title: Who said it? Establishing professional attribution among authors of Veterans' Electronic Health Records.
abstract: BACKGROUND
  A practical data point for assessing information quality and value in the Electronic Health Record (EHR) is the professional category of the EHR author. We evaluated and compared free form electronic signatures against LOINC note titles in categorizing the profession of EHR authors.
  
  
  METHODS
  A random 1000 clinical document sample was selected and divided into 500 document sets for training and testing. The gold standard for provider classification was generated by dual clinician manual review, disagreements resolved by a third reviewer. Text matching algorithms composed of document titles and author electronic signatures for provider classification were developed on the training set.
  
  
  RESULTS
  Overall, detection of professional classification by note titles alone resulted in 76.1% sensitivity and 69.4% specificity. The aggregate of note titles with electronic signatures resulted in 95.7% sensitivity and 98.5% specificity.
  
  
  CONCLUSIONS
  Note titles alone provided fair professional classification. Inclusion of author electronic signatures significantly boosted classification performance.
authors.affiliation: Health Services Research and Development, Tennessee Valley Healthcare System, Department of Veterans Affairs, 1310 24 Avenue South, Nashville, TN 37212, USA. ruth.reeves2@va.gov
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Reeves
authors.forename: Fern
authors.initials: F
authors.lastname: FitzHenry
authors.forename: Steve H
authors.initials: SH
authors.lastname: Brown
authors.forename: Kristen
authors.initials: K
authors.lastname: Kotter
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Gobbel
authors.forename: Diane
authors.initials: D
authors.lastname: Montella
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Murff
authors.forename: Ted
authors.initials: T
authors.lastname: Speroff
authors.forename: Michael E
authors.initials: ME
authors.lastname: Matheny
mesh_terms: D000465:Algorithms; D001319:Authorship; D057286:Electronic Health Records; D006801:Humans; D007256:Information Systems; D039703:Logical Observation Identifiers Names and Codes; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration; D014728:Veterans
keywords: EHR meta-data; Health-care profession; LOINC title; document quality; electronic signature