From clinics to discoveries: harnessing national EHR interoperability for research

Objectives To assess whether existing nationwide Health Information Networks (HINs) and Health Information Exchanges (HIEs) can be leveraged for electronic health record (EHR) data acquisition for research—specifically, for the NIH’s All of Us Research Program. Materials and Methods The All of Us Center for Linkage and Acquisition of Data (CLAD) collaborated with eHealth Exchange, the nation’s largest HIN, to transmit participant-authorized queries to an HIE and a hospital system. Returned FHIR and C-CDA records were mapped to the OMOP Common Data Model and compared with existing All of Us EHR data. Results Newly obtained records provided complementary information, enhancing completeness and research utility. Discussion This pilot demonstrates the feasibility of using HINs/HIEs for patient-authorized data exchange for research. Barriers remain—including inconsistent technical capacity to transact authorizations and data quality variations. Conclusion HINs and HIEs can support secure, patient-authorized EHR exchange for research, offering a pathway to more comprehensive, participant-driven biomedical discovery.