Data Broker Services : Request Clinical Data

Request Clinical Data

All data requests related to clinical data are documented in the UM Information Technology Service Now platform. To make a data request there are two options:

Clinical Data Request Form

Use the clinical data request form available on the 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 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.

If you did not complete one of the required fields you will see a pop-up with all the missing fields.

Click “OK” and the required fields will display with a red *.

Email the UM IT Help Desk

Requests may be sent via email to

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.

As always, you should state the reason for the request (research, healthcare operations etc.) and supply the criteria for selection of the appropriate population.

For example, for research, provide the IRB number, and other criteria such as:

  • Date range e.g. Patients seen between 0 1/01/2015 and 12/31/2017:
  • If Applicable, appropriate diagnosis codes: ICD-10 codes e.g. C44.91, C44.92, C44.99
  • If Applicable, appropriate CPT codes: e.g. 58150 or 58180
  • Any Age restrictions: e.g. 18yrs and over
  • What data fields are required? E.g. Name, MRN, DOB, Dx, DOS, etc.
  • Any Other criteria such as specific locations or providers

IT will only extract what is specified.

Note, the protocol will be reviewed to ensure what is being requested matches what has been approved via the IRB/HSRO office.