Are electronic health record big data ready for secondary use in research? Exploring potential limitations with opioids as a case study.

Healthcare big data has raised expectations for secondary use in research and information-based management. This case study explores limitations of using electronic health record (EHR) data from a hospital data lake by deriving indicators on opioid prescribing. A multi-staged method to calculate indicators of rational opioid use was developed covering both inpatient orders and outpatient prescriptions. The process included data selection, editing, organization, and validation. Visual Basic was employed to calculate indicators and to semi-quantify data limitations. Data (2015-2019) covered 3.3 million patients with 179,853 opioid and 22,415 benzodiazepine orders. Data quality issues, including unstructured, irregular, and invalid entries, limited analysis to indicators on opioid use and contraindications. In conclusion, secondary use should be considered in EHR system development. Data should be recorded in structured and unambiguous format, and methods for data quality measurement should be developed to ensure high-quality data is readily available in data lakes.