains and continuously updates a centralized clinical data repository that stores all information passing through the health information exchange, a data sharing infrastructure to facilitate care coordination across community-based clinics and currently one hospital system. The HarmonIQ data warehouse draws data from two major electronic health record (EHR) systems used within the Louisiana State University Health System. Both the GNOHIE and HarmonIQ accept, standardize, and validate health information from a multitude of EHR systems and have vast experience in sharing data across networks. In total, these systems currently have approximately 382,000 unique patients with full demographic and clinical information, approximately 210,000 in the GNOHIE and approximately 172,000 in HarmonIQ. Both systems have expansion strategies to collectively increase this number to approximately 1,000,000 unique patients in 18 months.
Louisiana has some of the worst health outcomes (and disparities) in the country and has a high prevalence of diabetes and obesity. LPHI and its partners have a rich background in translational research and clinical trials related to these conditions (and others). Pennington has extensive experience in designing and conducting various types of research studies, including analyses of retrospective data, prospective quasi-experimental designs, and prospective randomized clinical trials. Tulane University has conducted retrospective comparative effectiveness research (CER) studies utilizing a diverse assortment of data sources, including Veterans Affairs EHRs, commercial insurance claims, prospective observational databases, and randomized clinical trials. This three-way partnership will develop the capacity to serve as a national resource jointly with other CDRNs throughout the country. REACHnet provides a unique opportunity to study and test health system improvements and conduct CER in an underserved, safety-net population that faces significant environmental, socioeconomic, and health challenges.
The proposed network will advance the capacity to conduct efficient clinical research on two highly prevalent health conditions (obesity and diabetes), multiple associated comorbidities, sickle cell disease, and a group of 10 rare cancers. By conducting ongoing, broad recruitment across the partner health systems to build cohorts of patients with these diagnoses, REACHnet will improve access to these particular patients for prospective studies, and rich clinical and patient-reported data on these specific health conditions to facilitate efficient and robust clinical research.
REACHnet will be a significant socio-technical advancement in CER. The project will provide a large volume of comprehensive, longitudinal, and up-to-date clinical data on a diverse, statewide patient population. The project will also employ innovative technologies in the routine collection of patient-reported data both within and outside the clinical setting. The availability of this innovative data resource will enhance the efficiency and effectiveness of clinical research that will ultimately improve healthcare delivery and health outcomes within and beyond the network's patient population. By actively and continuously engaging patients, clinicians, and health systems leadership in REACHnet governance, design and implementation, the network will be a patient-centered, community-based resource that prioritizes and facilitates clinical research that reflects and addresses patients' needs and is conducted congruously with healthcare delivery.
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^Anjum Khurshid, PhD, MD, MPA, was the original principal investigator for this project.