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Objective: Implement and assess personal health identifying information (PHI)substitution strategies and quantify their privacy preserving benefits.  Materials and Methods: We implement and assess 3 different `Hiding in PlainSight` (HIPS) strategies for PHI replacement including a standard Consistentreplacement strategy, a Random replacement strategy and a novel Markovmodel-based strategy. We evaluate the privacy preserving benefits of thesestrategies on a synthetic PHI distribution and real clinical corpora from 2different institutions using a range of false negative error rates (FNER).  Results: Using FNER ranging from 0.1% to 5% PHI leakage at the document levelcould be reduced from 27.1% to 0.1% (0.1% FNER) and from 94.2% to 57.7% (5%FNER) utilizing the Markov chain strategy versus the Consistent strategy on acorpus containing a diverse set of notes from the University of Alabama atBirmingham (UAB). The Markov chain substitution strategy also consistentlyoutperformed the Consistent and Random substitution strategies in a MIMICcorpus of discharge summaries and on a range of synthetic clinical PHIdistributions. Discussion: We demonstrate that a Markov chain surrogategeneration strategy substantially reduces the chance of inadvertent PHI releaseacross a range of assumed PHI FNER and release our implementation`BRATsynthetic` on Github.  Conclusion: The Markov chain replacement strategy allows for the release oflarger de-identified corpora at the same risk level relative to corporareleased using a consistent HIPS strategy.

BRATsynthetic: Text De-identification using a Markov Chain Replacement Strategy for Surrogate Personal Identifying Information