A survey of practices for the use of electronic health records to support research recruitment

Abstract

Electronic health records (EHRs) provide great promise for identifying cohorts and enhancing research recruitment. Such approaches are sorely needed, but there are few descriptions in the literature of prevailing practices to guide their use. A multidisciplinary workgroup was formed to examine current practices in the use of EHRs in recruitment and to propose future directions. The group surveyed consortium members regarding current practices. Over 98% of the Clinical and Translational Science Award Consortium responded to the survey. Brokered and self-service data warehouse access are in early or full operation at 94% and 92% of institutions, respectively, whereas, EHR alerts to providers and to research teams are at 45% and 48%, respectively, and use of patient portals for research is at 20%. However, these percentages increase significantly to 88% and above if planning and exploratory work were considered cumulatively. For most approaches, implementation reflected perceived demand. Regulatory and workflow processes were similarly varied, and many respondents described substantive restrictions arising from logistical constraints and limitations on collaboration and data sharing. Survey results reflect wide variation in implementation and approach, and point to strong need for comparative research and development of best practices to protect patients and facilitate interinstitutional collaboration and multisite research.

Keywords: CTSA; Electronic health records; biomedical informatics; clinical research; recruitment.

Fig. 1

Summary of responses to questions regarding methods of electronic health records (EHR)-based cohort identification and recruitment. (a) Current implementation. (b) Perceived demand. Brokered data warehouse (DW), access to data warehouse by staff members; Self-serve Qry, use of self-service tools to run de-identified queries; EHR registry, use of EHRs to build patient lists to aid in recruitment; Patient portal, use of EHR patient portals to notify patients of research opportunities; Provider alerts, use of electronic alerts to care providers of patients in clinic meeting eligibility requirements; Research associate (RA) alert, use of electronic alerts to the research team if patients in clinic meet eligibility requirements; Business intelligence (BI) tools access, research given direct query access to data warehouse through business intelligence tools.