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Database Design to Ensure Anonymous Study of Medical Errors: A Report from the ASIPS collaborative

Affiliations of the authors: Department of Family Medicine, University of Colorado Health Sciences Center, Aurora, Colorado (WDP, EWS, GSH, DSM, DRW); The CNA Corporation, Alexandria, Virginia (DMH).

Correspondence and reprints: Wilson D. Pace, MD, Department of Family Medicine: UCHSC at Fitzsimons, PO Box 6508 - Mail Stop F496, Aurora, CO 80045-0508; e-mail: <wilson.pace{at}uchsc.edu>.

Received for publication: 01/29/03; accepted for publication: 04/23/03.

Medical error reporting systems are important information sources for designing strategies to improve the safety of health care. Applied Strategies for Improving Patient Safety (ASIPS) is a multi-institutional, practice-based research project that collects and analyzes data on primary care medical errors and develops interventions to reduce error. The voluntary ASIPS Patient Safety Reporting System captures anonymous and confidential reports of medical errors. Confidential reports, which are quickly de-identified, provide better detail than do anonymous reports; however, concerns exist about the confidentiality of those reports should the database be subject to legal discovery or other security breaches. Standard database elements, for example, serial ID numbers, date/time stamps, and backups, could enable an outsider to link an ASIPS report to a specific medical error. The authors present the design and implementation of a database and administrative system that reduce this risk, facilitate research, and maintain near anonymity of the events, practices, and clinicians.