Confidentiality of patient information is an essential part of Electronic Health Record System. Patient information, if exposed, can cause a serious damage to the privacy of individuals receiving healthcare. Hence it is important to remove such details from physician notes. A system is proposed which consists of a deep learning model where a de-convolutional neural network and bi-directional LSTM-CNN is used along with regular expressions to recognize and eliminate the individually identifiable information. This information is then removed from a medical practitioner's data which further allows the fair usage of such information among researchers and in clinical trials.
Use of medical data, also known as electronic health records, in research helps develop and advance medical science. However, protecting patient confidentiality and identity while using medical data for analysis is crucial. Medical data can be in the form of tabular structures (i.e. tables), free-form narratives, and images. This study focuses on medical data in the free form longitudinal text. De-identification of electronic health records provides the opportunity to use such data for research without it affecting patient privacy, and avoids the need for individual patient consent. In recent years there is increasing interest in developing an accurate, robust and adaptable automatic de-identification system for electronic health records. This is mainly due to the dilemma between the availability of an abundance of health data, and the inability to use such data in research due to legal and ethical restrictions. De-identification tracks in competitions such as the 2014 i2b2 UTHealth and the 2016 CEGS N-GRID shared tasks have provided a great platform to advance this area. The primary reasons for this include the open source nature of the dataset and the fact that raw psychiatric data were used for 2016 competitions. This study focuses on noticeable trend changes in the techniques used in the development of automatic de-identification for longitudinal clinical narratives. More specifically, the shift from using conditional random fields (CRF) based systems only or rules (regular expressions, dictionary or combinations) based systems only, to hybrid models (combining CRF and rules), and more recently to deep learning based systems. We review the literature and results that arose from the 2014 and the 2016 competitions and discuss the outcomes of these systems. We also provide a list of research questions that emerged from this survey.
Patient notes contain a wealth of information of potentially great interest to medical investigators. However, to protect patients' privacy, Protected Health Information (PHI) must be removed from the patient notes before they can be legally released, a process known as patient note de-identification. The main objective for a de-identification system is to have the highest possible recall. Recently, the first neural-network-based de-identification system has been proposed, yielding state-of-the-art results. Unlike other systems, it does not rely on human-engineered features, which allows it to be quickly deployed, but does not leverage knowledge from human experts or from electronic health records (EHRs). In this work, we explore a method to incorporate human-engineered features as well as features derived from EHRs to a neural-network-based de-identification system. Our results show that the addition of features, especially the EHR-derived features, further improves the state-of-the-art in patient note de-identification, including for some of the most sensitive PHI types such as patient names. Since in a real-life setting patient notes typically come with EHRs, we recommend developers of de-identification systems to leverage the information EHRs contain.
De-identification of electronic health records (EHR) is a vital step towards advancing health informatics research and maximising the use of available data. It is a two-step process where step one is the identification of protected health information (PHI), and step two is replacing such PHI with surrogates. Despite the recent advances in automatic de-identification of EHR, significant obstacles remain if the abundant health data available are to be used to the full potential. Accuracy in de-identification could be considered a necessary, but not sufficient condition for the use of EHR without individual patient consent. We present here a comprehensive review of the progress to date, both the impressive successes in achieving high accuracy and the significant risks and challenges that remain. To best of our knowledge, this is the first paper to present a complete picture of end-to-end automatic de-identification. We review 18 recently published automatic de-identification systems -designed to de-identify EHR in the form of free text- to show the advancements made in improving the overall accuracy of the system, and in identifying individual PHI. We argue that despite the improvements in accuracy there remain challenges in surrogate generation and replacements of identified PHIs, and the risks posed to patient protection and privacy.
Objective: Patient notes in electronic health records (EHRs) may contain critical information for medical investigations. However, the vast majority of medical investigators can only access de-identified notes, in order to protect the confidentiality of patients. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) defines 18 types of protected health information (PHI) that needs to be removed to de-identify patient notes. Manual de-identification is impractical given the size of EHR databases, the limited number of researchers with access to the non-de-identified notes, and the frequent mistakes of human annotators. A reliable automated de-identification system would consequently be of high value. Materials and Methods: We introduce the first de-identification system based on artificial neural networks (ANNs), which requires no handcrafted features or rules, unlike existing systems. We compare the performance of the system with state-of-the-art systems on two datasets: the i2b2 2014 de-identification challenge dataset, which is the largest publicly available de-identification dataset, and the MIMIC de-identification dataset, which we assembled and is twice as large as the i2b2 2014 dataset. Results: Our ANN model outperforms the state-of-the-art systems. It yields an F1-score of 97.85 on the i2b2 2014 dataset, with a recall 97.38 and a precision of 97.32, and an F1-score of 99.23 on the MIMIC de-identification dataset, with a recall 99.25 and a precision of 99.06. Conclusion: Our findings support the use of ANNs for de-identification of patient notes, as they show better performance than previously published systems while requiring no feature engineering.