The North Carolina Translational and Clinical Sciences (NC TraCS) Institute recently awarded their first round of awards from the Carolinas Collaborative pilot program to two multi-institutional teams of researchers whose teams are now up and running, working with electronic health record data in innovative ways, with the goal of advancing clinical research. The new grants, known as the "Carolinas Collaborative" awards, are designed to generate new knowledge and improve the quality of care delivered to patients in the Carolinas.

North and South Carolina now house four of these CTSA hubs, the academic homes of the National Institutes of Health's (NIH) Clinical and Translational Science Awards (CTSAs). These hubs are located at Duke University, the Medical University of South Carolina, as well as the University of North Carolina at Chapel Hill (UNC), and Wake Forest University.

Recently, four of the over 60 Clinical and Translational Science Awards (CTSA) Institutions across the states, partnered with Health Sciences South Carolina (HSSC) to create the Carolinas Collaborative, a data resource that harmonizes electronic health record (EHR) data across the institutions to expedite clinical research and quality improvement. The new awards from NC TraCS, the CTSA hub at the University of North Carolina at Chapel Hill, are designed to encourage collaborations amongst these National Institutes of Health (NIH) Programs that apply and accelerate discovery into testing in clinical and population settings.

The Carolinas Collaborative is part of a larger movement to transform our health care systems into ones that continuously learn with our patients and deliver the best care possible.
— Tim Carey, MD, MPH

"In the past, progress has been hindered by studies that took too long, studied too few patients, did not include patients who were from underserved groups, and were too expensive," said Tim Carey, MD, MPH Co-Principal Investigator of the NC Translational and Clinical Sciences (NC TraCS) Institute, home of UNC's CTSA. "The Carolinas Collaborative is part of a larger movement to transform our health care systems into ones that continuously learn with our patients and deliver the best care possible. These projects reflect some of the most ambitious realizations of that effort."

One of the funded projects, "Harmonization of Patient-Reported Outcomes Across Four CTSAs: Leveraging EHRs to Enable Comparative Effectiveness Research to Improve the Quality of Cancer Care," will study the feasibility of collecting a common set of patient-reported outcome measures in routine cancer care across four healthcare systems. The project will harmonize patient-reported outcomes across four electronic health record systems (EHRs) and also to the PCORnet Common Data Model. The identification and management of symptoms experienced during cancer treatment is important, but not symptoms may not be routinely collected in clinical care. Thus, collecting a core set of measures across health systems will improve the quality of symptom management in cancer care and facilitate the use of these data for comparative effectiveness research. The project will be the first effort across CTSAs to collect and harmonize a standard set of patient-reported outcome measures across EHRs.

The study is led by Arlene Chung, MD, MHA, MMCi, Assistant Professor of Medicine and Pediatrics at UNC; Thomas LeBlanc, MD, Assistant Professor of Medicine at Duke; Phil Smeltzer, PhD, Assistant Professor at Medical University of South Carolina, and Lynne Wagner, PhD, Professor of Social Sciences and Health Policy at Wake Forest. The research team includes: Ethan Basch, MD, MSc, Bryce Reeve, PhD, and Angela Stover, PhD from UNC; Leah Zullig, PhD, and Yousuf Zafar, MD, MHS from Duke; and Umit Topalaglu, PhD and Brian Wells, MD, PhD from Wake Forest.

The other funded project will lay the groundwork for implementing a new decision support tool for chest pain across the Carolinas Collaborative Health systems. While over 50 percent of patients presenting with chest pain are hospitalized, less than 10 percent are ultimately diagnosed with acute coronary syndrome. Wake Forest has achieved great success with its HEART pathway, an EHR-based tool that provides real-time decision support to its providers. This project will explore the feasibility of disseminating the tool to other systems in the region.

The research team includes Abhishek Mehrotra, MD, Associate Professor of Emergency Medicine at UNC; Alexander Limkakeng, MD, Associate Professor of Emergency Medicine at Duke; Christine Carr, MD, Associate Professor of Emergency Medicine at MUSC; and prinicipal investigator: Simon Mahler, MD, Associate Professor of Emergency Medicine at Wake Forest.

Research teams can request patient counts or sets of EHR data from the Carolinas Collaborative institutions. The Collaborative offers additional support to researchers through early-stage consults and support in finding collaborators at other Collaborative institutions. For information about current Carolinas Collaborative projects, working with Collaborative and other clinical data research networks: tracs.unc.edu/cdrn.