Universal Data Store
The Universal Data Store (UDS) is a new supporting infrastructure data warehouse that serves as a broker to capture, save and annotate messages from a variety of clinical systems internal and external to the CERNER electronic medical record. It permits replay of data and thus provides the flexibility to add data elements as needed. The UDS performs automated distribution of annotated data to downstream systems and operates as the primary data source for Automated Cancer Extraction (ACE) application system and Clinical Trials Eligibility Database (CTED). The UDS represents a superset of data including all patients seen at VCU Health System and against which queries may be run directly or through the CTED Automated Matching Tool (AMT). The electronic data captured in the UDS and available for CTED, ACE and for integration with the Massey Cancer Center Information System (MCCIS) are provided in formats available in most health care settings (i.e. HL7 text message formats and 837-formatted claims). Text documents maintained include: pathology reports, discharge summaries, operative notes, radiology reports, and clinic dictation notes. These provide essential information such as detailed histopathologic information from surgical pathology, outcomes such as metastatic occurrence from radiology dictations, and clinical note dictations on all patient visits utilized in supporting investigators. Discrete data from billing are incorporated from all claims, and represent information on comorbidity, detailed treatment and prior cancer diagnoses. Other discrete data include clinical laboratory test results such as tumor markers, and measures of organ system function. The latter provide important information related to specific eligibility criteria used in preparatory to research identification of patients. As the most immediate needs for the UDS data was for clinical trials assessment (requiring IRB approval) and cancer surveillance (HIPAA exempt), which require patient identifiers, no automated de-identification process is currently in place. However, a major focus of the next evolutionary phase of the Cancer Research Informatics and Services Core is to create an Honest Broker system to expand the direct availability and access to de-identified data to a broader range of investigators.