2a-List of PHI Identifiers

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					SDPI CGP Diabetes Prevention Program                                   ADPF1a List of PHI Identifiers

         List of Personal Health Information Identifiers
   that Must Not Be On Data Sent to the Coordinating Center

Data sent to the Coordinating Center cannot include any of the following 18
fields of information:

      names
      geographic subdivisions smaller than a state (tribe is ok)
      date of birth** and date of death
      telephone numbers
      fax numbers
      electronic mail addresses
      social security numbers
      medical record numbers
      health plan beneficiary numbers
      account numbers, certificate/license numbers
      vehicle identifiers and serial numbers (including license plate numbers)
      device identifiers and serial numbers
      URLs, IP address numbers
      biometric identifiers (including finger and voice prints)
      full face photographic images and any comparable images
      any other unique identifying number, characteristic or code.

   ** For all subjects over 89 years of age, all elements of dates including year
      indicative of their age cannot be used; however, age can be aggregated into a
      category of age 90 or older.

None of these identifiers should be forwarded to the Coordinating Center. These
should be removed from all data collection documents and email correspondence.
They should also be removed from all other forms submitted to the Coordinating
Center such as Serious Adverse Event Forms (date of death is ok on this form);
and Incident Report Forms.

G: Data Core\Manual + Forms CURRENT\DP appendices\e96177e2-9e83-430b-ab99-aa17cc98711b.doce96177e2-
 Last revised 12/10/11

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