The Disclosure of Personally Identifiable Information in Studies of Neighborhood Contexts and Patient Outcomes

Clinical epidemiology and patient-oriented health care research that incorporates neighborhood-level data is becoming increasingly common. A key step in conducting this research is converting patient address data to longitude and latitude data, a process known as geocoding. Several commonly used approaches to geocoding (eg, ggmap or the tidygeocoder R package) send patient addresses over the internet to web-based third-party geocoding services. Here, we describe how these approaches to geocoding disclose patients' personally identifiable information (PII) and how the subsequent publication of the research findings discloses the same patients' protected health information (PHI). We explain how these disclosures can occur and recommend strategies to maintain patient privacy when studying neighborhood effects on patient outcomes.

Automated summary

Clinical epidemiology and patient-oriented health care research often use neighborhood-level data and require geocoding of patient address data to conduct the study. However, commonly used geocoding methods may reveal patients' personally identifiable information and compromise their protected health information when publishing research findings.