Program of Experimental Medicine
POEM

Health Record Chart Pulling

POEM will pay up to a max/year (contact POEMadmin@lhsc.on.ca for amount of support) for health record chart pulling services from the Health Information Management department at LHSC or Health Information Management department at SJHC for DOM Practice Plan members. This service is for non-industry sponsored research only.

DOM faculty can access this service by:

1. Completing a Request for Access to Personal Health Information for Research, Education and Quality Assurance form with all required information. Note data is hosted at the site where the patient-visit or IP stay happened (where the patient was registered), which will determine which form to complete:
   • For St. Joseph’s, go to: https://intra.sjhc.london.on.ca/support-teams/health-information-management/forms.
     • Click on Request for Use of Personal Health Information for Research, Education and Quality Assurance to download the form.
     • Submit the completed form to QAHIM@sjhc.london.on.ca.
   • For LHSC, go to https://intra.lhsc.on.ca/health-information-management-him.
     • Under Quick links, click Use of Personal Health Information for Research, Education and Quality Assurance.
     • Login with your LHSC Username and Password, which will open the Policy.
     • At the bottom of the Policy, under Appendices, click Appendix C – Request for Access to Personal Health Information for Research, Education and Quality Assurance Form. This will download the form.
     • Submit the completed form to the Research Contact in HIM, Jason.Nagyszegi@lhsc.on.ca, 519-685-8500 Ext 52830.
2. Send your invoice to DOM Finance for reimbursement of up to $500/year. Make sure the invoice includes Western University in the To: address field.

Note if the services will exceed the allotted max/year and you do not have the research funds to pay for additional records, you may e-mail POEMadmin@lhsc.on.ca with the cost estimate and reason why additional funding is needed.