Cosmos doesn’t only cover billing data — I think you’d be surprised how useful the operational clinical data are for understanding clinical cohorts and measures of interest (this used to be my job as a data analyst, though using Epic data from just 1 hospital system) - ThreadSky

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christiannolan.bsky.social • 18 hours ago

Cosmos doesn’t only cover billing data — I think you’d be surprised how useful the operational clinical data are for understanding clinical cohorts and measures of interest (this used to be my job as a data analyst, though using Epic data from just 1 hospital system)

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travisgerke.bsky.social•17 hours ago

For sure, also spent a lot of time working with Epic/EMR data and it’s not just billing per se, but that is the focus of *why* data is captured and the completeness/missingness that results poses intractable problems. Certainly valuable for some use-cases but not as good as say natl health registry

christiannolan.bsky.social•17 hours ago

Pretty big “enemy of the good is the perfect” though .. there are entire research consortiums spending gobs of money and engineer and physician time to basically do Cosmos (like PEDSnet), where analysts painstakingly work together to create one OMOP model across health systems.

The value is real

travisgerke.bsky.social•17 hours ago

Would love to see it! In oncology, for example, I very often see that outcomes just aren’t captured in EMRs - you only see things like treatment changes which probably indicate progression but it’s very hard to know for sure

christiannolan.bsky.social•17 hours ago

Ok Oncology was *always* the exception IME! One of my first projects was trying to assess adherence to an oncology with fever clinical pathway and even just mapping meds to the right encounters was heavy lifting!

And saw that repeated in other instances too. ICUs were similarly nuanced

christiannolan.bsky.social•17 hours ago

I find myself in the odd position of appearing to defend Epic — in my time in healthcare I did not love Epic and its imperialistic approach to, well, everything

travisgerke.bsky.social•17 hours ago

🤣 I hear this, same. There was some admirable company stuff in that episode

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