Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: The Emergency Medicine Education and Research by Global Experts (EMERGE) network was formed to generate and translate evidence to improve global emergency care. We share the challenges faced and lessons learned in establishing a global research network.

Methods: We describe the challenges encountered when EMERGE proposed the development of a global Emergency Department (ED) visit registry. The proposed registry was to be a 6-month, retrospective, deidentified, parsimonious dataset of routinely collected variables, such as patient demographics, diagnosis, and disposition.

Results: Obtaining reliable, accurate, and pertinent data from participating EDs is challenging in a global context. Barriers experienced ranged from variable data taxonomies, need for language translation, varying processes for data cleaning and transfer of deidentified data, navigating numerous data protection regulations and substantial variation in each participating institution’s research infrastructure including training in research related activities. We have overcome many of these challenges through creating detailed data sharing agreements with bilateral regulatory oversight, developing relationships with and training site health informaticians to ensure secure transfer of deidentified data, and formalizing a transfer process ensuring data privacy.

Conclusions: We believe that networks like EMERGE are integral to provide the necessary platforms for education, training and research collaborations. We identified substantial challenges in data sharing and variation in local sites’ research infrastructure, and propose approaches which may overcome the data quality and access issues that we encountered.