Development of an optical character recognition pipeline for handwritten form fields from an electronic health record

Luke V. Rasmussen, Peggy L. Peissig, Catherine A. McCarty, Justin Starren

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Background: Although the penetration of electronic health records is increasing rapidly, much of the historical medical record is only available in handwritten notes and forms, which require labor-intensive, human chart abstraction for some clinical research. The few previous studies on automated extraction of data from these handwritten notes have focused on monolithic, custom-developed recognition systems or third-party systems that require proprietary forms. Methods: We present an optical character recognition processing pipeline, which leverages the capabilities of existing third-party optical character recognition engines, and provides the flexibility offered by a modular custom-developed system. The system was configured and run on a selected set of form fields extracted from a corpus of handwritten ophthalmology forms. Observations: The processing pipeline allowed multiple configurations to be run, with the optimal configuration consisting of the Nuance and LEADTOOLS engines running in parallel with a positive predictive value of 94.6% and a sensitivity of 13.5%. Discussion: While limitations exist, preliminary experience from this project yielded insights on the generalizability and applicability of integrating multiple, inexpensive general-purpose third-party optical character recognition engines in a modular pipeline.

Original languageEnglish (US)
Pages (from-to)e90-e95
JournalJournal of the American Medical Informatics Association
Issue numberE1
StatePublished - Jun 2012
Externally publishedYes


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