Patient recruitment into a multicenter clinical cohort linking electronic health records from 5 health systems: Cross-sectional analysis

Wendy L. Bennett, Carolyn T. Bramante, Scott D. Rothenberger, Jennifer L. Kraschnewski, Sharon J. Herring, Michelle R. Lent, Jeanne M. Clark, Molly B. Conroy, Harold Lehmann, Nickie Cappella, Megan Gauvey-Kern, Jody McCullough, Kathleen M. McTigue

Research output: Contribution to journalArticlepeer-review


Background: There is growing interest in identifying and recruiting research participants from health systems using electronic health records (EHRs). However, few studies have described the practical aspects of the recruitment process or compared electronic recruitment methods to in-person recruitment, particularly across health systems. Objective: The objective of this study was to describe the steps and efficiency of the recruitment process and participant characteristics by recruitment strategy. Methods: EHR-based eligibility criteria included being an adult patient engaged in outpatient primary or bariatric surgery care at one of 5 health systems in the PaTH Clinical Research Network and having ≥2 weight measurements and 1 height measurement recorded in their EHR within the last 5 years. Recruitment strategies varied by site and included one or more of the following methods: (1) in-person recruitment by study staff from clinical sites, (2) US postal mail recruitment letters, (3) secure email, and (4) direct EHR recruitment through secure patient web portals. We used descriptive statistics to evaluate participant characteristics and proportion of patients recruited (ie, efficiency) by modality. Results: The total number of eligible patients from the 5 health systems was 5, 051, 187. Of these, 40, 048 (0.8%) were invited to enter an EHR-based cohort study and 1085 were enrolled. Recruitment efficiency was highest for in-person recruitment (33.5%), followed by electronic messaging (2.9%), including email (2.9%) and EHR patient portal messages (2.9%). Overall, 779 (65.7%) patients were enrolled through electronic messaging, which also showed greater rates of recruitment of Black patients compared with the other strategies. Conclusions: We recruited a total of 1085 patients from primary care and bariatric surgery settings using 4 recruitment strategies. The recruitment efficiency was 2.9% for email and EHR patient portals, with the majority of participants recruited electronically. This study can inform the design of future research studies using EHR-based recruitment.

Original languageEnglish (US)
Article numbere24003
JournalJournal of medical Internet research
Issue number5
StatePublished - May 2021

Bibliographical note

Funding Information:
Funding for the study was provided by the Patient-Centered Outcomes Research Institute.

Funding Information:
In 2014, the National Patient-Centered Research Network (PCORnet) was launched with funding from the Patient-Centered Outcomes Research Institute (PCORI). PCORnet's infrastructure can support EHR-based recruitment and study implementation [7]. The PaTH Clinical Research Network (CRN) originally brought together 4 academic medical centers in the mid-Atlantic region of the United States to build the infrastructure to share EHR data across health systems so that patient-centered clinical questions could be answered in real-world settings [8]. A fifth academic health center (Geisinger Health System) was added to the network in 2015.

Publisher Copyright:
© 2021 Journal of Medical Internet Research. All rights reserved.


  • Bariatric
  • Clinical research network
  • Cohort
  • Cohort study design
  • Efficiency
  • Electronic health record
  • Eligibility
  • Enrollment
  • Health system
  • Primary care
  • Process
  • Recruitment
  • Recruitment methods
  • Research
  • Surgery

PubMed: MeSH publication types

  • Journal Article


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