JAMA Viewpoint: EHR Systems Not Capable of Handling 'Big Data'


In a viewpoint published in the Journal of the American Medical Association, Justin Starren -- chief of the division of health and biomedical informatics in the department of preventive medicine at the Northwestern University Feinberg School of Medicine -- and co-authors write that current electronic health record systems are not sophisticated enough to handle the storage of "big data," United Press International reports.

Big data refers to large volumes of raw information, such as an individual's complete genome (United Press International, 4/3).

The viewpoint was co-authored by:

Current Challenges

In a statement, Starren notes that current EHR systems "are not designed to store large blocks of data that do not require rapid access, nor are they currently capable of integrating genomi[c] clinical decision support."

According to the viewpoint's authors, clinicians typically transfer only a small portion of relevant information from diagnostic tests to a patient's EHR. They note that this practice generally is not problematic because doctors rarely need to refer to previous testing data.

However, it is significantly more challenging to determine which information is relevant in genomic tests, the authors write.

Starren states, "Areas of DNA that were once considered genetic 'junk' are now known to play important roles in gene regulation and disease." He adds, "We need dynamic systems that can reanalyze and reinterpret stored raw data as knowledge evolves, and can incorporate genomic clinical decision support" (United Press International, 4/3).


The viewpoint's authors recommend that health care providers immediately begin implementing ancillary storage systems as an interim solution for storing big data.

Starren notes, "This approach adds value by providing a location to store variants of unknown significance until enough knowledge emerges to move these variants into clinical practice" (Feinberg School of Medicine release, 3/15).

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