Resilience of clinical text de-identified with "hiding in plain sight" to hostile reidentification attacks by human readers

David S. Carrell, Bradley A. Malin, David J. Cronkite, John S. Aberdeen, Cheryl Clark, Muqun Rachel Li, Dikshya Bastakoty, Steve Nyemba, Lynette Hirschman

Abstract: Effective, scalable de-identification of personally identifying information (PII) for information-rich clinical text is critical to support secondary use, but no method is 100% effective. The hiding-in-plain-sight (HIPS) approach attempts to solve this “residual PII problem.” HIPS replaces PII tagged by a de-identification system with realistic but fictitious (resynthesized) content, making it harder to detect remaining unredacted PII.