健保資料目的外利用之法律爭議──從去識別化作業工具談起

Unsolved De-Identification Dilemma in Secondary Use of National Health Insurance Research Database

我國衛生福利部中央健康保險署（原行政院衛生署中央健康保險局）於一九九六年委託國家衛生研究院建置「全民健康保險研究資料庫」，釋出依據法律執行全民健康保險業務所蒐集之全國民眾納保與就醫資料，提供醫療政策與公共衛生研究應用。然而，資料之釋出卻引起侵害民眾資訊隱私與隱私自主之疑慮，相關爭議包括告知後同意之欠缺、作業程序是否公開透明、新舊法之適用爭議、公共利益之範圍、資訊安全之質疑等，並有後續相關訴訟之提起。本文將就個人資料保護中之去識別化（無從識別特定當事人）議題，包括去識別化之內涵及如何達成去識別化，進行深入討論。

The National Health Insurance Research Database (NHIRD), derived from Taiwan’s mandatory National Health Insurance program with registration files and original claim data for reimbursement, were established by the National Health Insurance Administration (NHIA, the former Bureau of National Health Insurance, BNHI) in 1996 and maintained by the National Health Research Institute (NHRI). The database is commonly used for different types of researches such as biomedical, pharmacoepidemiological, and public health ones in Taiwan. However, the secondary use of individuals’ healthcare data has raised legitimate privacy concerns, including potential infringements of information privacy and privacy autonomy, lack of transparency,  delineation of public interest, and information security. Legal suits against NHRI and NHIA were also brought by human rights advocates. This article analyzed the legal requirements and techniques for de-identification of personal data under Taiwan’s privacy and personal data protection laws, with focus on the definition and concept of de-identification and different approaches and tools that can be applied to remove personal information from data and to delink relationships between data so that specific persons and their identities cannot be identified.