DHHS could greatly facilitate the routine generation of high-quality, uniform, and nondisclosing geographically linked data sets by providing a linking service that could be used by private- and public-sector health care organizations. Such a service could be administered, for example, through a Web site. The organization would anonymously submit a file containing member addresses, and receive in return a file of masked geographical variables at several levels.
The greatest expertise within the federal government for solving the problems involved in establishing such a service resides in the Bureau of the Census. Within DHHS, the National Center for Health Statistics (NCHS) has been a leader in dealing with confidentiality issues. Alternatively, a private-sector vendor with the necessary geocoding expertise could be recruited, although such vendors do not typically deal with the related confidentiality issues.
RECOMMENDATION 6-3: DHHS should establish a service that would geocode and link addresses of patients or health plan members to census data, with suitable protections of privacy, and make this service available to facilitate development of geographically linked analytic data sets.