{"type":"data","nodes":[{"type":"data","data":[{"mainNavPagesCollection":1,"subnavPagesCollection":26},{"currentSlug":2,"topLevelSlug":-1,"total":3,"items":4},"designing-a-durable-patient-identification-system-for-healthcare",6,[5,8,11,14,17,20,23],{"title":6,"slug":7},"Home","",{"title":9,"slug":10},"About GPII","about-gpii",{"title":12,"slug":13},"Why the Need?","why-the-need",{"title":15,"slug":16},"Our Services ","our-services",{"title":18,"slug":19},"Privacy Protection","privacy-protection",{"title":21,"slug":22},"Contact Us","contact-us",{"title":24,"slug":25},"Articles","articles",{"currentSlug":2,"total":27,"items":28},0,[]],"uses":{"params":["slug"]}},{"type":"data","data":[{"title":1,"sanitizedBodyMarkup":2,"published":3,"author":4,"category":7,"tagsCollection":10,"pdf":23,"link":25}," Designing a Durable Patient Identification System for Healthcare","\u003Ch2>Executive summary\u003C/h2>\u003Cp>Dr. Barry Hieb, an expert in the field of patient identification, presents requirements that must\nbe satisfied for any patient identification system to succeed in United States healthcare.\n“Success” is more than accurate patient identification, which is essential to safely manage\nhealth records. Today, in any healthcare organization, patients may have duplicate records or,\nworse still, their data may be mixed with other patients. In the United States, any successful\napproach to patient identification must also address many issues -- patient safety, organization\nefficiency, patient privacy, security, fraud, universality, cost, simplicity and future proofing -- in\na manner acceptable to patients, providers, payers, IT system vendors and, of course, all\nhealthcare organizations.\u003C/p>\u003Ch2>Introduction\u003C/h2>\u003Cp>Accurately identifying patients has been a longstanding topic among virtually all healthcare\nstakeholders. It is universally acknowledged that accurate patient identification is a critical prerequisite\nto the provision of safe and effective medical care. However, the heterogeneous nature of healthcare\ninformation systems, the appropriate but demanding requirements for healthcare privacy, the\nbewildering politics surrounding healthcare at the federal level, and the complex requirements of\nindividual patients have all combined to make progress on this issue extremely difficult. Despite these\nobstacles, some progress is being made. (CHIME is nearing the end of a \u003Ca href=\"https://herox.com/PatientIDChallenge\">National Patient Identification Challenge\u003C/a>\nand the \u003Ca href=\"https://www.challenge.gov/challenge/patient-matching-algorithm-challenge/\">ONC is conducting a challenge concerning patient matching algorithm\u003C/a>.)\u003C/p>\u003Cp>This is one in a series of white papers discussing current issues relating to the healthcare\nindustry’s efforts to improve patient identification. This document reviews high-level\nrequirements that must be satisfied if a patient identification system is to be embraced by the\nUnited States healthcare environment. It provides a broad context concerning the need for accurate\npatient identification, and offers a framework for subsequent drill-down to explore various aspects of\nthis complex challenge in the context of the solution offered by Global Patient Identifiers, Inc. (GPII).\u003C/p>\u003Ch2>Safety\u003C/h2>\u003Cp>The highest priority for any patient identification approach is to support the healthcare system in\ndelivering safe and effective clinical care. This requires that each encounter be based on positive\nidentification of the patient and assured access to all clinical information concerning this patient that\nmay be relevant to this treatment episode. It is critical that no information from any other person be\ninappropriately mixed with the clinical record for this patient. The primary goal for accurate patient\nidentification is this ability to present the patient’s clinicians with a comprehensive and accurate medical\nrecord.\u003C/p>\u003Ch2>Effectiveness\u003C/h2>\u003Cp>The cost of healthcare continues to escalate. One factor that leads to increased cost is the ineffective\nand error-prone method healthcare organizations use to identify patients. Any solution to this problem\nmust streamline various processes associated with registering patients and rendering care, virtually\neliminating all of the patient identification errors that currently plague identification approaches.\u003C/p>\u003Ch2>Comprehensiveness\u003C/h2>\u003Cp>It is essential that we accurately identify patients for all clinical encounters and healthcare-related\nactivities. For most episodes, the patient will be physically present (e.g., clinic visits and hospital\nadmissions). However, many healthcare activities are performed while the patient is absent. These\ninclude billing, referrals, and interoperability situations where patient information is shared among\norganizations. The chosen patient identification methodology must provide equally accurate\nidentification across all these activities and provider sites, regardless of their individual health\ninformation technology suite.\u003C/p>\u003Ch2>Scalability\u003C/h2>\u003Cp>The chosen patient identification methodology must scale to arbitrarily large populations. In the near\nterm, this may mean being able to handle the entire population of a community or a state, but\neventually the entire United States. In the future, this may well mean being able to scale to\naccommodate global populations, or at least accurate patient identification to support data sharing\nacross borders and continents.\u003C/p>\u003Ch2>Universality\u003C/h2>\u003Cp>There must not be any factors that prevent certain patient populations from being processed.\nInsurance, language, citizenship, ability to pay, age, politics, access to technology – none of these can be\na barrier to a person’s participation in the patient identification system. Any individual in need of\nhealthcare services is qualified.\u003C/p>\u003Ch2>Interoperability\u003C/h2>\u003Cp>There are thousands of information systems used in healthcare. A comprehensive patient identification\nsystem cannot by itself achieve interoperability. However, it is the bedrock capability upon which all\ninteroperability efforts must be based. If two organizations are going to exchange clinical information,\nthey must be certain that they are talking about the same individual. Only when identification is assured\ncan the benefits of interoperability be realized. No amount of technology can produce a safe and\neffective information exchange without accurate patient identification.\u003C/p>\u003Ch2>Billing Accuracy\u003C/h2>\u003Cp>In the United States, we must accurately link an individual’s treatment to the appropriate mechanisms\nthat ensure proper payment. Any patient identification approach must link directly to financial and\nbilling systems to ensure that financial healthcare information is complete and accurate for this\nindividual.\u003C/p>\u003Ch2>Simplicity\u003C/h2>\u003Cp>Patient identification must be simple to use by clinicians, clinical care organizations and, most\nimportantly, by patients. To paraphrase the words of Albert Einstein, “Everything must be as simple as\npossible, but no simpler.” This ensures that the system can be used effectively by all healthcare workers\nand patients. Simplicity and, as much as possible, transparency, will minimize identification errors that\ncan create risks to patient safety.\u003C/p>\u003Ch2>Resilience\u003C/h2>\u003Cp>No matter how simple and elegant a healthcare information system is, the participation of humans\nguarantees that errors will occur. The identification system must be designed to minimize the incidence\nof errors. It must also be sufficiently transparent that users can readily detect an error. Finally, the\nsystem must be able to perform rapid and complete repairs once an error has been isolated and\nunderstood.\u003C/p>\u003Ch2>Privacy\u003C/h2>\u003Cp>Many patients will opt out of any method of identification they believe will jeopardize their privacy.\nBecause there are at present no universally accepted models for how to ensure the privacy of medical\ninformation, the identification system must be able to adapt to the privacy wishes of each individual\nperson. Furthermore, the system must continue to adapt to the patient’s wishes as their medical\nsituation evolves over time. A well-designed patient identification system can support these privacy\nrequirements for each individual patient, regardless of the limitations of the underlying healthcare IT\nsystems that are being used by that patient’s providers.\u003C/p>\u003Ch2>Secondary uses\u003C/h2>\u003Cp>Medical education, medical research, pharmaceutical research, and public health all require clinical\ninformation. The patient identification system must enable publishing appropriate subsets of a patient’s\nclinical information in such a way that there is no ability for that information to be linked back to the\nactual patient.\u003C/p>\u003Ch2>Anonymization\u003C/h2>\u003Cp>To serve both privacy and secondary use functions, a patient identification system must, ironically, have\nstrong anonymization and de-identification capabilities. For example, a researcher studying colon\ncancer must be able to de-identify a data set from a patient and publish it as part of a research paper\ninvestigating treatment protocols. Furthermore, at a later date, the researcher must be able to update\nthat set of information with new information concerning this patient. It must be possible to do this with\n100% confidence that the correct data set is being updated, that the data is not inadvertently being\n“double counted” by creating a duplicate data set, and that this update does not in any way jeopardize\nthe anonymity of the patient involved.\u003C/p>\u003Ch2>Synergy\u003C/h2>\u003Cp>Healthcare already uses a myriad of patient identification technologies. These include techniques such\nas demographic matching, knowledge-based authentication, and biometric technologies. A new patient\nidentification system must work synergistically with these existing technologies. It must not require “rip\nand replace,” but rather enable “upgrade and improve.” The patient identification system should\nenable a care delivery organization, if it chooses, to continue to use its existing identification capabilities\nand improve the performance of those systems by eliminating errors.\u003C/p>\u003Ch2>Fraud\u003C/h2>\u003Cp>Achieving accurate patient identification will enable care delivery organizations to eliminate one of the\nmost significant sources of healthcare fraud. Medical identity theft enables an individual who has stolen\nsomeone else’s identifying information to then obtain clinical care that is billed to the victim’s insurance.\nA robust patient identification approach must offer a variety of features and safeguards that make this\ndeception impossible.\u003C/p>\u003Ch2>Security\u003C/h2>\u003Cp>The implementation of a new patient identification strategy must include stringent security safeguards\nthat ensure that the new system does not represent an increased security risk. Tools such as encryption\nand anonymization can help achieve this goal. In addition, it is important that the patient identification\nsystem avoids the need for an actual or virtual nationwide database of patient identifiable information.\nAvoiding the creation of such a database eliminates a major vulnerability that might inevitably attract\nhackers, lawyers, and others who have a self-interest in gaining access to such information.\u003C/p>\u003Ch2>Standards\u003C/h2>\u003Cp>To the maximum extent possible, a national patient identification system must avoid the use of\nproprietary technologies and capabilities. Not only do such proprietary components add to the overall\nexpense of the systems implementation, they also tie the longevity of the system to the business\nfortunes of the involved companies. Use of public standards will ensure that the identification system\ncan realize reliable long-term operational stability.\u003C/p>\u003Ch2>Cost-effective\u003C/h2>\u003Cp>The patient identification strategy must be able to serve the entire spectrum of healthcare facilities. Its\ncost must not place an undue financial burden on organizations that adopt it. Meticulous attention\nmust be paid to all aspects of the system’s design to ensure that the deployment and operational costs\nof the entire system are kept to an absolute minimum. Accurate patient identification is good for\nbusiness – better service for patients, faster access to the right patient information for clinicians, and\nreduced duplicate tests and medical errors. Cost savings that far exceed the cost of implementation will\nbe derived from operational efficiencies and improvements in accuracy of patient information.\u003C/p>\u003Ch2>Future proofing\u003C/h2>\u003Cp>It is not possible to foresee all the potential future requirements that may be placed on a patient\nidentification system. Consequently, it is essential to build in as much flexibility as is possible to support\nfuture requirements as efficiently as possible. The system must include features to assist the\ndeployment of increased operational scope and new capabilities as the system evolves over time.\u003C/p>\u003Ch2>Summary\u003C/h2>\u003Cp>The set of requirements given above is by no means exhaustive. However, it generates a daunting list of\nfeatures that are required to achieve a successful national patient identification strategy. Subsequent\ndocuments in this series will explore these topics in more detail and will describe how the GPII system\ncan achieve all the goals outlined above. We welcome dialogue on these and related issues.\u003C/p>","2017-07-31T00:00:00.000Z",{"firstName":5,"lastName":6},"Barry","Hieb",{"slug":8,"title":9},"patient-matching","Patient Matching",{"total":11,"items":12},4,[13,16,18,21],{"slug":14,"title":15},"patient-identification","patient identification",{"slug":17,"title":17},"misidentification",{"slug":19,"title":20},"national-patient-identifier","National Patient Identifier",{"slug":8,"title":22},"patient matching",{"title":24,"url":24},"",{"title":24,"url":24}],"uses":{"params":["slug"]}}]}