Leveraging Electronic Health Record–Based, Real-World Data to Advance Hepatology and Liver Transplant Research and Clinical Care

Electronic health record (EHR)-based real-world data (RWD) are increasingly used in clinical research for hepatology and liver transplantation and have the potential to shape quality improvement, clinical trials, and regulatory decision-making. Large-scale EHR-based datasets such as Epic Cosmos, TriNetX, OMOP-based networks, All of Us, PCORnet, Mayo Clinic Platform Connect, and the Veterans Health Administration’s national EHR and linked research data resources offer unprecedented opportunities to study liver disease at scale, but differ substantially in structure, governance, analytic flexibility, and validity for specific research questions.   This 60-minute Community Conversation, presented as a partnership between the Clinical Informatics and Digital Health SIG and the Clinical Research Committee, will provide a practical framework for understanding EHR-based RWD, with an emphasis on applications in chronic liver disease and liver transplantation. Three focused presentations will review the strengths and limitations of EHR-derived datasets, highlight Epic Cosmos as one of the largest available platforms, and explore how the VA’s integrated national data infrastructure has generated real-world evidence and clinically actionable insights in liver disease. The session will conclude with an interactive panel discussion addressing methodological challenges, real-world use cases, and future directions for hepatology research and quality improvement.