How to Request Clinical Data

Portal Location & Access

Where the Form Is Found

  • The form appears under the following Catalog Filters:
    • Data Services
    • Research Access & Support

Form Behavior & Requirements

  • Required fields are marked with an asterisk.
  • Supporting documents can be attached using the paperclip icon at the bottom of the form.
  • The Terms and Conditions checkbox must be selected before submission.
  • If required fields are missing, the system displays a pop‑up list of what needs to be completed.

After Submission

  • An Order Status page appears with the ticket number.
  • Users can track progress under My Orders and Tickets, including which ServiceNow group currently has the request.

  1. Visit the UHealth IT ServiceNow Portal.
  2. Under Catalog Filters, click on Research Access & Support or Data Services.
  3. Select Data Broker Services (Clinical) Request under the Item column.
  4. Under Service Requested, select Clinical Data (Research/Operations).
  5. Review the required information needed for filling out the request.
  6. Scroll down and complete all necessary fields.
  7. Select the frequency for how often the report should run. If Other is selected, provide details about when the data extract should be run.
  8. If the data will be shared outside of the requester's area or externally, select Yes and list all recipients (internal business units, departments, or external/non-UM entities).
  9. Specify the purpose for the data request, whether it is for Credentialing Case Logs, QA/QI, Research, Preparatory to Research, or Other.
  10. When Research is selected, an additional field will appear where the associated IRB Study Number can be entered.
  11. Specify whether the request should be De-Identified, include Limited Data, or PHI.
  12. Clinical Data Criteria. Provide factors such as:
    1. Location or Department
    2. CPT Procedure Codes
    3. ICD-10 Diagnosis Codes
    4. Date Range

Please see A Guide to the Data Broker Services Request Form for additional information located on the Data Broker website.

  1. Clinical Data Output: Provide fields such as:
    1. MRN
    2. Patient Demographics
    3. CPT Procedure Codes
    4. ICD-10 Diagnosis Codes
    5. Service Location
    6. Service Provider

Please see A Guide to the Data Broker Services Request Form for more information. Located within the Data Broker Website.

  1. Feel free to include any additional information you would like the fulfillment team to be aware of.
  2. Review and acknowledge the Terms and Conditions.
  3. Click Submit.

Cards

Processing Time

  • Data Broker Services reviews all clinical data requests within 2–3 business days.
  • Approved requests are then assigned to UHealth IT for fulfillment.
  • UHealth IT typically requires two weeks or more, depending on volume, priority, and complexity.

Important Note

All Clinical Data requests must be submitted through the UHealth IT ServiceNow Self‑Service Portal using the Data Broker Services (Clinical) Request form.

The sole exception is research‑related Consent to Contact lists, which must be submitted via the REDCap application.

For instructions, refer to the Consent to Contact page. 

What to Include in the Clinical Data Request

Open All Tabs
  • Clinical Data Requests for Research or Healthcare Operations

    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
      • Requested date range math protocol
    • Provide IBISResearch IRB study ID 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 (Form E) is 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
    • Manager approval may be requested for all Quality Assurance (QA) and Quality Improvement (QI) requests.
    • Provide Inclusion/Exclusion Criteria
    • List fields/columns to include in the data output

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