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

El Emam K, Hu J, Mercer J, Peyton L, Kantarcioglu M, Malin B, Buckeridge D, Samet S, Earle C
J Am Med Inform Assoc. 2011 18 (3): 212-7

PMID: 21486880 · PMCID: PMC3078664 · DOI:10.1136/amiajnl-2011-000100

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.

MeSH Terms (6)

Computer Security Confidentiality Disease Notification Disease Outbreaks Humans Population Surveillance

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