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. 2023 Jun 13;6(2):ooad040.
doi: 10.1093/jamiaopen/ooad040. eCollection 2023 Jul.

Procurement of patient medical records from multiple health care facilities for public health research: feasibility, challenges, and lessons learned

James M McMahon  1 , Judith Brasch  1 , Eric Podsiadly  1 , Leilani Torres  1 , Robert Quiles  1 , Evette Ramos  1 , Hugh F Crean  1 , Jessica E Haberer  2   3
Affiliations

Procurement of patient medical records from multiple health care facilities for public health research: feasibility, challenges, and lessons learned

James M McMahon et al. JAMIA Open. .

Abstract

Objectives: Studies that combine medical record and primary data are typically conducted in a small number of health care facilities (HCFs) covering a limited catchment area; however, depending on the study objectives, validity may be improved by recruiting a more expansive sample of patients receiving care across multiple HCFs. We evaluate the feasibility of a novel protocol to obtain patient medical records from multiple HCFs using a broad representative sampling frame.

Materials and methods: In a prospective cohort study on HIV pre-exposure prophylaxis utilization, primary data were collected from a representative sample of community-dwelling participants; voluntary authorization was obtained to access participants' medical records from the HCF at which they were receiving care. Medical record procurement procedures were documented for later analysis.

Results: The cohort consisted of 460 participants receiving care from 122 HCFs; 81 participants were lost to follow-up resulting in 379 requests for medical records submitted to HCFs, and a total of 343 medical records were obtained (91% response rate). Less than 20% of the medical records received were in electronic form. On average, the cost of medical record acquisition was $120 USD per medical record.

Conclusions: Obtaining medical record data on research participants receiving care across multiple HCFs was feasible, but time-consuming and resulted in appreciable missing data. Researchers combining primary data with medical record data should select a sampling and data collection approach that optimizes study validity while weighing the potential benefits (more representative sample; inclusion of HCF-level predictors) and drawbacks (cost, missing data) of obtaining medical records from multiple HCFs.

Keywords: health care facilities; medical record procurement; medical research.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Magnetic Couples Study flow chart for procurement of subject medical records from multiple health care facilities.
See this image and copyright information in PMC

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