Premier Health

IRB Human Subjects Protection CITI Training Requirements:

CITI Program.2023 Updatepdf.docx 

Premier Health Human Investigational Research Committee (HIRC) Application

Premier HIRC APplication v12.2023.docx 

Case report or Case series request form:

Case Report Request.docx 

For data gathering from the premier EMR:

Gathering EMR data.docx 

Request for research EPIC account with remote access:

Research Student Info Form Premier.docx 

Is your research quality improvement? Quality improvement checklist (first link) and quality improvement protocol template (second link):

QI Checklist.docx 

QI Protocol Template.docx 

Phases of study: 

Credentialing phase: 

Regulatory Phase.docx 

Design Phase:

Design Phase.docx 

Monitoring Phase:

Monitoring Phase.docx 

Other links:

RACI matrix for minimal risk human subjects research:

Clinical Research RACI May 2023.xlsm 

Educational resources for investigators:

educational-resources-for-investigators.docx 

Visting Medical Students, Healthstream Learning Modules for EPIC and HIPPA:

Visiting Students Healthstream Learning Modules for EPIC and HIPPA.docx 

Medical Library

1 Wyoming Street

Dayton, Ohio 45409​

Phone: (937) 208-2612

Fax: (937) 208-2569

Email: mvhmedlibrary@premierhealth.com

Hours ​

Monday – Friday  8:00 am - 4:30 pm 

Closed Saturdays, Sundays, and Holidays​

Medical students and outside interns requiring EPIC access for research, please fill out the following forms: 

1. CARF - Clinical Research 

2. Electronic Medical Record Research Agreement. 

You can request on site Epic (quick disclosure) and/or Epic Carelink (remote) access for medical students who are rotating elsewhere or are not able to work on campus. Please check with your PI to ensure you are added and approved to work on IRB protocols prior to requesting access. An IRB number is requested on the CARF and audits are conducted to ensure proper use and distribution of access to EMR is meeting the requirements for minimally necessary access.

Completed forms can be sent to Jllader@premierhealth.com. For issues with accessing EpicCare Link or setting up the 2-factor authentication, please contact the customer support desk at (937) 208-2737 – please note however that level-2 support for non-patient care issues is during normal business hours only.