title: Comparison of electronic health record system functionalities to support the patient recruitment process in clinical trials.
abstract: OBJECTIVE
  Reusing data from electronic health records for clinical and translational research and especially for patient recruitment has been tackled in a broader manner since about a decade. Most projects found in the literature however focus on standalone systems and proprietary implementations at one particular institution often for only one singular trial and no generic evaluation of EHR systems for their applicability to support the patient recruitment process does yet exist. Thus we sought to assess whether the current generation of EHR systems in Germany provides modules/tools, which can readily be applied for IT-supported patient recruitment scenarios.
  
  
  METHODS
  We first analysed the EHR portfolio implemented at German University Hospitals and then selected 5 sites with five different EHR implementations covering all major commercial systems applied in German University Hospitals. Further, major functionalities required for patient recruitment support have been defined and the five sample EHRs and their standard tools have been compared to the major functionalities.
  
  
  RESULTS
  In our analysis of the site's hospital information system environments (with four commercial EHR systems and one self-developed system) we found that - even though no dedicated module for patient recruitment has been provided - most EHR products comprise generic tools such as workflow engines, querying capabilities, report generators and direct SQL-based database access which can be applied as query modules, screening lists and notification components for patient recruitment support. A major limitation of all current EHR products however is that they provide no dedicated data structures and functionalities for implementing and maintaining a local trial registry.
  
  
  CONCLUSIONS
  At the five sites with standard EHR tools the typical functionalities of the patient recruitment process could be mostly implemented. However, no EHR component is yet directly dedicated to support research requirements such as patient recruitment. We recommend for future developments that EHR customers and vendors focus much more on the provision of dedicated patient recruitment modules.
authors.affiliation: Center for Information Technology and Medical Engineering, Heidelberg University Hospital, Speyerer Straße 4, 69115 Heidelberg, Germany. Electronic address: bjoern.schreiweis@med.uni-heidelberg.de.
authors.forename: Björn
authors.initials: B
authors.lastname: Schreiweis
authors.affiliation: Institute of Medical Informatics, University of Münster, Albert-Schweitzer-Campus 1, A11, 48149 Münster, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Trinczek
authors.affiliation: Chair of Medical Informatics, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstraße 12, 91054 Erlangen, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Köpcke
authors.affiliation: Department of Information- and Communication-Technology, Düsseldorf University Hospital, Moorenstraße 5, 40225 Düsseldorf, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Leusch
authors.affiliation: Department of Medical Informatics in Anesthesiology and Intensive Care Medicine, Justus-Liebig University Gießen, Rudolf-Buchheimstraße 7, 35385 Gießen, Germany.
authors.forename: Raphael W
authors.initials: RW
authors.lastname: Majeed
authors.affiliation: Coordination Centre for Clinical Trials, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Wenk
authors.affiliation: Center for Information Technology and Medical Engineering, Heidelberg University Hospital, Speyerer Straße 4, 69115 Heidelberg, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Bergh
authors.affiliation: Coordination Centre for Clinical Trials, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Ohmann
authors.affiliation: Department of Medical Informatics in Anesthesiology and Intensive Care Medicine, Justus-Liebig University Gießen, Rudolf-Buchheimstraße 7, 35385 Gießen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Röhrig
authors.affiliation: Institute of Medical Informatics, University of Münster, Albert-Schweitzer-Campus 1, A11, 48149 Münster, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Dugas
authors.affiliation: Chair of Medical Informatics, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstraße 12, 91054 Erlangen, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Prokosch
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D002986:Clinical Trials as Topic / Q000379:methods*; D057286:Electronic Health Records / Q000458:organization & administration*; D005858:Germany; D055991:Health Records, Personal; D016247:Information Storage and Retrieval / Q000379:methods*; D018579:Patient Selection
keywords: Clinical trials; Electronic health records; Hospital information systems; Patient selection