Epic Cosmos

National-level electronic health record data linked with unique phenotype and genotype information are available through All of Us and N3C.

Epic Cosmos is an aggregated electronic health record database made up of data from organizations that use Epic as their electronic health record system. As of 2025, about 200 institutions have shared longitudinal data for 300 million individuals, including Baylor Medicine and Texas Children’s Hospital. These individuals are linked across health systems.

The underlying data model for Cosmos is a streamlined version of Epic Caboodle, a dimensional data model organized in a “star” or “snowflake” schema. In this structure, a table containing clinical information (called a fact table) is connected to metadata tables (called dimension tables).

  • An encyclopedia of available data (Baylor Epic credentials required) includes:

    • Demographics

    • Encounters

    • Diagnoses

    • Procedure occurrences

    • ICU events

    • Vital signs

    • Medication orders, fills, and administrations

    • Social drivers of health (SDOH)

    • Surveys and patient-reported outcomes

    Limitations

    Data in Epic Cosmos are de-identified, and dates are time-shifted by a random number of days within each individual. These create important limitations that may impact feasibility of some studies. Please refer to the data dictionary to confirm whether your data elements are represented. If you have any questions, please submit a general consultation request.

    • Institutions that use Epic for only part of their health system (such as inpatient only) will only have that portion represented in Cosmos.

    • Investigators should be aware of potential non-detection bias, which may be especially important for diseases that require frequent inpatient care.

    • Information commonly stored in flowsheets — other than vital signs — such as respiratory care events or pain scores, is unavailable.

    • Results from specialized testing, including pulmonary function tests, EKGs and echocardiograms, are unavailable.

    • The day of the week (such as weekday or weekend) cannot be identified.

    • Specific health systems cannot be identified.

    • Geocoding information is limited to the patient’s state of residence.

  • Tier 1: SlicerDicer

    • Epic’s graphical interface for generating descriptive statistics

    • Ideal for summarizing and exploring data

    • Requires completion of a free self-study module

    Tier 2: Line-Level Access via Citrix Cloud

    • Secure environment with tools like SQL Server Management Studio and RStudio

    • Enables data extraction, processing, and statistical analysis

    • Requires a two-day virtual training class (Epic-organized, fee applies)

    Access can be requested through the Epic Cosmos-CTPH form (Baylor credentials required).

  • Epic requires users to be affiliated with an Epic customer institution. Faculty from the University of Houston and other collaborating institutions must partner with Baylor faculty to participate in Cosmos research projects.

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