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 are increasingly used in clinical research for hepatology and liver transplantation. Analysis of these data 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, Target RWE, AASLD’s Cirrhosis Quality Collaborative (CQC), and the Veterans Affairs' CIPHER, LEAP, and MVP—offer unprecedented opportunities to study liver disease at scale but differ substantially in structure, governance, analytic flexibility, and validity for specific research questions. This community conversation—presented as a partnership between the Clinical Informatics and Digital Health Special Interest Group and the Clinical Research Committee—provides a practical framework for understanding EHR–based, real-world data, with an emphasis on applications in chronic liver disease and liver transplantation. Three focused presentations review the strengths and limitations of EHR–derived datasets, highlight Epic Cosmos as one of the largest available platforms, and explore Target RWE’s collaboration with AASLD through the CQC. The session concludes with an interactive panel discussion addressing methodological challenges, real-world use cases, and future directions for hepatology research and quality improvement.