The ACT Network and COVID-19 Response


The global pandemic caused by SARS-CoV-2 with the attendant morbidity and mortality requires urgent understanding of the natural course of COVID-19 and characterization of the factors of disease severity and poor outcomes. A significant source of data for COVID-19 research is patient data captured in electronic health records (EHRs). To leverage EHRs for COVID-19 research, the national Accrual to Clinical Trials (ACT) network - a federated network of Clinical and Translational Science Award (CTSA) hubs - has implemented an efficient and extensible electronic infrastructure of SHRINE/i2b2 technology to enable clinical and translational research. The ACT network, which links EHR data on >130M patients from 48 CTSA hubs, provides a unique real-time platform for conducting research on COVID-19 at unprecedented national scale. We mobilized the network to support an array of COVID-19 studies ranging from assessing spatial and temporal incidence and characterizing the influence of co-morbidity and current medications to identifying cohorts for clinical trials. To enable this work, we developed a specialized COVID-19 ontology that enables harmonization of data elements that that are critical to COVID-19 research, refreshed COVID-19 related EHR data across the network at a frequency of at least once a week, conducted ‘smoke’ tests to ensure quality of the key COVID-19 related data at the hubs, and are adding capability to perform automated advanced analytics.