Request for Yale Diagnostic Radiology IDX Database Search
v 7.8.09findit
Request for IDX Imaging Report Data in Department of Diagnostic Radiology/Yale-New Haven Health System/Yale Univ/YNHH
Request for access to Protected Health Information for Healthcare Operations or Research Purposes
Information in red is REQUIRED
TITLE of educ/admin/res activity:
SUMMARY of activity (brief):
Additional documents are attached?
YDR FACULTY supervisor
COLLABORATORS:
TIME FRAME Today’s date:
Data will only be sent to a Yale email
address of a YDR faculty member
Date needed by:
(please allow
minimum of 10 days)
mbermember
Please choose one request box & check the appropriate boxes - A, B, or C
A. Healthcare Operations (including Training & Administration) request for Electronic Records
I request data from the electronic IDX clinical radiology database & AGREE to all of the following:
The protected health information for which access is sought is necessary for the following Healthcare Operations:
Training/Education purposes
Administrative purposes
No protected health information (PHI) will be removed from the YNHHS/YSM facility in the course of my review (laptops
must follow University guidelines in terms of password & encryption protection: http://mire.med.yale.edu/hipaapolicies). All
identifiers, including names, dates, MRN, etc will be removed from any poster or slide presentation.
B. Research request for Electronic Records
I hereby request to review individually identifiable health records for the research purpose specified in the HIC approved
research study entitled:
HIC #
I certify that either (a) I am listed in the approved protocol and waiver by name or category, that the applicable Yale IRB has
also waived consent, and that I will follow all provisions specified in the approved waiver, including disposition of the PHI;
or (b) I have a signed research authorization for each subject that I am reviewing.
No protected health information (PHI) will be removed from the YNHHS/YSM facility in the course of my review (laptops
must follow University guidelines in terms of password & encryption protection: http://mire.med.yale.edu/hipaapolicies).
All identifiers, including names, dates, MRN, etc will be removed from any poster or slide presentation.
Note: The PI of a clinical trial MUST register their trial on ClinicalTrials.gov & most journal editors require this
registration for any research publication – see: http://ycci.yale.edu/researchers/register_ctg.html
C. Request for Electronic Records in PREPARATION for Research
I hereby request to review individually identifiable health records for activities preparatory to research. I represent that the
protected health information (PHI) for which use or access is sought is necessary to prepare research protocol or other
activity preparatory to research. No PHI will be removed from YNHHS/YSM facility in the course of my review (laptops
must follow University guidelines in terms of password & encryption protection http://mire.med.yale.edu/hipaapolicies).
I certify that NO RESEARCH WILL BEGIN prior written approval by Yale HIC institutional review board and will destroy
all identifiers if IRB approval is not obtained. For the request in Box C, fax a signed form to Serena DelBasso 785-3024.
REQUESTER
YDR FACULTY *
*If not the requestor
DATE
DATE
Please SAVE this document as Lastname_RadSearch.doc (eg, Smith1_RadSearch.doc)
and
EMAIL this document to Serena.DelBasso@yale.edu with “IDX request” in the subject heading
Pg 1
SEARCH CRITERIA:
What time frame, patient age, exam type, & specific terms do you seek?
Q1. TIME RANGE OF RECORDS
Start date (mm/dd/yy):
End date: (mm/dd/yy):
Q2. AGE RANGE: All
or current date
OR specific range:
in years
or
mos
or
days
SEARCH by either CATEGORY (Q3) &/or SPECIFIC TERM (Q4) – most of the time you will need to use both
Q3. CATEGORY SEARCH: EXAM/ CPT CODES: Fill out either Column A or Column B
Col A: Limit search to GENERAL CATEGORIES
BODY
Abdomen
Pelvis
BREAST
CARDIAC
INTERVENTION
MUSCULOSKEL
Upper Extr
Lower Extr
Arthrogram
NEURORAD
Brain
ENT
Spine
Interventional
NUCLEAR MED
THORAX
ULTRASOUND
Limit to 3T MRI
Signa 5, since June 2005
Col B: Limit search to SPECIFIC CODES
(download the exam/CPT code list from web)
EXAM CODES
EXAM CODES
EXAM CODES
EXAM CODES
EXAM CODES
EXAM CODES
EXAM CODES
CPT CODES
CPT CODES
CPT CODES
CPT CODES
CPT CODES
CPT CODES
CPT CODES
(note YNHH PACS began 12/97 with CT & MR)
Q4. SEACHING FOR TERMS: Choose either 4A or 4B (use 4B if parenthesis needed)
Q4A. SEARCH SPECIFIC TERMS OR PHRASES (be VERY specific, even with the inclusion of spaces eg, If searching for tumors, term 1=”neoplasm” or term 2= “tumor” or term 3= “extraaxial lesion”)
↓ CLICK HERE FOR and/or/except
TERM 1
TERM 2
TERM 3
TERM 4
TERM 5
TERM 6
TERM 7
TERM 8
Q4B. LOGIC SENTENCE FOR SEARCH, if parenthesis needed:
[if you need parenthesis for your search– eg, if searching for lung cancers, you might structure this as: “lung and (neoplasm or cancer or tumor or ca)”]
Q4C. LIMIT term search{from 4A or 4B} to the following FIELDS (pick one or more):


ALL
(use this for most searches)
  Diagnostic Report Text
(use this for most searches)

 IMPRESSION portion of Report Text (use this for most searches)





 Preliminary Diagnosis
 Clinical History
 Signs & Symptoms: Reason For Exam
 Radiologist Attending



 Radiologist Trainee
(Rad 2)
 Physician - Patient's Responsible
 Physician - Exam Requesting
(Rad 1)
Pg 2
Q5. FACILITY & PATIENT TYPE: Search for exams at which of the following facilities or with this patient status:

FACILITY
ALL facilities
YNHH – the hospital
Long Wharf, Shoreline
Breast Imaging
DI, BI, LW
DI
LW
BI

PATIENT TYPE
ALL Inpatient & Outpatient & ED
IN-Patient
OUT-Patient
ED
DISPLAY OF RESULTS: After the records are found using the above search,
what fields do you wish to have displayed in your results?
Q6. Please check off the information you wish to obtain:
 ALL (fields listed below, including PHI info)
 ALL (fields listed below) without PHI info
(Research without PHI)
 Patient Name
 Medical Record No
 Accession Number
PHI
 Patient Date of Birth
 Exam Completed Date
 Patient Age At Time Of Exam
 Patient Gender/Sex
 Report Date
 Patient Status
 Patient Location
 Exam Description
}
info
 Exam Record
 Physician, Exam Requesting
 Phone - Physician Requesting
 Physician, Patient's Responsible
 Phone - Responsible Physician
 Radiologist Attending (Rad 1)
 Radiologist Trainee (Rad 2)
 Clinical History
 Signs & Symptoms: Reason for Exam
 Preliminary Diagnosis
 Diagnostic Report Text
 Impression Text
Other
FORMAT OF RESULTS: Results distributed in electronic format - which format?
We will NOT PRINT the results. Electronic data will be sent to the faculty member listed on the first page
Q7. Format:
Word text file
Excel file (Reports are TRUNCATED, so only if no Diagnostic Report Text is included;
you are better off requesting Impression Text rather than full Report if you want an excel file)

CSV (comma separated values) file
WHERE DO WE SEND DATA?
Solely to Yale Attending’s email address listed here (must be a Yale email):

Pg 3