J Am Med Inform Assoc doi:10.1136/amiajnl-2013-001922

• Research and applications

Correlating electronic health record concepts with healthcare process events

1. George Hripcsak, 
2. David J Albers

+Author Affiliations

1. Biomedical Informatics, Columbia University, New York, New York, USA

1. Correspondence toDr George Hripcsak, Vivian Beaumont Allen Professor and Chair, Department of Biomedical Informatics, Columbia University Medical Center, 622 West 168th Street, VC5, New York, NY 10027, USA; hripcsak@columbia.edu

• Received 15 April 2013
• Revised 12 July 2013
• Accepted 5 August 2013
• Published Online First 23 August 2013

Abstract

Objective To study the relation between electronic health record (EHR) variables and healthcare process events.

Materials and methods Lagged linear correlation was calculated between five healthcare process events and 84 EHR variables (24 clinical laboratory values and 60 clinical concepts extracted from clinical notes) in a 24-year database. The EHR variables were clustered for each healthcare process event and interpreted.

Results Laboratory tests tended to cluster together and note concepts tended to cluster together. Within each of those two classes, the variables clustered into clinically sensible groupings. The exact groupings varied from healthcare process event to event, with the largest differences occurring between inpatient events and outpatient events.

Discussion Unlike previously reported pairwise associations between variables, which highlighted correlations across the laboratory–clinical note divide, incorporating healthcare process events appeared to be sensitive to the manner in which the variables were collected.

Conclusion We believe that it may be possible to exploit this sensitivity to help knowledge engineers select variables and correct for biases.

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