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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.

226 Million
9.8 Billion
4.8 Billion
Face-to-Face Visits

Key Benefits

The largest integrated database of clinical information in the United States

Cosmos has records from over 226 million patient records from over 9.8 billion encounters, representing patients in all 50 states.

Query millions of patients in minutes

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.

Data that looks like the United States

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.

Longitudinal charts across inpatient, outpatient, every patient

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.

Data sets from labs, meds, social determinants, patient-entered data

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





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 Catalyst


Diabetes Care


JAMA Network Open

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 and Opiate Toxicology Screening Rates

Fentanyl testing rate up to nearly 14% of overdose ED encounters, still lags behind opiate testing.

Comment Guidelines

Two in three Mpox cases prevented in patients fully vaccinated with JYNNEOS. Even one dose of JYNNEOS provided some protection against Mpox infection.

Percentage of Encounters for Strep Throat

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.

Knee Replacement Failure Rates by BMI

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

Rules of the Road

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.
Data De-identification

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.
Patient Privacy

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.

Request Cosmos Access

If you are affiliated with a health system or academic medical center, let us know a bit more about your interest, and we'll connect you with the best person to discuss your Cosmos request.

Select Your Organization

Participating Health Systems

236 health systems, and counting, are currently participating in Cosmos

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