Physicians differ in their perceptions of sensitive medical records: Survey and interview study

Area of Science:

• Health Informatics
• Medical Data Classification
• Patient Data Privacy

Background:

• Electronic health record (EHR) data requires sensitive categorization for privacy.
• Physician perspectives on EHR data classification adequacy are not well understood.

Purpose of the Study:

• To assess physician categorizations of EHR data into sensitive categories.
• To evaluate physician perspectives on the adequacy of current data categories.
• To inform the development of digital patient-controlled granular data sharing.

Main Methods:

• 20 physicians (10 psychiatrists, 10 non-psychiatrists) classified 1000 EHR data items via survey.
• Statistical analysis included cluster-adjusted chi-square tests and mixed models.
• Follow-up interviews thematically analyzed 100 selected items.

Main Results:

• Physician agreement on EHR data categorization was 50%, with 32.5% partial agreement.
• Disagreements varied by physician specialty and patient history.
• Non-psychiatrists used more categories than psychiatrists (p=.016); Mental Health and Substance Use categories were linked (p=.001).

Conclusions:

• Current EHR data categories are insufficient for precise classification.
• Physicians recommend expanding data categories for improved sensitivity and sharing.
• Findings can guide advancements in digital health data sharing technologies.