openevidence-data-handling

OpenEvidence Data Handling

Overview

OpenEvidence provides AI-powered clinical evidence synthesis for healthcare professionals. Data types include clinical queries (potentially containing PHI), evidence citations from medical literature, patient-contextualized responses, research paper references, and usage analytics. All data handling must comply with HIPAA (PHI safeguards, minimum necessary standard, BAA requirements), GDPR for EU clinicians, and FDA guidance on clinical decision support. Query data may contain patient identifiers, diagnoses, or treatment details that require de-identification before storage or analytics.

Data Classification

Data Type	Sensitivity	Retention	Encryption
Clinical queries (may contain PHI)	Critical	De-identify within 24h, purge raw in 7 days	AES-256 + TLS, field-level for PHI
Evidence citations	Low	Indefinite (public literature)	TLS in transit
Patient-contextualized responses	High (derived PHI)	30 days max, then de-identify	AES-256 at rest
Research paper metadata	Low	Indefinite	TLS in transit
Clinician usage analytics	Medium	1 year (de-identified)	AES-256 at rest

Data Import

interface ClinicalQuery {
  queryId: string; clinicianId: string; queryText: string;
  patientContext?: { age?: number; sex?: string; conditions?: string[] };
  timestamp: string;
}

async function submitClinicalQuery(query: ClinicalQuery): Promise<string> {
  const sanitized = { ...query, queryText: deidentifyPHI(query.queryText) };
  const res = await fetch('https://api.openevidence.com/v1/query', {
    method: 'POST',
    headers: { Authorization: `Bearer ${process.env.OPENEVIDENCE_API_KEY}`, 'Content-Type': 'application/json' },
    body: JSON.stringify(sanitized),
  });
  return (await res.json()).evidenceId;
}

function deidentifyPHI(text: string): string {
  return text
    .replace(/\b(MRN|mrn)[:\s]?\d{6,}\b/g, '[MRN_REDACTED]')
    .replace(/\b\d{3}-\d{2}-\d{4}\b/g, '[SSN_REDACTED]')
    .replace(/\b(DOB|dob)[:\s]?\d{1,2}\/\d{1,2}\/\d{2,4}\b/g, '[DOB_REDACTED]')
    .replace(/\b[A-Z][a-z]+ [A-Z][a-z]+, (MD|DO|NP|PA)\b/g, '[PROVIDER_REDACTED]');
}

Data Export

async function exportEvidenceSummary(queryIds: string[]) {
  const summaries = [];
  for (const id of queryIds) {
    const res = await fetch(`https://api.openevidence.com/v1/evidence/${id}`, {
      headers: { Authorization: `Bearer ${process.env.OPENEVIDENCE_API_KEY}` },
    });
    const data = await res.json();
    summaries.push({ queryId: id, citations: data.citations,
      summary: deidentifyPHI(data.summary), confidence: data.confidenceScore });
  }
  return summaries;
}

Data Validation

function validateClinicalQuery(q: ClinicalQuery): string[] {
  const errors: string[] = [];
  if (!q.queryId) errors.push('Missing query ID');
  if (!q.clinicianId) errors.push('Missing clinician identifier');
  if (!q.queryText || q.queryText.length < 10) errors.push('Query too short for meaningful evidence retrieval');
  if (q.queryText.length > 5000) errors.push('Query exceeds 5000 char limit');
  if (/\b\d{3}-\d{2}-\d{4}\b/.test(q.queryText)) errors.push('CRITICAL: SSN detected in query text');
  if (/\b(MRN|mrn)[:\s]?\d{6,}\b/.test(q.queryText)) errors.push('CRITICAL: MRN detected in query text');
  if (q.timestamp && isNaN(Date.parse(q.timestamp))) errors.push('Invalid timestamp');
  return errors;
}

Compliance

• HIPAA: BAA executed with OpenEvidence before any PHI transmission
• HIPAA: PHI de-identified using Safe Harbor method before storage/analytics
• HIPAA: Minimum necessary standard enforced — only transmit required clinical context
• HIPAA: Audit trail for all PHI access with clinician ID, timestamp, and query purpose
• HIPAA: Breach notification procedure documented (72-hour window)
• GDPR: EU clinician data subject rights (access, erasure, portability)
• FDA: Clinical decision support disclaimer included in all evidence responses
• Data retention: raw queries purged at 7 days, de-identified analytics retained 1 year

Error Handling

Issue	Cause	Fix
PHI detected in stored query	De-identification regex missed a pattern	Add pattern to deidentifyPHI, re-scan stored queries
API 403 on query submission	BAA not on file or expired API credentials	Verify BAA status, rotate API key
Evidence response contains patient name	Upstream model hallucinated PHI	Post-process all responses through de-identification before display
Audit log gap	Logging service outage during query window	Replay from API request logs, flag gap in compliance report
Export exceeds size limit	Too many citations in bulk export	Paginate export, limit to 50 evidence summaries per request

Resources

• OpenEvidence Platform
• HIPAA De-Identification Guidance

Next Steps

See openevidence-security-basics.