title: An evaluation of personal health information remnants in second-hand personal computer disk drives.
abstract: BACKGROUND
  The public is concerned about the privacy of their health information, especially as more of it is collected, stored, and exchanged electronically. But we do not know the extent of leakage of personal health information (PHI) from data custodians. One form of data leakage is through computer equipment that is sold, donated, lost, or stolen from health care facilities or individuals who work at these facilities. Previous studies have shown that it is possible to get sensitive personal information (PI) from second-hand disk drives. However, there have been no studies investigating the leakage of PHI in this way.
  
  
  OBJECTIVE
  The aim of the study was to determine the extent to which PHI can be obtained from second-hand computer disk drives.
  
  
  METHODS
  A list of Canadian vendors selling second-hand computer equipment was constructed, and we systematically went through the shuffled list and attempted to purchase used disk drives from the vendors. Sixty functional disk drives were purchased and analyzed for data remnants containing PHI using computer forensic tools.
  
  
  RESULTS
  It was possible to recover PI from 65% (95% CI: 52%-76%) of the drives. In total, 10% (95% CI: 5%-20%) had PHI on people other than the owner(s) of the drive, and 8% (95% CI: 7%-24%) had PHI on the owner(s) of the drive. Some of the PHI included very sensitive mental health information on a large number of people.
  
  
  CONCLUSIONS
  There is a strong need for health care data custodians to either encrypt all computers that can hold PHI on their clients or patients, including those used by employees and subcontractors in their homes, or to ensure that their computers are destroyed rather than finding a second life in the used computer market.
authors.affiliation: University of Ottawa and Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. kelemam@uottawa.ca
authors.forename: Khaled
authors.initials: K
authors.lastname: El Emam
authors.forename: Emilio
authors.initials: E
authors.lastname: Neri
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Jonker
mesh_terms: D003132:Commerce; D003219:Confidentiality; D006801:Humans; D016247:Information Storage and Retrieval; D008838:Microcomputers