Clinical Data Warehouse (CDW) for Research:
Data Request Form

Use this form to submit a research data request.

We encourage research teams to
visit our website before submitting a CDW data request. Our website provides information on CDW services, data request form submission, and fees and billing. 

Current Wait Times & Fees - Updated October 2022
BMC FY23 Fees

Research teams must provide a funding account number and finalize the 
study's IRB protocol before a data request will be added to the CDW work queue. 

If you are interested in speaking with CDW personnel about your study or request, email cdw@bmc.orgAn initial consultation is provided to all studies free of charge. Research teams do not need to submit a data request form to request a consultation.

If you are concerned about CDW fees, please reach out to the CDW to schedule a consultation. We can work with you to keep costs low.

Study Information
















CDW Data Request Information





Medical Record Selection: How will the CDW for Research identify the medical records to pull data from? 
Define the inclusion criteria and exclusion criteria for the medical records from which to build the requested data set.
  • Include all relevant ICD-10 and/or CPT codes.
  • Fully spell out all medications, treatments, surgeries, and/or procedures (do not use acronyms).
If IRB-approved study: Inclusion/exclusion criteria must match the IRB protocol or be a subset of IRB protocol criteria. We cannot pull data from medical records that are not in-line with what is described in your IRB protocol.


Record Date Range: Enter the date range for the requested data. 
The range may be exact dates (March 1, 2018 - December 31, 2018) or may be a specified period of time pre/post study enrollment.

If IRB-approved study: The CDW for Research can only pull data within the date range reflected in the HIPAA section of the study's INSPIR application.

Data Fields: List all data fields you want the CDW for Research to provide to you in the data set.
  • Include all applicable ICD-10 and CPT codes. 
  • Fully spell out all medications, treatments, surgeries, and/or procedures. Do not use acronyms.
  • List only the data fields you need the CDW for Research analyst to pull for you. Do not include any data that you will hand abstract or collect via primary collection. If you are unsure about what information to include in your request, please email cdw@bmc.org to set up a quick consultation. 
  • Requested data fields may also be uploaded as a Word document or Excel file below.
If IRB-approved study: The CDW for Research can only pull data fields listed in the HIPAA section of the study's INSPIR application. 

Attachments

Attachments: Upload the list of data fields and/or other relevant study documents.
  • Reference P.I. Name and Study H-# in file title.
  • Select "Upload another file" to upload additional files.

Contact Information











The CDW for Research requires mentors to be engaged in the trainee's data request process. Mentors should plan to attend the initial data request consultation with the trainee. 






Funding Information

The CDW for Research charges an hourly fee for all projects beyond simple count requests. Research teams are encouraged to review the Fees & Billing policies before submitting a data request.