Anonymization and pseudonymization of FHIR resources for secondary use of healthcare data

Along with the creation of medical profiles of patients, Electronic Health Records have several secondary missions, such as health economy and research. The recent, increasing adoption of a common standard, i.e., the Fast Healthcare Interoperability Resources (FHIR), makes it easier to exchange medical data among the several parties involved, for example, in an epidemiological research activity. However, this exchange process is hindered by regulatory frameworks due to privacy issues related to the presence of personal information, which allows patients to be identified directly (or indirectly) from their medical data. When properly used, de-identification techniques can provide crucial support in overcoming these problems. FHIR-DIET aims to bring flexibility and concreteness to the implementation of de-identification of health data, supporting many customised data-processing behaviours that can be easily configured and tailored to match specific use case requirements. Our solution enables faster and easier cooperation between legal and IT professionals to establish and implement de-identification rules. The performance evaluation demonstrates the viability of processing hundreds of FHIR patient information data per second using standard hardware. We believe FHIR-DIET can be a valuable tool to satisfy the current regulation requirements and help to create added-value for the secondary use of healthcare data.