A review of the impact of utilising electronic medical records for clinical research recruitment

Introduction: Recruitment is an important aspect of clinical research, as poor recruitment could undermine the scientific value of a trial or delay the development process of new treatments. The development of electronic medical records provides a new way to identify potential participants for trials by matching the eligibility criteria with patients' data within electronic medical records. Methods: A literature search was performed to examine the effectiveness and efficiency of the electronic medical record recruitment method using MEDLINE, PubMed, PubMed Central, CINAHL Plus with Full Text, ScienceDirect and Cochrane Library databases. These searches generated 11 articles that met the eligibility criteria, and handsearching reference lists generated two additional articles bringing the total number of articles to 13. These articles were subjected to critical appraisal utilising the Effective Public Health Practice Project tool. Results: Out of the 13 included articles, 11 provided quantitative data on recruitment effectiveness while seven articles provided quantitative data on recruitment efficiency. The automation in screening and patient identification by using alerts, a notification system, to notify research staff of a potential participant, was observed to contribute to higher recruitment yield and reduced workload due to its specificity on participant screening. The use of electronic medical record alerts was found to be associated with better recruitment outcomes when they were sent to dedicated research staff rather than physicians. Using electronic medical records for recruitment was found to be effective due to its capability for patient identification outside working hours and fast processing time, which was particularly useful for clinical trials in acute conditions. Several challenges may hinder the impact of the electronic medical record recruitment method, including the lack of conformity of clinical trial eligibility criteria and electronic medical record data structure and missing data. 'Alert fatigue' could also impact on the effectiveness of this method in the long term. Conclusion: The results from this review supports electronic medical record being an effective and efficient method for clinical trial recruitment. Recommendations were made in order to maximise the potential of the electronic medical record recruitment method and also for future research in order to improve the quality of evidence to support this strategy for recruitment.