BMC Med Inform Decis Mak - Development and evaluation of a de-identification procedure for a case register sourced from mental health electronic records.

Tópicos

{ ehr(2073) health(1662) electron(1139) }
{ studi(1410) differ(1259) use(1210) }
{ method(1969) cluster(1462) data(1082) }
{ take(945) account(800) differ(722) }
{ research(1085) discuss(1038) issu(1018) }
{ extract(1171) text(1153) clinic(932) }
{ record(1888) medic(1808) patient(1693) }
{ patient(2315) diseas(1263) diabet(1191) }
{ data(3008) multipl(1320) sourc(1022) }
{ system(1050) medic(1026) inform(1018) }
{ problem(2511) optim(1539) algorithm(950) }
{ control(1307) perform(991) simul(935) }
{ featur(1941) imag(1645) propos(1176) }
{ learn(2355) train(1041) set(1003) }
{ case(1353) use(1143) diagnosi(1136) }
{ model(3404) distribut(989) bayesian(671) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ concept(1167) ontolog(924) domain(897) }
{ method(1557) propos(1049) approach(1037) }
{ data(2317) use(1299) case(1017) }
{ can(981) present(881) function(850) }
{ high(1669) rate(1365) level(1280) }
{ decis(3086) make(1611) patient(1517) }
{ can(774) often(719) complex(702) }
{ data(1737) use(1416) pattern(1282) }
{ general(901) number(790) one(736) }
{ visual(1396) interact(850) tool(830) }
{ sampl(1606) size(1419) use(1276) }
{ structur(1116) can(940) graph(676) }
{ estim(2440) model(1874) function(577) }
{ detect(2391) sensit(1101) algorithm(908) }
{ bind(1733) structur(1185) ligand(1036) }
{ method(1219) similar(1157) match(930) }
{ network(2748) neural(1063) input(814) }
{ studi(2440) review(1878) systemat(933) }
{ treatment(1704) effect(941) patient(846) }
{ framework(1458) process(801) describ(734) }
{ care(1570) inform(1187) nurs(1089) }
{ search(2224) databas(1162) retriev(909) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ spatial(1525) area(1432) region(1030) }
{ monitor(1329) mobil(1314) devic(1160) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ patient(1821) servic(1111) care(1106) }
{ imag(1947) propos(1133) code(1026) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ imag(2675) segment(2577) method(1081) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ model(2220) cell(1177) simul(1124) }
{ method(984) reconstruct(947) comput(926) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ state(1844) use(1261) util(961) }
{ model(2656) set(1616) predict(1553) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ gene(2352) biolog(1181) express(1162) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ use(2086) technolog(871) perceiv(783) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(2212) result(1239) propos(1039) }

Resumo

CKGROUND: Electronic health records (EHRs) provide enormous potential for health research but also present data governance challenges. Ensuring de-identification is a pre-requisite for use of EHR data without prior consent. The South London and Maudsley NHS Trust (SLaM), one of the largest secondary mental healthcare providers in Europe, has developed, from its EHRs, a de-identified psychiatric case register, the Clinical Record Interactive Search (CRIS), for secondary research.METHODS: We describe development, implementation and evaluation of a bespoke de-identification algorithm used to create the register. It is designed to create dictionaries using patient identifiers (PIs) entered into dedicated source fields and then identify, match and mask them (with ZZZZZ) when they appear in medical texts. We deemed this approach would be effective, given high coverage of PI in the dedicated fields and the effectiveness of the masking combined with elements of a security model. We conducted two separate performance tests i) to test performance of the algorithm in masking individual true PIs entered in dedicated fields and then found in text (using 500 patient notes) and ii) to compare the performance of the CRIS pattern matching algorithm with a machine learning algorithm, called the MITRE Identification Scrubber Toolkit - MIST (using 70 patient notes - 50 notes to train, 20 notes to test on). We also report any incidences of potential breaches, defined by occurrences of 3 or more true or apparent PIs in the same patient's notes (and in an additional set of longitudinal notes for 50 patients); and we consider the possibility of inferring information despite de-identification.RESULTS: True PIs were masked with 98.8% precision and 97.6% recall. As anticipated, potential PIs did appear, owing to misspellings entered within the EHRs. We found one potential breach. In a separate performance test, with a different set of notes, CRIS yielded 100% precision and 88.5% recall, while MIST yielded a 95.1% and 78.1%, respectively. We discuss how we overcome the realistic possibility - albeit of low probability - of potential breaches through implementation of the security model.CONCLUSION: CRIS is a de-identified psychiatric database sourced from EHRs, which protects patient anonymity and maximises data available for research. CRIS demonstrates the advantage of combining an effective de-identification algorithm with a carefully designed security model. The paper advances much needed discussion of EHR de-identification - particularly in relation to criteria to assess de-identification, and considering the contexts of de-identified research databases when assessing the risk of breaches of confidential patient information.

Resumo Limpo

ckground electron health record ehr provid enorm potenti health research also present data govern challeng ensur deidentif prerequisit use ehr data without prior consent south london maudsley nhs trust slam one largest secondari mental healthcar provid europ develop ehr deidentifi psychiatr case regist clinic record interact search cris secondari researchmethod describ develop implement evalu bespok deidentif algorithm use creat regist design creat dictionari use patient identifi pis enter dedic sourc field identifi match mask zzzzz appear medic text deem approach effect given high coverag pi dedic field effect mask combin element secur model conduct two separ perform test test perform algorithm mask individu true pis enter dedic field found text use patient note ii compar perform cris pattern match algorithm machin learn algorithm call mitr identif scrubber toolkit mist use patient note note train note test also report incid potenti breach defin occurr true appar pis patient note addit set longitudin note patient consid possibl infer inform despit deidentificationresult true pis mask precis recal anticip potenti pis appear owe misspel enter within ehr found one potenti breach separ perform test differ set note cris yield precis recal mist yield respect discuss overcom realist possibl albeit low probabl potenti breach implement secur modelconclus cris deidentifi psychiatr databas sourc ehr protect patient anonym maximis data avail research cris demonstr advantag combin effect deidentif algorithm care design secur model paper advanc much need discuss ehr deidentif particular relat criteria assess deidentif consid context deidentifi research databas assess risk breach confidenti patient inform

Resumos Similares

Methods Inf Med - Utilizing IHE-based Electronic Health Record systems for secondary use. ( 0,729781136712167 )
J Am Med Inform Assoc - Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative. ( 0,713108809891089 )
J Am Med Inform Assoc - Data standards to support health information exchange between poison control centers and emergency departments. ( 0,703326919316516 )
Appl Clin Inform - Capturing information needs of care providers to support knowledge sharing and distributed decision making. ( 0,6992380077428 )
J Med Syst - Organization's quality maturity as a vehicle for EHR success. ( 0,697895910382743 )
Int J Med Inform - Collaboration in electronic medical evidence development: a case study of the Social Security Administration's MEGAHIT System. ( 0,696076294142986 )
Appl Clin Inform - Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes. ( 0,694512296892469 )
J Med Syst - Benefits and challenges of electronic health record system on stakeholders: a qualitative study of outpatient physicians. ( 0,691841733903163 )
AMIA Annu Symp Proc - The promise of the CCD: challenges and opportunity for quality improvement and population health. ( 0,689893718123282 )
J Am Med Inform Assoc - There is no neutral position on fraud! ( 0,68634326734612 )
J Am Med Inform Assoc - A typology of electronic health record workarounds in small-to-medium size primary care practices. ( 0,684907485893657 )
J Biomed Inform - Translating standards into practice: experience and lessons learned at the Department of Veterans Affairs. ( 0,68397512423768 )
Methods Inf Med - Semantic validation of standard-based electronic health record documents with W3C XML schema. ( 0,680356980442951 )
Perspect Health Inf Manag - Use of health information technology among racial and ethnic underserved communities. ( 0,677413909449088 )
BMC Med Inform Decis Mak - Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico. ( 0,677393358754715 )
J Am Med Inform Assoc - The Hub Population Health System: distributed ad hoc queries and alerts. ( 0,6738005028711 )
J Biomed Inform - Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region. ( 0,672790192354898 )
J Med Syst - Threat modeling for electronic health record systems. ( 0,672127932227144 )
J Am Med Inform Assoc - Evaluating and classifying the readiness of technology specifications for national standardization. ( 0,670884879709423 )
Int J Med Inform - The trends in EMR and CPOE adoption in Japan under the national strategy. ( 0,667465533878232 )
J Am Med Inform Assoc - The long-term financial impact of electronic health record implementation. ( 0,667419856878649 )
AMIA Annu Symp Proc - Cross-mapping clinical notes between hospitals: an application of the LOINC Document Ontology. ( 0,666861762169706 )
J Am Med Inform Assoc - Electronic health record use and preventive counseling for US children and adolescents. ( 0,666840816162447 )
Int J Med Inform - Rates, levels, and determinants of electronic health record system adoption: a study of hospitals in Riyadh, Saudi Arabia. ( 0,664095030678864 )
Perspect Health Inf Manag - Leveraging the cloud for electronic health record access. ( 0,662775821684068 )
Perspect Health Inf Manag - The impact of electronic health record usage on cancer registry systems in Alabama. ( 0,661741141659911 )
Int J Med Inform - Adoption of electronic health records in Korean tertiary teaching and general hospitals. ( 0,661658221017035 )
Healthc (Amst) - Instant replay. ( 0,660359080389891 )
Perspect Health Inf Manag - Health information technology: integration of clinical workflow into meaningful use of electronic health records. ( 0,659674823808472 )
BMC Med Inform Decis Mak - Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers. ( 0,659021528267902 )
Appl Clin Inform - Predictors of success for electronic health record implementation in small physician practices. ( 0,658781384359386 )
J Am Med Inform Assoc - Health-information exchange: why are we doing it, and what are we doing? ( 0,657634246715087 )
Healthc (Amst) - Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers. ( 0,657201182273664 )
AMIA Annu Symp Proc - Clinical Decision Support-based Quality Measurement (CDS-QM) Framework: Prototype Implementation, Evaluation, and Future Directions. ( 0,656029757470626 )
J Biomed Inform - Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data: the SHARPn project. ( 0,654422243556717 )
Int J Med Inform - Do integrated record systems lead to integrated services? An observational study of a multi-professional system in a diabetes service. ( 0,653418068316632 )
Perspect Health Inf Manag - Electronic health record adoption and use by Nebraska pharmacists. ( 0,652969301291151 )
AMIA Annu Symp Proc - Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation. ( 0,649276207513951 )
Healthc (Amst) - A novel community-based delivery model to combat cancer disparities. ( 0,648530796345773 )
Perspect Health Inf Manag - Electronic health records and information portability: a pilot study in a rural primary healthcare center in India. ( 0,648068936253682 )
Appl Clin Inform - Physician specialty and variations in adoption of electronic health records. ( 0,648037046060939 )
J Am Med Inform Assoc - Assessing the process of designing and implementing electronic health records in a statewide public health system: the case of Colima, Mexico. ( 0,647211751943009 )
Perspect Health Inf Manag - Use of health information technology by office-based physicians: comparison of two contemporaneous public-use physician surveys. ( 0,645267440865622 )
BMC Med Inform Decis Mak - A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review. ( 0,643161667492837 )
J Am Med Inform Assoc - Exploring the sociotechnical intersection of patient safety and electronic health record implementation. ( 0,643138411448537 )
J Med Syst - Factors associated with health information exchange system usage in a safety-net ambulatory care clinic setting. ( 0,643119582335104 )
Artif Intell Med - Creating personalised clinical pathways by semantic interoperability with electronic health records. ( 0,64234947460117 )
AMIA Annu Symp Proc - Assessing readiness for meeting meaningful use: identifying electronic health record functionality and measuring levels of adoption. ( 0,639551139165601 )
J Am Med Inform Assoc - Implications of an emerging EHR monoculture for hospitals and healthcare systems. ( 0,637831100416898 )
J Am Med Inform Assoc - Sequencing of EHR adoption among US hospitals and the impact of meaningful use. ( 0,63549203756866 )
J Med Syst - Challenges, alternatives, and paths to sustainability for health information exchange efforts. ( 0,634921110953029 )
J Am Med Inform Assoc - Phased implementation of electronic health records through an office of clinical transformation. ( 0,63425238872207 )
J Am Med Inform Assoc - Next-generation phenotyping of electronic health records. ( 0,634130550889403 )
J Med Syst - Analysis of network type exchange in the health care system: a stakeholder approach. ( 0,633960337344291 )
Methods Inf Med - Electronic health record interoperability as realized in the Turkish health information system. ( 0,633645968339642 )
J Am Med Inform Assoc - The marginal value of pre-visit paper reminders when added to a multifaceted electronic health record based quality improvement system. ( 0,633574111925825 )
Health Info Libr J - Do quality improvement systems improve health library services? A systematic review. ( 0,632664181086908 )
Health Informatics J - Evaluation of ISO EN 13606 as a result of its implementation in XML. ( 0,632631480666479 )
BMC Med Inform Decis Mak - Towards plug-and-play integration of archetypes into legacy electronic health record systems: the ArchiMed experience. ( 0,632619631977175 )
AMIA Annu Symp Proc - Leveraging standards to support patient-centric interdisciplinary plans of care. ( 0,631990293496992 )
J Am Med Inform Assoc - Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research. ( 0,631844930310509 )
Perspect Health Inf Manag - Hospital characteristics related to the intention to apply for meaningful use incentive payments. ( 0,630291691478643 )
J Am Med Inform Assoc - Security practices and regulatory compliance in the healthcare industry. ( 0,629906322194305 )
AMIA Annu Symp Proc - Using Arden Syntax to identify registry-eligible very low birth weight neonates from the Electronic Health Record. ( 0,629783919495387 )
J Biomed Inform - Implementations of the HL7 Context-Aware Knowledge Retrieval (Infobutton) Standard: challenges, strengths, limitations, and uptake. ( 0,629277657489849 )
J Am Med Inform Assoc - Same organization, same electronic health records (EHRs) system, different use: exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting. ( 0,626423194938716 )
J Med Syst - Development of fundamental infrastructure for nationwide EHR in Japan. ( 0,624422459750791 )
J Med Syst - Usability evaluation of paper-based Hajji Health Record format. ( 0,624007733663725 )
Appl Clin Inform - Drivers and barriers in health IT adoption: a proposed framework. ( 0,623969563152509 )
AMIA Annu Symp Proc - Implementing the IT infrastructure for health reform: adoption of health IT among patient-centered medical home practices. ( 0,623722329091617 )
Appl Clin Inform - The impact of geography on hospital electronic health records implementation in alabama: implications for meaningful use. ( 0,623638060665438 )
AMIA Annu Symp Proc - Bridging informatics and implementation science: evaluating a framework to assess electronic health record implementations in community settings. ( 0,622589564491942 )
J Am Med Inform Assoc - Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. ( 0,620920842916861 )
J Med Syst - Quality and cost improvement of healthcare via complementary measurement and diagnosis of patient general health outcome using electronic health record data: research rationale and design. ( 0,61822331983428 )
J Med Syst - EHR systems in the Spanish Public Health National System: the lack of interoperability between primary and specialty care. ( 0,617374630951927 )
IEEE J Biomed Health Inform - Service for the pseudonymization of electronic healthcare records based on ISO/EN 13606 for the secondary use of information. ( 0,617170343543224 )
Perspect Health Inf Manag - Adding a genomic healthcare component to a health information management curriculum. ( 0,617023666546839 )
Perspect Health Inf Manag - Evaluation of inpatient clinical documentation readiness for ICD-10-CM. ( 0,616595390048962 )
J Am Med Inform Assoc - Re-examining health IT policy: what will it take to derive value from our investment? ( 0,61630020362834 )
J Am Med Inform Assoc - When does adoption of health information technology by physician practices lead to use by physicians within the practice? ( 0,615705658570234 )
Appl Clin Inform - Adoption of electronic health records: a qualitative study of academic and private physicians and health administrators. ( 0,609974608770409 )
Appl Clin Inform - Electronic Health Record Adoption - Maybe It's not about the Money: Physician Super-Users, Electronic Health Records and Patient Care. ( 0,609902905175238 )
Comput Methods Programs Biomed - The relationship between usage intention and adoption of electronic health records at primary care clinics. ( 0,609049563570585 )
J Am Med Inform Assoc - Harmonized patient-reported data elements in the electronic health record: supporting meaningful use by primary care action on health behaviors and key psychosocial factors. ( 0,608029532678958 )
J Am Med Inform Assoc - Consumer experience with and attitudes toward health information technology: a nationwide survey. ( 0,606385747515986 )
Telemed J E Health - Teledentistry in practice: literature review. ( 0,606232622249279 )
Appl Clin Inform - Utilizing an electronic health record system to improve vaccination coverage in children. ( 0,605030863457476 )
Int J Med Inform - Electronic health records implementation: an evaluation of information system impact and contingency factors. ( 0,604341047852261 )
AMIA Annu Symp Proc - Progress and challenge in meeting meaningful use at an integrated delivery network. ( 0,603979624053553 )
J Am Med Inform Assoc - The use of open source electronic health records within the federal safety net. ( 0,603864646066369 )
Telemed J E Health - New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain. ( 0,60317383093728 )
J Am Med Inform Assoc - Patient safety goals for the proposed Federal Health Information Technology Safety Center. ( 0,602762811618149 )
Healthc (Amst) - Meaningful use: Floor or ceiling? ( 0,602686058012136 )
AMIA Annu Symp Proc - Data Quality and Interoperability Challenges for eHealth Exchange Participants: Observations from the Department of Veterans Affairs' Virtual Lifetime Electronic Record Health Pilot Phase. ( 0,601734729037519 )
Perspect Health Inf Manag - Impact of electronic health record systems on information integrity: quality and safety implications. ( 0,601423551322714 )
Appl Clin Inform - How could health information exchange better meet the needs of care practitioners? ( 0,601299827585076 )
J Biomed Inform - Content overlap in nurse and physician handoff artifacts and the potential role of electronic health records: a systematic review. ( 0,60065734612903 )
J Am Med Inform Assoc - Genetic data and electronic health records: a discussion of ethical, logistical and technological considerations. ( 0,599462455312456 )
AMIA Annu Symp Proc - A qualitative analysis of EHR clinical document synthesis by clinicians. ( 0,599456569822742 )
Inform Health Soc Care - Attitudes of health professionals towards electronic health records in primary health care settings: a questionnaire survey. ( 0,599299525080188 )