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Patient Privacy and Secondary Use of Administrative Databases-Reply

Lawrence O. Gostin, JD; Zita Lazzarini, JD, MPH; Verla S. Neslund, JD; Michael I. Osterholm, PhD, MPH
JAMA. 1996;276(14):1138. doi:10.1001/jama.1996.03540140026015.
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In Reply.  —Drs Kumar and Lucey insightfully present a classic illustration of the trade-offs between the public benefits of health information and the need to protect personal privacy. Secondary uses of administrative claims in the health care system can provide powerful public health benefits ranging from identification of barriers to health care access, improvement in outcomes research, and prevention of nosocomial infections to cost control and detection of fraud. At the same time, matching of patient records in numerous databases, perhaps with the use of a unique identifier such as the Social Security number, can pose a powerful threat to personal privacy.The research and policy question then becomes the following: How can society facilitate the secondary use of health information through standardized data sets and increased automation while at the same time protecting patient privacy? This tension perhaps is not capable of full resolution. Yet, in our work on health care


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