Hospital Authority Data Sharing Portal

Online Application Form

▼ Personal Information (* required fields)

Applicant*	Name	University	Faculty / Department
Applicant*	Job Title	Email	Phone

Principal Investigator*	Name	University	Faculty / Department
Principal Investigator*	Job Title	Email	Phone

Researcher*	Name	University	Faculty / Department
Researcher*	Job Title	Email	Phone

Researcher*	Name	University	Faculty / Department
Researcher*	Job Title	Email	Phone

Add Researcher

HA Collaborator	Name	Institution / Department
Job Title	Email	Phone

HA Collaborator	Name	Institution / Department
HA Collaborator	Job Title	Email	Phone

Add HA Collaborator

▼Project Details (* required fields)

Project Title*
(Not more than 255 characters)

Project Summary*
(to be published to portal for the general public to read)
(Not more than 1000 characters)

Project Objectives*
(Please include the contribution to the public good.)
(Not more than 255 characters)

Type of Project*

AI/ML

AI/ML with image analytics

Traditional statistics

Research Methodology*
(Not more than 2000 characters)

Expected Deliverables*
(Not more than 255 characters)

Tool Requirements*
(Available tools in HADCL Platform)
(Not more than 4000 characters)

Has Self-service Data Platform been used to prepare for this project submission?*

Yes

Project Plan

From

Plan / Progress

▼Data Requirements (* required fields)

Required Period of Data*
Structure Data	From	TO	(Recent two years of structural data is not available in HADCL)
Textual Data	From	TO	(Recent two years of textual data is not available in HADCL)
Image Data	From	TO	(Thick slice lossy image is available in HADCL)
Image Modality	X-ray CT MRI

Data Inclusion and Exclusion Criteria*

Data Inclusion Criteria*
(Not more than 255 characters of each Criteria)

Exclusion Criteria (if any)
(Not more than 255 characters of each Criteria)

Remarks:
Please provide the inclusion and exclusion criteria as well as required dataset for each set of the study group, if necessary.

Required Dataset in HA DCL Data Catalogue *
HA DCL Data Catalogue	Dataset ID	Dataset Name	Required (Y/N)	Relevance to Study Objectives (100 characters)
Demographic data	D01	Patient Demographic
Clinical structured notes	D02	Diabetes Mellitus Complication Screening
	D03	Family Medicine - Patient Disease
	D04	Family Medicine - Consultation Note ICPC
Immunization	D05	Immunization
Diagnosis	D06	Diagnosis Progress
Procedure	D07	Procedure Progress
Summary of episodes / Clinical Activity	D08	Outpatient Appointment and Attendance
	D12	Inpatient Admission, Transfer & Discharge - Episode's Transaction
	D09	Accident and Emergency Department Attendance
Radiology examinations	D13	Radiology Appointment
	D14	Radiology Examination Result
	T01	Radiology Exam Report (TEXT)
	X01	Radiology Image (DICOM)
Medications	D15	Medications - Prescription
Medications	D16	Medications - Multiple Dosage
Laboratory tests & results	D17	Laboratory Result - Chemical Pathology
	D18	Laboratory Result - Hematology & Immunology
	D19	Laboratory Result - Microbiology & Virology
	D20	Laboratory Result - Bacterial Culture and Sensitivity Test
	D21	Anatomical Pathology - Specific SNOMED Result
	T02	Laboratory Result (TEXT)
Obstetrics data	D23	Obstetrics
Clinical notes / Summary (Text)	T03	Clinical & Discharge Note (TEXT)

▼Specific Requirement for Dataset

Please provide requirement details of dataset (If any)

Dataset ID

Dataset Name

Description or Definition / Criteria of Required Data
(255 characters)

e.g. D15

Medications - Prescription

Dispensed antimicrobials under BNF 5.1 of included patients

e.g. X01

Radiology Image (DICOM)

Brain CT, thin slice, in year 2019

▼Other Data (NOT under HADCL Data Catalogue)

Required Period of Data

Data Name / Classification
(100 characters)

Description or Definition / Criteria of Required Data
(255 characters)

Relevance to Study Objectives
(100 characters)

Remarks:
Data request(s) that is/are beyond the scope of the HADCL Data Catalogue are subject to exploration and panel review.

▼Attachment (* required fields)

Ethics Approval*	Attach Remove
Support from Organization*	Attach Remove
Supplementary information	Attach Remove Attach Remove Attach Remove

I accept and agree to the Personal Information Collection Statement.*

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