Grand Rounds October 17, 2025: Making Effective Use of Data Infrastructure in PCORnet® (Charles Bailey, MD, PhD; Keith Marsolo, PhD)

Speakers

Charles Bailey, MD, PhD
Department of Pediatrics
Perelman School of Medicine
University of Pennsylvania
Biomedical and Health Informatics
Children’s Hospital of Philadelphia

Keith Marsolo, PhD
Associate Professor
Department of Population Health Sciences
Duke Clinical Research Institute
Duke University School of Medicine

Keywords

PCORnet®; Data; Clinical Research Network; Patient-Centered Research; Common Data Model

Key Points

  • PCORnet® is a clinical research network that connects communities (namely providers; researchers; patients, caregivers, and advocates) and data (EHR, claims, and patient-reported). It functions as a learning health system to help researchers generate answers that advance health outcomes.
  • The network is made up of healthcare institutions, from large academic health centers to local community clinics. As of August 2025, PCORnet® had collated data from healthcare encounters in all 50 states, representing over 47 million people. There had been 57 PCORnet® studies and 991 publications supported by PCORnet® resources.
  • To be useful, data have to be standardized across systems. Frequent data curation and a single language enabled by the PCORnet® Common Data Model (CDM) facilitates this. Data that are in the CDM and currently available for use in research include demographics, diagnoses, and vital signs. Data that may or may not be in the CDM and require additional work for research include immunizations, social determinants of health, and patient-reported outcomes.
  • Quarterly, the PCORnet® team executes a data curation process. This includes a range of checks looking at data completeness; plausibility; persistence; and conformance to the PCORnet® CDM. Over the last decade, PCORnet® network performance has improved in terms of data mapping and latency.
  • Researchers can approach the PCORnet® Front Door with both simple univariate and bivariate statistical questions – i.e. how often a particular medication is used within the PCORnet® population – and with prep-to-research queries, which may identify an eligible population and generate some information about how that population behaves.
  • Once a team is running a PCORnet® study, they can submit queries for study-specific data extracts. This involves identifying a cohort and extracting patient-level data.
  • In the near future, PCORnet® will include additional data visualization options to increase the ease of navigating complex results. The team is also working on a Query Tools repository that will show what other people have already asked about a given set of data.
  • Because each study operates on specific variables and general characteristics do not predict specific characteristics, study-focused assessment of data fitness is critical.
  • The presenters walked attendees through 5 different PCORnet® studies and how they utilized this data infrastructure in their projects.

Discussion Themes

There is no charge for Front Door queries; they are part of the research engagement process. However, prep-to-research queries are limited to those that can be turned around in a reasonable period of time; they don’t extend to statistical modeling or requests that involve asking sites to get new kinds of data. At the pilot level, researchers can execute custom queries that provide a deeper look at the data.

Linkage partners will depend on the needs of a study. For example, PCORnet® Studies have linked to claims data from Centers for Medicare & Medicaid Services, registries that collect lived experience information, and commercial vendors that perform specialty lab or image testing.

An advantage of using PCORnet® for pragmatic and prospective trials is the connection with the health system, local investigators, and data experts. These can serve as valuable resources during the design, recruitment, and analysis stages.

October 15, 2025: Making Effective Use of Data Infrastructure, in This Week’s Rethinking Clinical Trials Grand Rounds

In this Friday’s Rethinking Clinical Trials Grand Rounds, Charles Bailey of the University of Pennsylvania and Keith Marsolo of the Duke University School of Medicine will present “Making Effective Use of Data Infrastructure in PCORnet®.”

The Grand Rounds session will be held on Friday, October 17, 2025, at 1:00 pm eastern.

Bailey is an associate professor of pediatrics and attending physician at the Children’s Hospital of Philadelphia. Marsolo is an associate professor of population health sciences and a cochair of the NIH Collaboratory’s Electronic Health Records Core.

Join the online meeting.

July 30, 2025: Podcast Episode Takes Listeners Behind the Scenes of New Learning Module

Headshots of Dr. Lesley Curtis and Dr. Keith MarsoloIn a new episode of the NIH Pragmatic Trials Collaboratory Podcast, Lesley Curtis and Keith Marsolo of the NIH Pragmatic Trials Collaboratory discuss the latest Living Textbook learning module, “Healthcare Data Interoperability and Standardization for Research.”

Listen and subscribe to the podcast on SoundCloud or Apple Podcasts.

Curtis and Marsolo developed the module to help researchers understand how healthcare data are collected and how those data can be used in a variety of research projects.

“For people who haven’t tried to use healthcare data before in research, it seems obvious that it should be so easy. We hear about these things and think, well surely, it all works together to help me answer my question. When in fact, it’s pretty complicated,” Curtis noted on the podcast.

“And unless you have a good understanding of how the pieces fit together and where they don’t, you might be in for a whole lot of frustration and heartache.”

Curtis is professor and chair of population health sciences at Duke University and a co–principal investigator of the NIH Pragmatic Trials Collaboratory Coordinating Center. Marsolo is an associate professor of population health sciences and a cochair of the NIH Collaboratory’s Electronic Health Records Core.

Podcast July 30, 2025: Healthcare Data Interoperability and Standardization for Research (Lesley Curtis, PhD; Keith Marsolo, PhD)

In this episode of the NIH Collaboratory podcast, Drs. Lesley Curtis and Keith Marsolo discuss the new learning module “Healthcare Data Interoperability and Standardization for Research.”

Read the transcript. For alerts about new episodes, subscribe free on Apple Podcasts or SoundCloud.

August 13, 2024: EHR Core and Patient-Centered Outcomes Core Reflect on Challenges in Pragmatic Trials

At the NIH Pragmatic Clinical Trials Collaboratory’s 2024 Annual Steering Committee Meeting, leaders of the Electronic Health Records (EHR) Core and the Patient-Centered Outcomes (PCO) Core discussed challenges and lessons learned in the NIH Collaboratory Trials.

EHR cochairs Keith Marsolo and Rachel Richesson shared challenges related to EHR usage, including EHRs switching midtrial, unanticipated changes to the EHR that impacted intervention delivery, and difficulties navigating data sharing policies.

“We continue to be challenged, but we fall back on our core principles, which is looking for good quality data and good quality research with an eye on how we can share the results in the underlying data in the future,” Richesson said.

Over the next year, the EHR Core will explore improving data access, transparency of computable phenotypes, and capturing dietary supplement information in the EHR.

PCO Core cochairs Cristy Zigler and Emily O’Brien shared goals for effective collection PCO data.

“We have advised studies about the importance of delivering patient-reported outcomes to participants in a way that is easy to complete, doesn’t overburden them, and is relevant for their population,” O’Brien said.

The Core has compiled a list of best practices for collecting PCO data and collaborated with the Health Equity Core to create a Health Equity Toolkit, designed to give investigators practical guidance for incorporating health and equity considerations in research.

The Core has also been working closely with Implementation Science Core to consider the sustainability of PCO data systems and facilitate reuse of collection methods.

“We often see separate systems set up to collect PCO data for the trial, and then those systems sunset at the end and are not in place to support an assessment over time,” O’Brien said.

Access the complete meeting materials from the 2024 Annual Steering Committee Meeting.

October 11, 2023: In This Friday’s PCT Grand Rounds, Incorporating Social Determinants of Health Into PCORnet

Headshot of Dr. Keith Marsolo
Keith Marsolo, PhD

In this Friday’s PCT Grand Rounds, Keith Marsolo of Duke University will present “Incorporating Social Determinants of Health Into PCORnet.”

The Grand Rounds session will be held on Friday, October 13, 2023, at 1:00 pm eastern.

Marsolo is an associate professor of population health sciences at Duke University and a cochair of the NIH Pragmatic Trials Collaboratory’s Electronic Health Records Core Working Group.

Join the online meeting.

July 14, 2022: Solving Unexpected Challenges in Pragmatic Trial Data Collection

Headshot of Dr. Keith MarsoloDuring the NIH Pragmatic Trials Collaboratory Steering Committee meeting and 10th anniversary celebration, Dr. Keith Marsolo, Co-chair of the Electronic Health Records Core, moderated a panel on “Barriers and Challenges: Data Collection and Merging Datasets.” Four panelists shared their experiences collecting and aggregating data from diverse data sets and how they solved unexpected challenges.

The panelists included Drs. Ted Melnick (EMBED), Holt Oliver (ICD-Pieces), Margaret Kuklinski (GGC4H), and Andrea Cheville (NOHARM).

During the discussion, panelists shared lessons learned from collecting electronic health record (EHR) data during large pragmatic clinical trials across multiple health systems. Common challenges included:

  • Privacy concerns and not having the ability to collect deidentified patient or clinician demographic information
  • Working across health systems that use different EHR platforms and collecting data consistently across sites
  • Turnover of IT staff at participating sites and changes in site data agencies during the study period
  • Updates to the EHR that affect study algorithms and other issues with algorithms not identifying data as expected
  • Overcoming technical barriers with practice workflows and integrating with IT systems

The panelists shared solutions and possible best practices for future studies, including the need for planning, coordinating, and testing before study launch, the importance of being able to pivot and change directions as problems arise, being open to alternative data collection methods such as surveys to augment findings, and having the right team at the right time to be responsive to problems, which for one study meant having informaticists and expert EHR builders embedded in the trial team.

Panelists identified two key policy and infrastructure changes that would help trials be successful in the future. These changes include development of a national unique patient identifier across health systems and incentivizing EHR vendors to find common ground to better support research.

The Electronic Health Records Core continues to learn from experiences of the program’s NIH Collaboratory Trials and shares emerging information, resources, and EHR-related recommendations to improve future pragmatic research.

View slides from the discussion panel.

Learn more

View video collection that highlights advances in Electronic Health Records for pragmatic research.

Watch the August 2021 Interview with Electronic Health Record Core leaders Drs. Rachel Richesson and Keith Marsolo

August 11, 2021: EHR Core Facing Familiar Challenges, Intensified by Pandemic

Leaders of the NIH Collaboratory’s Electronic Health Records (EHR) Core Working Group spoke in a recent interview about the impacts of the COVID-19 pandemic on pragmatic trials. They also talked about upcoming projects and a recent survey of the NIH Collaboratory Trials.

 

“The pandemic amplified themes that we’ve heard all along, which is how to get resources, how to get support for the data that we need for these trials or to configure EHRs as we need for these trials,” said Dr. Rachel Richesson, a professor of learning health sciences at the University of Michigan and a cochair of the EHR Core. “The pandemic just shifted priorities tremendously and made it quite challenging. As a result, we’ve had discussions about…really making the value case for pragmatic research and embedded research,” Richesson said.

View the full video.

Dr. Keith Marsolo, also a cochair of the Core, added, “The pandemic obviously was a big challenge for health systems in general as they transitioned to telehealth, dealt with shutdowns, things of that nature.” Marsolo is an associate professor in population health sciences at Duke University.

“Things are starting to move forward a little bit more. In one [NIH Collaboratory Trial], they were able to leverage some infrastructure that was purchased to help provide telehealth services for their region. So they’ve been able to bootstrap their trial off of that infrastructure,” Marsolo said.

Richesson also described an upcoming paper reporting the results of a recent survey of the NIH Collaboratory Trials. The survey focused on the challenges of using EHR data in pragmatic trials embedded in healthcare systems.

“No surprise on the challenges we encountered: It’s still challenging to get data from organizations for research, the data are still heterogeneous,…and there are challenges on the research team to ensure that that information is equivalent and how these data can be pulled together to support the research question,” Richesson said. “There’s a particular emphasis with the newer studies on patient-reported outcomes and how to get those collected as part of routine care,” she said.

View the full video.

 

Screen shot of video interview with Dr. Rachel Richesson and Dr. Keith Marsolo
Dr. Rachel Richesson and Dr. Keith Marsolo