ArticleApplied clinical informatics2017
Screening Consolidated Clinical Document Architecture (CCDA) Documents for Sensitive Data Using a Rule-Based Decision Support System.
Article in Applied clinical informatics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Assessment of health conditions from patient electronic health record portals vs self-reported questionnaires: an analysis of the INSPIRE study.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Data Interoperability for Ambulatory Monitoring of Cardiovascular Disease: A Scientific Statement From the American Heart Association.Circulation. Genomic and precision medicine · 2024Article
- Applicability of Different Electronic Record Types for Use in Patient Recruitment Support Systems: Comparative Analysis.JMIR formative research · 2021Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Centers for Medicare & Medicaid Services' Stage 2 final rule requires that eligible hospitals provide a visit summary electronically at transitions of care in order to qualify for "meaningful use" incentive payments. However, Massachusetts state law and Federal law prohibit the transmission of documents containing "sensitive" data unless there is a new patient consent for each transmission.
objectivesTo describe the implementation and evaluation of a rule-based decision support system used to screen transition of care documents for sensitive data.
methodsWe implemented a rule-based document screening system to identify transition of care documents that might contain sensitive data. The transmission of detected documents is withheld until a new patient consent is obtained. The documents that were flagged as containing sensitive data were reviewed in two different time periods to verify that the decision support system was not missing documents or withholding more documents than necessary.
resultsThe rule-based screening system has been in regular production use for the past 18 months. During the first evaluation period, 3% of 5,841 documents were identified as containing sensitive data (true-positive rate of 44%). After additional enhancements to the rules, the system was evaluated a second time and 4.5% of 6,935 documents were identified as containing sensitive data (true-positive rate of 98.4%).
conclusionThe analysis of the system demonstrates that production rules can be used to automatically screen the content of transition of care documents for sensitive data. The utilization of the rule-based decision support system enabled our hospitals to achieve meaningful use and, at the same time, remain compliant with state and federal laws.
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