Preserving medical correctness, readability and consistency in de-identified health records

Health Informatics J. 2017 Dec;23(4):291-303. doi: 10.1177/1460458216647760. Epub 2016 May 19.

Abstract

A health record database contains structured data fields that identify the patient, such as patient ID, patient name, e-mail and phone number. These data are fairly easy to de-identify, that is, replace with other identifiers. However, these data also occur in fields with doctors' free-text notes written in an abbreviated style that cannot be analyzed grammatically. If we replace a word that looks like a name, but isn't, we degrade readability and medical correctness. If we fail to replace it when we should, we degrade confidentiality. We de-identified an existing Danish electronic health record database, ending up with 323,122 patient health records. We had to invent many methods for de-identifying potential identifiers in the free-text notes. The de-identified health records should be used with caution for statistical purposes because we removed health records that were so special that they couldn't be de-identified. Furthermore, we distorted geography by replacing zip codes with random zip codes.

Keywords: anonymity; consistency; correctness; de-identification; electronic health records; readability.

MeSH terms

  • Comprehension*
  • Confidentiality
  • Data Accuracy*
  • Electronic Health Records / standards*
  • Humans
  • Netherlands