Cerner real-world data (CRWD) - A de-identified multicenter electronic health records database.

Cerner Real-World Data TM (CRWD) is a de-identified big data source of multicenter electronic health records. Cerner Corporation secured appropriate data use agreements and permissions from more than 100 health systems in the United States contributing to the database as of March 2022. A subset of the database was extracted to include data from only patients with SARS-CoV-2 infections and is referred to as the Cerner COVID-19 Dataset. The December 2021 version of CRWD consists of 100 million patients and 1.5 billion encounters across all care settings. There are 2.3 billion, 2.9 billion, 486 million, and 11.5 billion records in the condition, medication, procedure, and lab (laboratory test) tables respectively. The 2021 Q3 COVID-19 Dataset consists of 130.1 million encounters from 3.8 million patients. The size and longitudinal nature of CRWD can be leveraged for advanced analytics and artificial intelligence in medical research across all specialties and is a rich source of novel discoveries on a wide range of conditions including but not limited to COVID-19.

HealtheDataLab - a cloud computing solution for data science and advanced analytics in healthcare with application to predicting multi-center pediatric readmissions.

BACKGROUND: There is a shortage of medical informatics and data science platforms using cloud computing on electronic medical record (EMR) data, and with computing capacity for analyzing big data. We implemented, described, and applied a cloud computing solution utilizing the fast health interoperability resources (FHIR) standardization and state-of-the-art parallel distributed computing platform for advanced analytics. METHODS: We utilized the architecture of the modern predictive analytics platform called Cerner® HealtheDataLab and described the suite of cloud computing services and Apache Projects that it relies on. We validated the platform by replicating and improving on a previous single pediatric institution study/model on readmission and developing a multi-center model of all-cause readmission for pediatric-age patients using the Cerner® Health Facts Deidentified Database (now updated and referred to as the Cerner Real World Data). We retrieved a subset of 1.4 million pediatric encounters consisting of 48 hospitals' data on pediatric encounters in the database based on a priori inclusion criteria. We built and analyzed corresponding random forest and multilayer perceptron (MLP) neural network models using HealtheDataLab. RESULTS: Using the HealtheDataLab platform, we developed a random forest model and multi-layer perceptron model with AUC of 0.8446 (0.8444, 0.8447) and 0.8451 (0.8449, 0.8453) respectively. We showed the distribution in model performance across hospitals and identified a set of novel variables under previous resource utilization and generic medications that may be used to improve existing readmission models. CONCLUSION: Our results suggest that high performance, elastic cloud computing infrastructures such as the platform presented here can be used for the development of highly predictive models on EMR data in a secure and robust environment. This in turn can lead to new clinical insights/discoveries.