Epic Cosmos
Evidence-Based Research and Individualized Patient Care
What is Cosmos?
Cosmos is a community collaboration between health systems that combines billions of clinical data points in a way that forms a high-quality, representative, and integrated data set that can be used to change the health and lives of people everywhere.
Key Benefits
Cosmos has records from over 226 million patient records from over 9.8 billion encounters, representing patients in all 50 states.
Cosmos is built on a data platform optimized to answer clinical questions over time in minutes. Clinicians and other scholarly explorers at organizations using Cosmos can ask questions on-demand without needing to put a request in for data.
Because Cosmos is built by health systems from across the country, it aligns closely to population metrics of the United States Census. Cosmos has a representative sample of patients across all races, sexes, ages, rural-urban locations, and types of insurance.
Epic integrates both inpatient and outpatient charts into a single record, including all clinical specialties to form a more comprehensive and detailed picture of a patient's health. For example, a cancer patient's record contains detailed oncology visits, cancer staging, advanced lab results, hospitalizations, and standard outpatient visits.
Cosmos goes well beyond diagnoses and medications found on claims transactions, and includes patient-generated health data (PGHD), birth records, vitals, and social determinants like transportation and financial security assessments.
The Cosmos Data Set is Representative of US Census for Age, Race, Ethnicity, and Coverage
Age
Race
Ethnicity
Coverage
Social Vulnerability Index
Harnessing the Power of Cosmos
The Epic Community has already seen great success using the universe of Cosmos data for research and are continuing to expand the impact of this unique data set.
Academic Research
Cosmos is the data source for studies in academic journals. These include:
NEJM
Vaccine Effectiveness of JYNNEOS against Mpox Disease in the United States published in The New England Journal of Medicine
Pediatrics
A study on neonatal hospitalizations and readmissions, published in Pediatrics
NEJM Catalyst
Findings on antibiotic prescribing and testing practices in NEJM Catalyst
CDC
Insights on COVID reinfections as seen in CDC's Morbidity and Mortality Weekly Report
Diabetes Care
Diabetic patient outcomes during the COVID pandemic in Diabetes Care
Diabetes
A study investigating the link between COVID-19 and type 1 diabetes in Diabetes
JAMA Network Open
Racial and ethnic differences in early diagnosis of autism spectrum disorder in JAMA Network Open
Journal of General Internal Medicine
Racial and ethnic disparities in the prescription of Nirmatrelvir (Paxlovid) for COVID-19 in Journal of General Internal Medicine
Epic Research
While traditional research continues to serve as a primary source of information to inform clinical practice, we identified a need for a new kind of analysis focused on getting good data out quickly to clinicians and decision-makers where it can make a difference. To address this need, we launched Epic Research. Using our dual-team process, Epic Research teams evaluate timely, topical, and relevant questions, and make findings available to the public at no-cost at EpicResearch.org and to Epic Research subscribers.
Several Epic Research briefs have gained media and policymaker attention, such as:
Fentanyl testing rate up to nearly 14% of overdose ED encounters, still lags behind opiate testing.
Two in three Mpox cases prevented in patients fully vaccinated with JYNNEOS. Even one dose of JYNNEOS provided some protection against Mpox infection.
Despite significant drops in 2020 and low rates in 2021 through the beginning of 2022, strep throat infections exceeded their 2017 peak by 30% in February 2023.
Patients with a higher BMI have a greater risk of knee replacement failure within a year of the procedure.
Bringing Insights to Point-of-Care
The vision for Cosmos has always included a way for providers to make an immediate impact with their patients. With our ongoing development of Best Care Choices for My Patient and Look-Alikes, providers will be able to use attributes from the patient in front of them to review real-time insights they can use alongside their own expertise and experience to partner with their patient on shared decision-making.
Keeping Cosmos Safe
Participating health systems agree to a legal structure that establishes shared trust.
- Data can't be sold. And data never leaves the secure Cosmos portal.
- Data can't be used for advertising or market comparisons.
- Violation can result in permanent loss of access.
Patient identifiers are removed before data moves from a healthcare organization.
- Data protection goes beyond HIPAA regulations.
- No Cosmos users access data without attesting to their use and funding source.
- End-users can only access fully de-identified data, with all actions audited.
From the start, no unique patient identifiers (names, phone numbers, etc) are sent or stored in Cosmos. Additionally, Cosmos is architected to allow each organization the ability to design their own local patient opt out policies that meet their communities' specific rules and regulations.
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Participating Health Systems
236 health systems, and counting, are currently participating in Cosmos