HIPAA has a concept called the "Unique Patient Identifier" which can be used as we describe to link data: http://www.ncvhs.hhs.gov/app4.htm
Unique Patient Identifier eliminates
the need for the repetitive use and
disclosure of an individual's personal
identification information (i.e. name,
age, sex, race, marital status, place
of residence, etc.) for routine
internal and external communications
(e.g. orders, results, medication,
consultation, etc.) and protects the
privacy of the individual. It helps
preserve the patient anonymity while
facilitating communication and
information sharing. Healthcare is
fundamentally a multi-disciplinary
process. A Unique Patient Identifier
enables the integration and the
availability of critically needed
information from multi-disciplinary
sources and multiple care settings.
Therefore, the integrity and security
of the patient information depend on
the use of a reliable Unique Patient
Identifier.
The privacy issue hinges not so much on the identifier itself, but on the security and privacy of the data that the identifier is used to access, and how that access is controlled. My understanding is that typically this means that a system querying for information via a patient identifier should only get back information that can not be pieced together to reveal private information.
Essentially you would generate an artificial key for each person. Even though it is unique to the person, it is not personally identifying, unless you also were to release personally identifiable information along with it. For example, if you let people see only first names with a particular query, but also returned the artificial key, then they now know that artificial key 00003 is associated with first name Bob. now if you allow them to somehow go back and query with 00003 as criteria, and allow them access to the lastname, you can see how they can start to accumulate information. It is important that there be no way for an unauthorized user to get the artifical key and PII returned in the same query, since that would then make the artifical key itself PII. that's my interpretation at least.