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Eluru M, Mendoza DH, Wong A, Jafari M, Todd M, Bayless P, Chern D, Eldredge C, Fonseca R, Franco-Fuquen P, Garcia-Robledo JE, Gifford BG, Hans R, Moreno-Cortes EF, Perumbeti A, Vargas-Cely FS, Zhao L, Grando MA. Physicians' Perspectives on HL7 Information Policy Sensitive Value Set: A Validation Study through Health Concept Categorization. Healthcare (Basel) 2023; 11:2845. [PMID: 37957990 PMCID: PMC10647660 DOI: 10.3390/healthcare11212845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023] Open
Abstract
The Health Level 7 (HL7) organization introduced the Information Sensitivity Policy Value Set with 45 sensitive data categories to facilitate the implementation of granular electronic consent technology. The goal is to allow patients to have control over the sharing of their sensitive medical records. This study represents the first attempt to explore physicians' viewpoints on these categories. Twelve physicians participated in a survey, leading to revisions in 21 HL7 categories. They later classified 600 clinical data items through a second survey using the updated categories. Participants' perspectives were documented, and data analysis included descriptive measures and heat maps. In the first survey, six participants suggested adding 19 new categories (e.g., personality disorder), and modifying 25 category definitions. Two new categories and sixteen revised category definitions were incorporated to support more patient-friendly content and inclusive language. Fifteen new category recommendations were addressed through a revision of category definitions (e.g., personality disorder described as a behavioral health condition). In the second survey, data categorizations led to recommendations for more categories from ten participants. Future revisions of the HL7 categories should incorporate physicians' viewpoints, validate the categories using patient data or/and include patients' perspectives, and develop patient-centric category specifications.
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Affiliation(s)
- Maheswari Eluru
- College of Health Solutions, Arizona State University, Phoenix, AZ 85054, USA (D.H.M.)
| | - Daniel Hector Mendoza
- College of Health Solutions, Arizona State University, Phoenix, AZ 85054, USA (D.H.M.)
| | - Audrey Wong
- College of Health Solutions, Arizona State University, Phoenix, AZ 85054, USA (D.H.M.)
| | - Mohammad Jafari
- College of Health Solutions, Arizona State University, Phoenix, AZ 85054, USA (D.H.M.)
- Health Level Seven International, Ann Arbor, MI 48104, USA
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA;
| | | | | | - Christina Eldredge
- Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA
| | | | | | | | | | - Rhea Hans
- Mayo Clinic, Phoenix, AZ 85054, USA; (R.F.); (F.S.V.-C.)
| | | | - Ajay Perumbeti
- College of Medicine, University of Arizona, Phoenix, AZ 85004, USA
- Banner Health Systems, Phoenix, AZ 85006, USA
| | | | - Lin Zhao
- HonorHealth, Phoenix, AZ 85020, USA
| | - Maria Adela Grando
- College of Health Solutions, Arizona State University, Phoenix, AZ 85054, USA (D.H.M.)
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Banerjee I, Syed K, Potturu A, Pragada VS, Sharma RS, Murcko A, Chern D, Todd M, Aking P, Al-Yaqoobi A, Bayless P, Belmonte W, Cuadra T, Dockins T, Eldredge C, El-Kareh R, Gale G, Gentile E, Kalpas E, Morris M, Mueller L, Piekut D, Ross MK, Sarris J, Singh G, Tharani S, Wallace M, Grando MA. Physicians differ in their perceptions of sensitive medical records: Survey and interview study. Health Informatics J 2023; 29:14604582231193519. [PMID: 37544770 DOI: 10.1177/14604582231193519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Physician categorizations of electronic health record (EHR) data (e.g., depression) into sensitive data categories (e.g., Mental Health) and their perspectives on the adequacy of the categories to classify medical record data were assessed. One thousand data items from patient EHR were classified by 20 physicians (10 psychiatrists paired with ten non-psychiatrist physicians) into data categories via a survey. Cluster-adjusted chi square tests and mixed models were used for analysis. 10 items were selected per each physician pair (100 items in total) for discussion during 20 follow-up interviews. Interviews were thematically analyzed. Survey item categorization yielded 500 (50.0%) agreements, 175 (17.5%) disagreements, 325 (32.5%) partial agreements. Categorization disagreements were associated with physician specialty and implied patient history. Non-psychiatrists selected significantly (p = .016) more data categories than psychiatrists when classifying data items. The endorsement of Mental Health and Substance Use categories were significantly (p = .001) related for both provider types. During thematic analysis, Encounter Diagnosis (100%), Problems (95%), Health Concerns (90%), and Medications (85%) were discussed the most when deciding the sensitivity of medical information. Most (90.0%) interview participants suggested adding additional data categories. Study findings may guide the evolution of digital patient-controlled granular data sharing technology and processes.
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Affiliation(s)
| | - Kazi Syed
- Arizona State University, Scottsdale, AZ, US
| | | | | | | | | | | | | | - Padma Aking
- Trinity Integrated Medicine, Phoenix, AZ, US
| | | | | | | | - Teresa Cuadra
- New York City Zen Center for Contemplative Care, New York, NY, US
| | | | | | | | | | | | - Edward Kalpas
- Arizona State University, Scottsdale, AZ, US
- HonorHealth, Scottsdale, AZ, US
| | - Meghan Morris
- Arizona State University, Scottsdale, AZ, US
- HonorHealth, Scottsdale, AZ, US
| | - Laurel Mueller
- Arizona Osteopathic Medical Association, Phoenix, AZ, US
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Ivanova J, Tang T, Idouraine N, Murcko A, Whitfield MJ, Dye C, Chern D, Grando A. Behavioral Health Professionals' Perceptions on Patient-Controlled Granular Information Sharing (Part 1): Focus Group Study. JMIR Ment Health 2022; 9:e21208. [PMID: 35442199 PMCID: PMC9069278 DOI: 10.2196/21208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/17/2020] [Accepted: 09/28/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Patient-controlled granular information sharing (PC-GIS) allows a patient to select specific health information "granules," such as diagnoses and medications; choose with whom the information is shared; and decide how the information can be used. Previous studies suggest that health professionals have mixed or concerned opinions about the process and impact of PC-GIS for care and research. Further understanding of behavioral health professionals' views on PC-GIS are needed for successful implementation and use of this technology. OBJECTIVE The aim of this study was to evaluate changes in health professionals' opinions on PC-GIS before and after a demonstrative case study. METHODS Four focus groups were conducted at two integrated health care facilities: one serious mental illness facility and one general behavioral health facility. A total of 28 participants were given access to outcomes of a previous study where patients had control over medical record sharing. Participants were surveyed before and after focus groups on their views about PC-GIS. Thematic analysis of focus group output was paired with descriptive statistics and exploratory factor analysis of surveys. RESULTS Behavioral health professionals showed a significant opinion shift toward concern after the focus group intervention, specifically on the topics of patient understanding (P=.001), authorized electronic health record access (P=.03), patient-professional relationship (P=.006), patient control acceptance (P<.001), and patient rights (P=.02). Qualitative methodology supported these results. The themes of professional considerations (2234/4025, 55.5% of codes) and necessity of health information (260/766, 33.9%) identified key aspects of PC-GIS concerns. CONCLUSIONS Behavioral health professionals agreed that a trusting patient-professional relationship is integral to the optimal implementation of PC-GIS, but were concerned about the potential negative impacts of PC-GIS on patient safety and quality of care.
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Affiliation(s)
- Julia Ivanova
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States
| | - Tianyu Tang
- College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Nassim Idouraine
- College of Health Solutions, Biomedical Informatics, Arizona State University, Scottsdale, AZ, United States
| | - Anita Murcko
- College of Health Solutions, Biomedical Informatics, Arizona State University, Scottsdale, AZ, United States
| | | | - Christy Dye
- Partners in Recovery, Phoenix, AZ, United States
| | - Darwyn Chern
- Partners in Recovery, Phoenix, AZ, United States
| | - Adela Grando
- College of Health Solutions, Biomedical Informatics, Arizona State University, Scottsdale, AZ, United States
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