Out-of-Hospital Research in the Era of Electronic Health Records

Craig D. Newgard, Rochelle Fu, Susan Malveau, Tom Rea, Denise E. Griffiths, Eileen Bulger, Pat Klotz, Abbie Tirrell, Dana Zive

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Conducting out-of-hospital research is unique and challenging and requires tracking patients across multiple phases of care, using multiple sources of patient records and multiple hospitals. The logistics and strategies used for out-of-hospital research are distinct from other forms of clinical research. The increasing use of electronic health records (EHRs) by hospitals and emergency medical services (EMS) agencies presents a large opportunity for accelerating out-of-hospital research, as well as particular challenges. In this study, we describe seven key aspects of designing and implementing out-of-hospital research in the era of EHRs: (1) selection of research sites, (2) defining the patient population, (3) patient sampling and sample size calculations, (4) EMS data, (5) hospital selection, (6) handling missing data, and (7) statistical analysis. We use examples from a recent prospective out-of-hospital cohort study to illustrate these topics, including lessons learned.

Original languageEnglish (US)
Pages (from-to)539-550
Number of pages12
JournalPrehospital Emergency Care
Issue number5
StatePublished - Sep 3 2018


  • emergency medical services
  • methodology
  • out-of-hospital
  • research

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency


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