Digitization of medical records has been widely adopted by physicians and health systems over the last 15 years, creating a vast quantity of health data. The COVID-19 pandemic exposed the need for interoperability of those electronic health record (EHR) systems so that the research community may study COVID-19 through the lens of clinical data and identify potential therapies. Led by NIH Clinical and Translational Science Award programs and spanning more than 70 institutions in the United States, the National COVID Cohort Collaborative (N3C) aggregates and harmonizes COVID-19 patient-level electronic health record (EHR) data across health care systems at an unprecedented scale.

James Cimino, MD, CCTS Co-Director and UAB Informatics Institute Director, led the CCTS Hub's (UAB's) participation in N3C as a data provider. “COVID-19 created a singular focus among a wide-array of stakeholders to get a nationwide view of COVID-19. While N3C is effectively a data enclave, it also represents deployment of rapid solutions in the spaces of legal agreements, governance, data and quality management and tools.” These collaborative efforts were recently documented in the Journal of the American Medical Informatics Association.  In parallel, CCTS Partners at Auburn, LSUHSC, PBRC, Tulane, the University of Alabama, UAB and USA and collaborators at the University of Mississippi Medical Center executed data use agreements that allow their researchers to leverage the resource.

As the pandemic evolves, so does the N3C data enclave – it is now one of the largest collections of COVID-19 health records in the world, representing an unprecedented opportunity for scientific investigation. As part of Domain Teams, the N3C platform supports a community of scholarship that enables investigators with shared interest to work together across institutional boundaries, proving to be an effective team-based approach. Noha Sharafeldin, MBBCh, Ph.D. co-leads an N3C Oncology Domain Team. Leveraging N3C, she and her collaborators reported on COVID-19 positive cancer patients and characteristics associated with increased risk of all-cause mortality in the Journal of Clinical Oncology. The team also plans to assess the effect of COVID-19 vaccination on cancer outcomes and continuity of cancer treatments. Eli Levitt, Ph.D., collaborated with a multi-institutional team to develop a model that predicts COVID-19 clinical severity, which was reported in JAMA Network Open. Similarly, CCTS Informaticist, Ron Horswell, Ph.D., participated on a project utilizing N3C data to study the COVID-19 hospitalization and mortality rates among individuals from rural settings (available in MedRxIV). Beyond assessing COVID-19 in the context of specific health conditions or populations, the N3C data enclave may serve as model towards strengthening future health emergency capacity.

If you are interested in leveraging N3C at your institution, This email address is being protected from spambots. You need JavaScript enabled to view it. can help you navigate how to get connected.

Written by the CCTS team | November 1, 2021