The 18 HIPAA identifiers are the identifiers that have to be removed from a designated record set before any information remaining in the designated record set is considered de-identified under the safe harbor method described in §164.514 of the Privacy Rule. However, it is important to be aware that removing just the 18 identifiers listed in this standard might not be enough to avoid a HIPAA violation. This is because there are now more ways to identify an individual than there were when the Privacy Rule was published. Therefore, if – for example – information relating to an emotional support animal is maintained in a designated record set, and the information could be used to identify the subject of the record set, this information also has to be removed so that any remaining information is de-identified. It is also important to be aware that, although this standard states that de-identified information is no longer individually identifiable health information and therefore no longer protected by the Privacy Rule, the 18 HIPAA identifiers should not be confused with Protected Health Information. The 18 HIPAA identifiers (and any others that could be used to identify an individual) are only protected by HIPAA when they are maintained in the same designated record set as health information.