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J Am Med Inform Assoc. 2011 May 1;18(3):212-7. doi: 10.1136/amiajnl-2011-000100.

A secure protocol for protecting the identity of providers when disclosing data for disease surveillance.

Author information

1
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. kelemam@uottawa.ca

Abstract

BACKGROUND:

Providers have been reluctant to disclose patient data for public-health purposes. Even if patient privacy is ensured, the desire to protect provider confidentiality has been an important driver of this reluctance.

METHODS:

Six requirements for a surveillance protocol were defined that satisfy the confidentiality needs of providers and ensure utility to public health. The authors developed a secure multi-party computation protocol using the Paillier cryptosystem to allow the disclosure of stratified case counts and denominators to meet these requirements. The authors evaluated the protocol in a simulated environment on its computation performance and ability to detect disease outbreak clusters.

RESULTS:

Theoretical and empirical assessments demonstrate that all requirements are met by the protocol. A system implementing the protocol scales linearly in terms of computation time as the number of providers is increased. The absolute time to perform the computations was 12.5 s for data from 3000 practices. This is acceptable performance, given that the reporting would normally be done at 24 h intervals. The accuracy of detection disease outbreak cluster was unchanged compared with a non-secure distributed surveillance protocol, with an F-score higher than 0.92 for outbreaks involving 500 or more cases.

CONCLUSION:

The protocol and associated software provide a practical method for providers to disclose patient data for sentinel, syndromic or other indicator-based surveillance while protecting patient privacy and the identity of individual providers.

PMID:
21486880
PMCID:
PMC3078664
DOI:
10.1136/amiajnl-2011-000100
[Indexed for MEDLINE]
Free PMC Article

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