Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Apr 2, 2020
Date Accepted: May 11, 2020
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The Kaiser Permanente Northern California Adult Alcohol Registry, an Electronic Health Records-Based Registry of Patients with Alcohol Problems: Protocol, Implementation, and Implications for Research
ABSTRACT
Background:
Electronic health record (EHR)-based disease registries have aided health care professionals and researchers in increasing their understanding of chronic illnesses, including identifying patients with (or at risk of developing) conditions and tracking treatment progress and recovery. Despite excessive alcohol use being a major contributor to the global burden of disease and disability, no registries focused on alcohol problems exist.
Objective:
Our objective was to develop a registry of patients with alcohol problems by leveraging EHR data in Kaiser Permanente Northern California, an integrated health system that conducts systematic alcohol screening, provides specialty addiction medicine treatment internally, and has a membership of over 4 million members that is highly representative of the U.S. population with access to care.
Methods:
We developed and implemented a protocol for assembling the KPNC Adult Alcohol Registry. The registry cohort included adult members with unhealthy alcohol use (using National Institute on Alcohol Abuse and Alcoholism guidelines), an alcohol use disorder (AUD) diagnosis, or an alcohol-related health problem between June 1, 2013 and May 31, 2019. We extracted patients’ longitudinal, multi-dimensional EHR data from one year prior to their date of eligibility through May 31, 2019 and conducted descriptive analyses.
Results:
We identified 723,604 patients meeting registry inclusion criteria: 615,147 with unhealthy drinking, 105,493 with an AUD, and 7,949 with an alcohol-related health problem. The registry cohort was 60% male, 41% non-White, and had a median age of 41 years (IQR=27). About 48% had a chronic medical condition, 18% had a mental health condition, and 4% had a drug use disorder diagnosis.
Conclusions:
We demonstrate that EHR-based data collected during clinical care within an integrated health system can be leveraged to develop a registry of patients with alcohol problems that is flexible and can be easily updated. The registry’s comprehensive patient-level data over multi-year periods provides a strong foundation for robust research addressing critical public health questions related to the full course and spectrum of alcohol problems, including recovery, which would complement other methods used in alcohol research (e.g., population-based surveys, clinical trials).
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