Pseudonymisation of Patient Data - hmislk/hmis GitHub Wiki

Overview

Pseudonymisation replaces a patient's identifying information โ€” name, NIC, address, contact details โ€” with non-identifying placeholder values, while keeping the clinical record intact. The patient's PHN (Personal Health Number) and all linked bills, investigation results, and clinical notes remain fully accessible and queryable; only the demographic identifiers are obscured.

This is different from anonymisation:

Concept What it does Can you find the record later?
Anonymisation Permanently destroys all links between data and the individual No โ€” the data is no longer traceable
Pseudonymisation Replaces identifiers with a placeholder โ€” the PHN remains the key Yes โ€” the record is still fully usable via PHN

CareCode HMIS does not support anonymous patient registration. Registering a patient with no real identity makes their clinical results (lab reports, prescriptions, imaging) unreachable in practice โ€” you cannot hand results to a patient you cannot identify. Pseudonymisation is the correct approach when a customer (hospital) needs to extract a cross-section of data for research, audit, or reporting, while complying with privacy obligations.


When to Pseudonymise

Pseudonymisation is used when:

  • A hospital needs to share a dataset with a third party (researcher, regulator, insurer) without disclosing patient identities.
  • An internal audit needs aggregate statistics without patient-level identification.
  • A patient requests that their identifying details be removed from visible records while their clinical history is retained.

It is not a substitute for proper patient registration. Every patient must be registered with real demographic data at the point of care.


What Gets Replaced

When a record is pseudonymised, the following fields are overwritten with placeholders:

Field Replacement value
Name Patient <PHN>
Full Name Patient <PHN>
Name with Initials Patient <PHN>
NIC / Passport <PHN>V (placeholder, derived from PHN)
Address Address <PHN>
Phone Number 10-digit placeholder derived from PHN
Mobile Number same as phone placeholder
Email blank

The following fields are not changed:

  • PHN (Personal Health Number) โ€” remains the permanent record key
  • Date of birth / Age
  • Sex
  • All bills, investigation results, prescriptions, admissions, and clinical notes

How to Pseudonymise a Patient Record

  1. Search for the patient and open their Edit Patient page. Main Menu โ†’ OPD โ†’ Patient Lookup & Registration โ†’ (search) โ†’ Edit
  2. Click the Pseudonymise button (visible only to users with the Clinical Patient Pseudonymise privilege).
  3. Read the warning dialog carefully. Confirm that you have the required authorisation.
  4. Click Yes, Pseudonymise to proceed.

The system will immediately replace the identifying fields with placeholders, save the record, and display a success message. The action is logged in the audit trail.


Reversibility

Pseudonymisation in CareCode HMIS is one-way. The original demographic data is not stored anywhere after the operation completes. If the real identity needs to be restored later, it must be re-entered manually by an authorised user on the Edit Patient page.


Privilege Required

Action Privilege needed
Pseudonymise a patient record ClinicalPatientPseudonymise
View the Pseudonymise button ClinicalPatientPseudonymise
Edit the pseudonymised record afterwards LabEditPatient (standard edit privilege)

To grant the privilege, a super user must go to:

Administration โ†’ Manage Users โ†’ User Roles โ†’ (select role) โ†’ Clinicals โ†’ Pseudonymise Patient


Audit Trail

Every pseudonymisation is logged. To view the history:

Main Menu โ†’ Administration โ†’ Audit Events

Look for events named "Pseudonymise Patient". Each entry shows the user who performed the action and the timestamp.


Note: Pseudonymisation is an irreversible action. The original identifying data cannot be recovered from the system after it is applied. Ensure you have explicit authorisation before proceeding.

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