Analysis Of Unique Patient Identifier Options
ANALYSIS OF UNIQUEPATIENT IDENTIFIEROPTIONSFINAL REPORTNovember 24, 1997Prepared for THE DEPARTMENT OF HEALTH AND HUMAN SERVICESby Soloman I. Appavu
Table of ContentsPart One: Executive Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Objective. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Method of Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Report Template. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Functions and Objectives of Unique Patient Identifier. . . . . . . . . . . . . . . . 2Required Components of Unique Patient Identifier. . . . . . . . . . . . . . . . . . 3Privacy, Confidentiality & Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Unique Patient Identifier Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Result of the Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6I. General Findings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6II. Compliance Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Available Courses of Action. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Part Two: Patient Identifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Patient Identifier - An Integral Part of the Delivery of Patient Care . . . .Patient Identifier - A Critical Component of Patient CareInformation and Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Typical Uses of Patient Identifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Current Method of Patient Identification used in HealthcareOrganizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Impact of Information and Communication Technologies on the PatientIdentifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .The Various Levels of Patient Identifier Usage. . . . . . . . . . . . . . . . . . . .151516Part Three: Unique Patient Identifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Unique Patient Identifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Industry Initiatives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .The Significance of Unique Patient Identifier. . . . . . . . . . . . . . . . . . . . . .Unique Patient Identifier - Definition. . . . . . . . . . . . . . . . . . . . . . . . . . . .Unique Patient Identifier - Basic Functions and Objectives. . . . . . . . . . .Components & Processes Integral to Unique Patient Identifier. . . . . . . .19191920202123Part Four: Privacy, Confidentiality & Security. . . . . . . . . . . . . . . . . . . . . . . . . . . .Privacy, Confidentiality and Security of Patient Care Information. . . . .Unique Patient Identifier’s Role in Protecting the Privacy ofPatient Care Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Security Risks and the Unique Patient Identifier. . . . . . . . . . . . . . . . . . .The Privacy and Confidentiality Challenge. . . . . . . . . . . . . . . . . . . . . . .1. Judicious Design. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2. Organizational Security Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . .3. Federal Legislation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4. Individual Responsibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2828161617171828292930313131Part Five: Method of Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Scope and Method of Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Part Six: Unique Patient Identifier Options and Alternatives. . . . . . . . . . . . . . . . . 35Unique Patient Identifier Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Non Unique Patient Identifier Options. . . . . . . . . . . . . . . . . . . . . . . . . . . 35Alternatives to Unique Patient Identifier. . . . . . . . . . . . . . . . . . . . . . . . . 35Part Seven: Analysis of Unique Patient Identifier Options. . . . . . . . . . . . . . . . . . . 37Report Template. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Manual Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371. Enhanced Social Security Number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . . .IV Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .393941412. Sample Universal Healthcare Identifier (UHID). . . . . . . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . . .UHID SAMPLE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . . .IV. Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50505151513. Unique Patient Identifier based on Bank Card Method. . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . . .e) Design Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IV. Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60606060624445454648495455555758586464656667684. Cryptography-based Patient Identifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . . .Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . . . . . .IV Compliance with Operational Characteristics. . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .697070735. Unique Patient Identifier based on Personal Immutable Properties. . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . . .IV. Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .787878786. Unique Patient Identifier based on Biometrics . . . . . . . . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics . . . . . . . . . . . . .IV. Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8686868673747576768181828384858989909192937. Lifetime Human Service & Treatment Record (LHSTR) Numberbased on Birth Certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94I. Description of the Identifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . . . 95III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . . . 95IV. Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . . . 99VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100VIII. Potential Barriers & Challenges to Overcoming the
Barriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1028. Existing Medical Record Number (MRN) based identification. . . . . . . . . . . . .I. Description of the Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . .IV. Compliance with Unique Patient Identifier’s OperationalCharacteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9. Identification based on Medical Record Number andProvider Prefix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . .IV. Compliance with Unique Patient Identifier’s OperationalCharacteristics and Readiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier’s ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1511611711710. CORBAMed Patient Identification Service (PIDS). . . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . .IV. Compliance with Unique Patient Identifier’s OperationalCharacteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Unique Patient Identifier’s BasicFunctions Criteria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11911911911911. HL7 Master Patient Index Mediator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . .IV. Compliance with Operational Characteristics and127127127127122122123124125125
Readiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13013013113213313312. FHOP’s Core Data Element-Based Patient Identification . . . . . . . . . . . . . . . .I. Description of the Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . .IV. Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient Identifier ComponentsRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13413413513513. Directory Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. Description of the Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II. Author/Proponent and Documentation. . . . . . . . . . . . . . . . . . . . . . . .III. Compliance with ASTM Conceptual Characteristics. . . . . . . . . . . .IV. Compliance with Operational Characteristics andReadiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .V. Compliance with Unique Patient IdentifierComponents Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VI. Compliance with Basic Functions Criteria. . . . . . . . . . . . . . . . . . . .VII. Strengths and Weaknesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VIII. Potential Barriers & Challenges to Overcoming theBarriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IX. Solutions to the Barriers:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . art Eight: Central Trusted Authority Options. . . . . . . . . . . . . . . . . . . . . . . . . . . 150Part Nine: Result of the Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1) General Findings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2) Compliance with Unique Patient Identifier Requirements . . . . . . . .3) Compliance Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4) Compliance Matrix for ASTM Conceptual Characteristics . . . . . . .5) Compliance Matrix for Operational, Components andBasic Functions Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151151157160162Part Ten: Available Courses of Action. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .An Ideal Unique Patient Identifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . .Available Courses of Action. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .The Need for Leadership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166166167170164
Part Eleven: References & Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . 172References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178Part Twelve: Author’s Biography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Part One: Executive SummaryIntroductionPatient Identifiers are vital for healthcare organization’s day to day operationssuch as the delivery of care, administrative processes, support services, recordkeeping, information management, and follow-up and preventive care. Therevolution, currently taking place in our national healthcare delivery system and inthe computer and telecommunication technologies, has expanded the scope of thesefunctions across multiple organizations spread around the nation. In addition,patients are mobile, visit multiple providers and treated by multiple organizations.Therefore, to support the continuum of care, it is necessary to uniquely identifypatients across multiple providers and access their information from multiplelocations.The current method of patient identification involves the use of a medical recordnumber, issued and maintained by a practitioner or a provider organization. Thisnumber is based on an institutional Master Patient Index (MPI) and the numberingsystem is specific to the issuing organization. Different provider organizations usedifferent numbering systems. Patients receive multiple Medical Record Numbers,each issued by the organization that provided them care. These numbers provideunique identification only within the issuing organization. A Patient Identifier that isunique only within a provider organization or a single enterprise is inadequate tosupport the national healthcare system. In order to uniquely identify an individualacross multiple organizations, a reliable Unique Patient Identifier is required. TheHealth Insurance Portability and Accountability Act of 1996 requires the Secretary ofHealth and Human Services to adopt standards for Unique Health Identifiers toidentify individuals in addition to providers, health plans and employers. Theindustry has put forth several options for the Unique Patient Identifier; this reportexamines their effectiveness and readiness.ObjectiveThe objective of this study is to perform an analysis of the various UniquePatient Identifier options that are available for use in healthcare. The result of thisanalysis will facilitate and support the recommendation to be made to the Secretaryof HHS by the NCVHS.Method of AnalysisIn order to evaluate all functional and operational aspects of the various UniquePatient Identifier options, this analysis employs a two step process. In the first step,various issues surrounding the Unique Patient Identifier including its requiredcharacteristics, capabilities, components, functions and use are analyzed. In the nextstep, each Unique Patient Identifier option is analyzed individually. The analysiswas based on a set of criteria including ASTM criteria for a Universal HealthcareANALYSIS OF UNIQUE PATIENT IDENTIFIER OPTIONS1
Identifier. ASTM’s “Standard Guide for Properties of a Universal HealthcareIdentifier (UHID)” includes thirty (30) conceptual characteristics for evaluatingidentifier candidates. However, it does not address implementation issues andoperational characteristics. Therefore, in order to fully evaluate the Unique PatientIdentifier options beyond a conceptual level and verify their compliance both withfunctional and operational capabilities required in a live day-to-day patient careenvironment, the options are analyzed based on the following evaluation criteria:1. ASTM’s Conceptual Characteristics2. Unique Patient Identifier’s Operational Characteristics3. Unique Patient Identifier’s Components4. Unique Patient Identifier’s Basic Functional Requirements.Report TemplateFor the sake of consistency, a common template consisting of the followingcategories is used to analyze each option:I.Description of the OptionII. Author/Proponent of the Option and DocumentationIII. Compliance with ASTM’s Conceptual CharacteristicsIV. Compliance with Operational CharacteristicsV. Compliance with Unique Patient Identifier ComponentsRequirementsVI. Compliance with Basic Functions RequirementsVII. Strengths and WeaknessesVIII. Potential Barriers and Challenges to Overcoming the Barriers.IX. Solutions to the Barriers.Functions and Objectives of Unique Patient IdentifierThe four (4) basic functions that a Unique Patient Identifier must support are:1)Positive identification of the individual:a) for delivery of care (e.g. diagnosis, treatment, blood transfusion andmedication)b) for administrative functions (e.g. eligibility, reimbursement, billing andpayment)2)Identification of information:ANALYSIS OF UNIQUE PATIENT IDENTIFIER OPTIONS2
a) Identification to access patient information for prompt delivery of care,coordination of multi-disciplinary patient care services during currentencounters and communication of orders, results, supplies, etc.b) Organization of patient care information into a manual medical recordchart or an automated electronic medical record for both current and futureusec) Manual and automated linkage of various clinical records pertaining to apatient from different practitioners, sites of care and times to form a lifelongview of the patient’s record and facilitate continuity of care in futured) Aggregation of information across institutional boundaries for populationbased research and planning3)Support the protection of privacy and confidentiality through, accurateidentification (explicit identification of patient information) anddis- identification (mask/encrypt/hide patient information).4)Reduce healthcare operational cost and enhance the health status of thenation by supporting both automated and manual patient recordmanagement, access to care and information sharing.Required Components of Unique Patient IdentifierA Unique Patient Identifier must include components that will provide it with thenecessary functional capabilities. Each identifier must be supported by adequateidentification information of the individual it identifies. Such information must becurrent; indexed and stored properly. The identification process includes searchingMPIs, matching identifiers and verifying information. Depending on the identifier’sscope and level of use, the search processes can range from a single providerorganization to the entire national healthcare system with the possibility, in future, toexpand worldwide. Therefore, the Unique Patient Identifier requires a robusttechnical and administrative infrastructure. The following six (6) components areintegral parts of the Unique Patient Identifier. They must work together in order forit to perform its functions and fulfill its objectives:1. An Identifier (numeric, alphanumeric, etc.) Scheme2. Identification Information3. Index4. Mechanism to hide or encrypt the Identifier5. Technology infrastructure to search, identify, match, encrypt, etc.6. Administrative infrastructure including the Central Governing Authority.Privacy, Confidentiality & SecurityANALYSIS OF UNIQUE PATIENT IDENTIFIER OPTIONS3
Privacy, Confidentiality and Security of Patient Care InformationPrivacy, in the healthcare context, amounts to the freedom and ability to share anindividual’s personal and health information in confidence. Confidentiality is theactual protection such information receives from the provider organizations. Anindividual’s personal and health information include those that were supplied by theindividual and those observed by the care giver during the course of the delivery ofcare. Security is the measure that an organization has employed to protect theconfidentiality of the patient information. In essence, privacy of an individual’shealth information depends on the level of confidentiality maintained byorganizations which in turn, depends on the security measures implemented by them.Respect for the privacy and confidentiality of patient information must be adoptedand fostered as an essential organizational policy and culture. Security measures thatare failsafe must be utilized. Yet, the organizational security measures can work onlywithin the walls of the organization and among its employees. Protection outside theprovider organization will require federal legislative measure in addition to anorganization’s security measures. Therefore, protecting the privacy of patientinformation is a joint responsibility of individuals, organizations and the nation as awhole; appropriate effort must be put forth by all of them.The Privacy and Confidentiality ChallengeThe privacy and confidentiality of patient care information is a difficult challengefacing the entire healthcare industry and cannot be ignored. The following measuresa
unique identification only within the issuing organization. A Patient Identifier that is unique only within a provider organization or a single enterprise is inadequate to support the national healthcare system. In order to uniquely identify an individual across multiple organizations, a reliable Unique Patient Identifier is File Size: 707KB
Tibetan Buddhist Wheel of Life Identifier: 141748 Yarmulke Identifier: 2004.53.4 Hebrew Bible (Tanakh) Identifier: 2004.23.1 Prayer Rug Identifier: 2005.31.1 Tibetan Lama’s Crown Identifier: 113860 Rama Figurine Identifier: 121085 Ganesh Figurine Identifier: 116859 Qu’ran Identifier: 2005.31.2 Creche Identifier: E2006.1.25a-b Torii .
UDI. The medical device UDI system is slightly different, consisting . of two identifiers: a unique device identifier and a unique production identifier. The GS1 GTIN-14 provides the unique device identifier (the manufacturer's ID and product ID). The production identifier can include a serial number, lot or batch
The Cisco UDI provides a unique identity for every Cisco product. The UDI is composed of thr ee separate data elements which must be stored in the entPhysicalTable: Orderable product identifier (PID)—Product Identifier (PID). PID is the alphanumeric identifier used by customers to
in this field, enter the new identifier here. If there has been no change in the identifier, enter the same identifier as in RREL4. The reporting entitymust not amend this unique identifier. NO RREL6 Data Cut -Off Date The data cut off date for this data submission. NO RREL7 Pool Addition Date The date on which the underlying exposure was .
Protocole / Moyens du centre Les points clefs Identifier toutes les spécialités médicales, paramédicales, techniques nécessaires. Identifier les locaux et sites concernés (imagerie, laboratoire, stockage des échantillons, pharmacie). Confidentialité Identifier le circuit des UT. Identifier le matériel et équipements nécessaires .
product itself. If required, lead free certification identifier text will be included next to the mark: If required, the lead free certification identifier text will be in one location near the certifier mark as free text or text enclosed in a box: 2. Certifier's. Identifier text. Mark Identifier text to left of mark. Certifier's Mark. I .
Cable Labeling Standards 1. Cable Identifier will consist of a two character group identifier followed by a six-digit number, for example, EC000221 or ID000093. System Identifier is the second line, beneath the Cable Identifier. It describes to what system the cable belongs. This is an English description of what the cable is used for.
Tank 6 API-653 In-Service, Internal Inspection Report less severe corrosion than the west perimeter. The average thickness of the sketch plates away from the west perimeter was 0.281”. Other than the perimeter corrosion noted, the remainder of the tank bottom showed no signs of significant metal loss and the thickness readings appeared consistent with the readings from the 2004 robotic .
