By Deborah Borfitz 

April 10, 2025 | As a longtime electronic health record (EHR) supplier for ambulatory care providers, Veradigm (formerly Allscripts) finds itself at the “intersection of research and patient care” with the wherewithal to offer medical practitioners research opportunities and clinical trial sponsors real-world data and solutions to support their R&D ambitions. “Everybody says they have big data, but what matters is clinical depth and data fidelity,” according to Mac Bonafede, vice president of research consulting at Veradigm. 

Being the originator of some “really big data,” Veradigm can readily back that assertion, he points out. Its network encompasses over 152 million unique patients nationally, and a growing proportion of them are represented in seven newly created cardiometabolic clinical data registries. 

Building of the datasets was a collaborative effort with the American College of Cardiology (ACC) and they are specific to heart failure, atrial fibrillation, atherosclerotic cardiovascular disease, hypertension, type 2 diabetes, type 1 diabetes, and chronic kidney disease. The datasets contain all the relevant details for understanding the burden of illness, disease pathways, and the length and type of treatments as well as their effect on different clinical measures (e.g., low-density lipoprotein and ejection fraction)—critical ingredients for real-world evidence projects in any of those therapeutic areas, says Bonafede.  

While other disease-specific datasets are out there, he says, a uniqueness of the ones here is that they were sourced through a collaboration with the ACC. As part of this collaboration, Veradigm operates the Veradigm Cardiology Registry (formerly the PINNACLE Registry) and Veradigm Metabolic Registry (formerly the Diabetes Collaborative Registry). 

The new research-ready datasets integrate disease-level data from over 80 distinct EHR technology platforms, which Veradigm has consolidated into one common data model, Bonafede says. Practitioners who opt to join the network can continue using whatever software they want to manage their practice.  

“It has got to be easy on the site; it can’t be just another burden on them,” continues Bonafede, noting that less than 1% of provider groups participate in clinical research. “We need our physicians focusing on their patients” and make any research they need or want to do “frictionless and seamless.” 

User Benefits 

In addition to proactively presenting relevant research opportunities to sites, Veradigm gives network providers access to its research-ready EHR database for patient recruitment and data collection purposes. They can even call in with questions or to get feedback on a study design. “It is a true partnership in that we give them something and they give us something,” Bonafede says. 

More broadly, the Veradigm Cardiology and Metabolic registries help providers with reimbursement by facilitating their participation in the Merit-Based Incentive Payment System, he adds. This is a Medicare program that offers payment adjustments based on performance in quality, improvement activities, promoting interoperability, and cost.  

The new datasets will enhance clinical insights across the entire drug development cycle, highlighting disease patterns, care approaches, and the costs and health outcomes of treatment, Bonafede says, and will therefore have many potential users. Since regulatory authorities want to know that pharmaceutical products are safe, their developers may need to conduct some kind of post-marketing surveillance, he offers as an example. 

Study sponsors can also easily tap any of Veradigm’s integrated datasets to identify patients who meet a clinical trial’s eligibility criteria, says Bonafede, including information on race and ethnicity as well as deep unstructured data on social determinants of health. The company can also help as needed with site outreach and activation. But the future lies in building the data flow pattern for a study since the “data pipes” already exist—meaning, sponsors will no longer need to build an electronic data capture system to collect and manage trial data.  

“We try hard to work well with everybody,” he adds. Veradigm’s current partners include HealthVerity, which focuses on real-world data and evidence, and Datavant, which specializes in connecting and managing health data. 

‘Depth and Breadth’

Shortly after Allscripts sold off its hospital business in 2022, the company officially changed its name to Veradigm. The move was intended to signal that the company was “doubling down” its focus on providing supportive offerings and services to ambulatory care practices, says Bonafede, who leads the real-world evidence team comprised of health economists, epidemiologists, and statisticians.   

Few researchers are interested in the entirety of the pan-cardiometabolic registry data; they generally care a great deal about one specific disease and “really want to go deep into that one area,” he continues. The common thread is obesity, which is an epidemic in the U.S. with recent data indicating well over 40% of the adult population is afflicted.    

The seven datasets have “depth and breadth,” in addition to hitting across so many EHRs, Bonafede says. The project was undertaken because it “could offer value back to practices and ultimately their patients,” he adds. “If we find we can do that in other therapeutic areas, I think we’d have those conversations.”  

Ultimately, the datasets could help narrow the gap between clinical research and clinical care by not only asking questions about historical data but also prospectively investigating the safety and effectiveness of treatments, says Bonafede. Because many of the important details are in unstructured chart notes and free-text patient-reported outcomes, the use of natural language processing has been key to moving toward more real-time research.  

The availability of the datasets has never been more important, since big data is now being used to answer tough questions such as whether a drug or medical device helps keep people well and out of the hospital, Bonafede says. Whether treatments are improving clinical measures is “becoming part of the reimbursement discussion” and, increasingly, a condition of coverage. 

As the need for demonstrating clinical effectiveness grows, so does interest in measuring it as a secondary objective in a clinical trial context, adds Bonafede, a health economist by training. Veradigm’s data model is “fully tokenized,” meaning all sensitive patient information has been replaced by unique, non-sensitive identifiers that retain essential information without compromising security. 

Patient clinical data can therefore be paired up with claims data to look at health outcomes alongside the cost of treatment. If cost effectiveness isn’t examined in a clinical trial, Bonafede says, it is typically the first amendment to the study’s statistical plan.