Data Broker Services : Clinical Data Requests

Request Clinical Data

There are two major ways to submit a Clinical Data Request to the Data Broker group. The exception is a research request that utilizes the Consent to Contact registry which is described in further detail in a separate section.

1. E-mail the UM IT Help Desk

Requests may be sent via email to with the Data Broker group ( cc’ed.

Briefly describe the data request and mention that the request is for clinical data and should be forwarded to the Data Broker Services (Clinical) group for review and approval. You can attach any documentation pertinent to the request, such as an IRB approval letter, Preparatory to Research Form E, etc. This request causes a ticket to be created in the UM IT Service Now system. All requests including reason, authorization and data details are documented in the Service Now platform.

2. Submit Request through the Service Now Self-Service Portal

  • Use the clinical data request form available on the UM IT Service Now website.
  • You will be prompted to login through UM IT’s Single Sign On page (DUO dual factor authentication) before being presented with the Service Now screen.
  • Make sure you are on the Homepage. If you are not, select Homepage from the left menu options and then choose Order Items & Services.
  • On the Order Items & Services page, select Clinical Data Request form.
  • Required fields have an *.
  • You must accept the Terms and Conditions by checking the box.
  • Attach any documents by using the paperclip icon available at the top of the form.
  • Scroll up and submit your request. Note: If you did not complete one of the required fields you will see a pop-up listing all missing required fields.
  • Click “OK” and the required fields will display with a red *.
    • Please note: If the ‘Requested For’ field is completed, that individual will receive an email which he/she must approve, prior to the request being routed to the data broker group.

What to Include in a Clinical Data Request

  • Request for Research -
    • Ensure:
      • Study is IRB approved and active
      • Recipient of data is on study team
      • Requested criteria match protocol
      • Requested fields match protocol
    • Provide IRB eProst study number
    • Provide Inclusion/Exclusion Criteria
    • List fields/columns to include in the data output
  • Request for Preparatory to Research -
    • Ensure Investigator’s Certification for Reviews Preparatory to Research form submitted to IRB
    • Attach copy of completed form
    • Provide Inclusion/Exclusion Criteria
    • List fields/columns to include in the data output
  • Request related to Healthcare Operations -
    • Briefly explain reason the data is needed
    • Provide contact information for administrator authorizing this request
    • Provide Inclusion/Exclusion Criteria
    • List fields/columns to include in the data output

In general when submitting a clinical data request include:

  • Reason for data request
  • Inclusion/Exclusion Criteria to select the appropriate population
    • These criteria could include: dates of service, ICD diagnosis codes, CPT procedure codes, provider, patient gender, patient age, service location, etc.
    • Note: Data from December 1, 2010 onwards is available from UChart
    • For Medical Chart data prior to December 1, 2010, a separate request will need to be submitted. Data fulfillment is completed by the third party vendor
  • Fields/columns to include in the data output