Pediatric Research in Inpatient Settings Network

Project Summary

The objective of the PHIS+ project is to build on the existing infrastructure provided by Child Health Corporation of America (CHCA)--a business alliance networking 43 of North America's leading children's hospitals--to augment its existing database with laboratory and radiology data for children seen in the ambulatory and inpatient departments of 6 large children's hospitals. The existing database, called the Pediatric Health Information System (PHIS), is a comprehensive pediatric database containing clinical and financial details of more than six million patient cases. The enhanced database, called PHIS+, will provide a rich data source for academic clinicians to answer in real time the comparative effectiveness questions that affect hospitalized children, thereby significantly enhancing the quality and scope of pediatric comparative effectiveness research.

Objectives

  1. To develop the infrastructure for accurately and reliably performing quarterly downloads of laboratory results and radiology reports from 6 CHCA-member children's hospitals into the existing Pediatric Health Information System (PHIS).
  2. To demonstrate the utility of the PHIS+ database in the performance of multiple comparative effectiveness research studies. The hospitals collaborating on this proposal are national leaders in the use of electronic medical records and will provide highly accurate and complete clinical data collected as a routine part of clinical care.

This work will build the data platform needed to make advances in the following 4 areas:

  1. Make the most efficient use of our diagnostic armamentarium (i.e. laboratory testing and imaging studies) to predict outcomes, select appropriate interventions, and improve the health status of hospitalized children
  2. Apply state-of-the art observational study design and analysis to existing data in administrative and clinical databases in to evaluate therapeutic, prognostic, and diagnostic strategies for conditions for which randomized controlled trials are not feasible
  3. Perform economic evaluations of inpatient management strategies to inform resource allocation and, coupled with outcomes measurement, better understand value
  4. Develop quality measures and severity adjustment tools to study inpatient quality (comparing hospitals, providers, systems) across multiple institutions using large administrative and clinical databases

The PHIS+ project will use an existing robust computational infrastructure—The Federated Utah Research and Translation Health electronic Repository (FURTHeR)—to link data from 6 children's hospitals (with the potential to expand to more) and sites of care (inpatient, outpatient, Emergency Department, Day Surgery) and conduct meaningful comparative effectiveness research in several AHRQ priority areas for several AHRQ priority populations, including children, children with multiple co-morbidities, minorities, and those from lower socioeconomic status.

Funding

The Agency for Healthcare Research and Quality (AHRQ) has funded $8,693,362 for this 3-year project.