A New Approach to Research Support Tracking: The Research Record System

1. A New Approach to Research Support Tracking:The Research Record System Peter J. Embi, MD, MS Biomedical Informatics DirectorCenter for Clinical and Translational Science and Training (CCTST)University of Cincinnati Academic Health Center, Cincinnati, Ohio Third Annual Clinical Research Management Workshop Bethesda, MD June 22, 2010

2. Background • Clinical and translational researchers need to access resources and expertise ranging from: • administrative and regulatory to materials, to methods, to biostatistical and informatics services. • AHCs are creating consultation or concierge services to coordinate resources and optimize utilization • Centers that coordinate these resources have begun to develop research support portals for • Requesting/Accessing services • To track utilization, among other metrics. • Formal frameworks for developing such systems lacking

3. Background • As such programs and services increase, systems for tracking and managing resource requests are required • We recognized early the need for driving paradigm to guide development • We were going in different directions • Without a driving paradigm, risk not developing effective process…

4. Methods: Development of RRS • Key faculty/staff of the Cincinnati Center for Clinical and Translational Science and Training (CCTST), involved: • Selected members of the BMI, biostat, and related programs to agree on paradigm • We settled on provider-patient paradigm to guide us • Focused on key outcomes related to investigator “health”, and our information collection needs, akin to “billing” etc. • Guided by metaphor that: • researcher-methodologist relationship is analogous to the patient-healthcare provider relationship • We judged all development decisions against this paradigm • Healthcare paradigm informed development of an EMR-analog, a Research Record System to manage information

5. Result: Research Record System • Iterative design process led to creation of Web-based intake and research-record system • The RRS is analogous to an Electronic Medical Record (EMR) and includes the ability to: • document and manage initial intake requests and assessments (or diagnostic visits) between a researcher and a research methodologist • notes from support personnel (progress notes) • facilitate referrals to researcher resources external to the CCTST (referrals to a specialist) • Enable tracking of information about request in single continuity record • Novel software development, and integration with existing resources like open-source ticket-tracking system to enable • Spawning and tracking of referrals from within the RRS • Capture of resultant interactions with specialists external to CCTST but related to a given research request.

6. Research Central System and Process • CCTST programmers developed the version 1.0 of the RRS, Sep 2008 • Research Central Intake process established • Basic intake form developed by methodology group • Single progress note interface with ability to send “consults” through integration with existing ticketing system • Initial process diagram shown

7. Research Central RRS: User Evaluation: Methods • Between Sep 2008 and Nov 2009: • 183 investigators from across our AHC and region have been processed through the RRS. • Following initial period, Web-based survey of researcher-user population • 50 investigators eligible • More than 2-months experience with the system • Had used it in the past 4 months • Results descriptively analyzed • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

8. Research Central RRS: User Evaluation: Results • 52% response rate • Respondents representative of larger population • Overall satisfaction with the efficiency and utility of the support received was good • e.g. 92% indicating they would use the service again • Selected additional results follow… • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

9. Investigator Survey of RC • How quickly were you contacted after you completed the request on research Central? • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

10. Investigator Survey of RC • The consultants coordinated my access to services: • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

11. Investigator Survey of RC • The services I received met my expectations: • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

12. Investigator Survey of RC • The timeliness of the services I received was: • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

13. Investigator Survey of RC • How was your initial consultation done? • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

14. Investigator Survey of RC • The services improved my research: • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

15. Investigator Survey of RC • Overall consultant experience: • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

16. Investigator Survey of RC • How likely are you to use Research Central in the future? • Embi PJ, Lindsell C, et al. Proc AMIA Summits on Translational Informatics, March, 2010

17. Research Central – version 2.0 • In addition to querying users, worked with methodologists, started RRS revision process • Group discussions about how to modify/ improve RRS system • Collaboration to inform specs for v2.0 • Main stakeholders: • BioMETrCS group (Biostat, Ethics, Methodology group) - The “Primary Care Providers” in our RC system who mainly use RRS • Evaluation group – who assessed and knew what information we needed to track key metrics for CCTST • CCTST Research Informatics group – experts in information system design and designing IT to workflow

18. Research Central – version 2.0 • Major process changes: • Simplify intake form that Investigators complete • Creation of on-call system of methodologists to immediately assign project to methodologist within 1 working day • Assign staff member to monitor and ensure response and documentation by methodologists • All informed changes to RRS

19. Research Central – version 2.0 • RRS System changes • Ability to assign and track methodologist interaction with investigators with date/time, workflow at key points • Further refined to enable more systematic data collection in RRS, more like EMR • Document and manage initial intake requests and assessments (or diagnostic visits) between a researcher and a research methodologist • H&P equivalent for “intake”, followed by periodic progress notes • Notes from support personnel (progress notes) • More flexible and customized consultation system • Some use RT ticketing, others email (use what works for groups) • Enable tracking of information related to research request in a single continuity record

20. Refined Research Central/ Research Record Process • Resultant workflow follows basic process:

21. Support Request Form

22. Support Request Form

24. RRS Main Menu

26. RRS Main Menu

27. RRS – Initial Intake Items

28. RRS Main Menu

31. RRS – Previous Notes View

32. RRS – Associated Files, Tickets

33. RRS – Canned Reports

34. Next Steps • 340 Investigators Served as of June 18 • Assess usage and capture of relevant data from RRS • Evaluate methodologist, consultant perceptions of RRS • Reassess Investigator perceptions • Integrate with other data sources to track “Investigator outcomes” akin to “patient outcomes” • Further enhance system based on user feedback • Make RRS available as open-source solution • Initially integrated into Drupal CMS – in progress • Consortium to work on development, enhancements

35. Conclusions • A Research Record System (RRS) based on an EMR metaphor with a researcher-methodologist dyad mirrors the patient-healthcare provider dyad • System designed to this paradigm yielded early efficiencies and widespread satisfaction from the researchers in the first year since its launch. • Further study of the RRS’ impacts, including its impact on hard outcomes including researcher productivity are indicated and planned for the future

36. Thanks • Acknowledgements: • NIH/NCRR (UL1RR026314-01) • Cincinnati CCTST collaborators

37. Extra Slides

38. RRS – Initial Intake Items