Introduction
The purpose of this document is to describe a de-identification approach for COVID ELR messages in two settings:
- Standardized reporting of over-the-counter COVID self-tests
- Capture of metadata from laboratory-performed PCR tests
De-identification supports transmission of ELR messages to HHS Protect and to federally funded entities providing analytics services.
LINK: Workflow diagrams
Principles of de-identification
Self-test and PCR reporting data can be reasonably assumed to fall under HIPAA guidelines. These guidelines and de-identification strategies can be found on the HHS website.
Defining where PHI exists in the ELR message
HL7 v2.5 message elements that are changed in the de-identification process are outlined in the table below. Several elements that are not intended to contain PHI are also removed to address potential inclusion of PHI in these elements erroneously.
Segment | Component | Title | Change |
---|---|---|---|
PID | 3.1 | Patient ID | Modify to "<deidentified>" if PID-3.5 does not equal "PI"; else, no change |
PID | 5.1 | Patient last name | If empty, no change; else, modify to "<deidentified>" |
PID | 5.2 | Patient first name | If empty, no change; else, modify to "<deidentified>" |
PID | 5.3 | Patient middle name | If empty, no change; else, modify to "<deidentified>" |
PID | 7.1 | Patient DOB | If empty, no change; else, modify to "<deidentified>" |
PID | 11.1 | Patient street address | If empty, no change; else, modify to "<deidentified>" |
PID | 11.2 | Patient street address 2 | If empty, no change; else, modify to "<deidentified>" |
PID | 11.3 | Patient city | If empty, no change; else, modify to "<deidentified>" |
PID | 13.4 | Patient email | If empty, no change; else, modify to "<deidentified>" |
PID | 13.6 | Patient phone area code | If empty, no change; else, modify to "<deidentified>" |
PID | 13.7 | Patient local phone | If empty, no change; else, modify to "<deidentified>" |
ORC | 3.1 | Filler order number | Remove |
ORC | 12.1 | Ordering provider ID | Remove |
ORC | 12.2 | Ordering provider last name | Remove |
ORC | 12.3 | Ordering provider first name | Remove |
ORC | 22.1 | Ordering facility street | Remove |
ORC | 22.2 | Ordering facility street 2 | Remove |
ORC | 22.3 | Ordering facility city | Remove |
ORC | 22.4 | Ordering facility state | Remove |
ORC | 22.5 | Ordering facility zip | Remove |
ORC | 22.9 | Ordering facility county | Remove |
ORC | 23.6 | Ordering facility phone area code | Remove |
ORC | 23.7 | Ordering facility local phone | Remove |
ORC | 24.1 | Ordering provider street | Remove |
ORC | 24.2 | Ordering provider street 2 | Remove |
ORC | 24.3 | Ordering provider city | Remove |
ORC | 24.4 | Ordering provider state | Remove |
ORC | 24.5 | Ordering provider zip | Remove |
ORC | 24.9 | Ordering provider county | Remove |
OBR | 3.1 | Filler order number | Remove |
OBR | 7.1 | Observation result date | Remove |
OBR | 16.1 | Ordering provider ID | Remove |
OBR | 16.2 | Ordering provider last name | Remove |
OBR | 16.3 | Ordering provider first name | Remove |
NTE | 1 | Set ID | Remove |
NTE | 2 | Source of comment | Remove |
NTE | 3 | Comment | Remove |