A Brief Introduction to Patient Identification Using the VUHID System

• Barry R. Hieb, MD• Chief Scientist, Global Patient Identifiers Inc.

• Kantara, June 10, 2010• \Kantara\VUHIDdemo6-10-10

Current Healthcare Environment

Heterogeneous clinical automation environmentNo standards for patient identificationFederal govt. continues to avoid healthcare identifierIncreasing automation & information exchange8-10% EMPI matching error ratesHealthcare identity theft grew 112% in 2009Lost information, duplicate recordsInadequate privacy managementUnique patient identifiers can address all of these needs

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Goals of a Potential Solution

Eliminate patient identification errors

Improve privacy management

Reduce medical identity theft

Cost effective

Deployable across a variety of policies

Simple, uniform syntax with consistent semantics

Standards-based

Implementable across a variety of technologies and geographies

Eliminate potential for counterfeiting

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VUHID Mission Statement

The goal of the Voluntary Universal Healthcare Identification (VUHID) project is to make unique healthcare identifiers available to individual patients who want one to enable:– unambiguous patient identification – error-free linkage of clinical information – enhance the privacy of patient information – improve the quality of medical care – reduce the rate of medical errors – decrease the incidence of healthcare-related identity theft – help control healthcare costs

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Identification Errors are a Patient Safety Issue

False positives create a clear patient danger

False negatives mean duplicate records, additional cost and needed information may not be available

Additional (duplicate) testing is expensive and can be dangerous

Good clinical decision support requires accurate and comprehensive information

Time spent looking for information is time not spent diagnosing and treating the patient

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VUHID Identifier Syntax

0000008562837139.749174221800000

Prefix

Identifier syntax

Open identifier 0000003693664829.210573900000000

DelimiterCheckdigits

Privacyclass

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

Private identifier 0000005637623757.077328571370000

Note: Private identifiers are anonymous

Compact display 3693664829.21057390

One Possible VUHID Card Configuration

HIE designs card format and produces the cards

Issued when the patient obtains their VUHID identifier

Stays permanently with the patient

Identifier is printed on the card

Has at least one machine-readable representation

–Bar code–Magnetic stripe–Smart card–RFID? (privacy concerns)

Photo/biometric may be included

John Q Public

18563823043.271457280Open Identifier

HIE logo here

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Issuing Institution’s Logo here

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Two Categories of IdentifiersVUHID identifiers are either an OVID or PVIDOpen Voluntary Identifier – OVID– Shared patient information for administrative, financial and

clinical uses– Patient identity is known– Wide variety of “open” medical uses

Private Voluntary Identifier – PVID– Many different classes:

• Psychiatry, STDs, research, genetics, etc.– Patient identity is not necessarily known

• Patient, selected physician(s), EMPI system– Specific set of “rules” for each privacy class

Ideally, a person has one OVID and many PVIDs Multiple OVIDs for one person are not ideal but tolerated

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Sample Identifiers for an IndividualOVID for a person (color added for emphasis only)– 0000005091093234.215712900000000

Compact display of the OVID above– 5091093234.21571290

PVIDs for the same person

0000056285294729.265932365824980

0000025234750372.025025026389256

1528810573905739.953057293059000

0000000519385638.795629763800000

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Six Critical HIE functions

Hospital1

Hospital3

Hospital2

EMPIandRLSClinic

Clinic

MDoffice

MDoffice

MDoffice

Long-termcare

1. User authentication 2. Patient registration3. Demographic matching4. Identifier mapping5. Record locator service6. Information sharing policies

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VUHID System Architecture

VUHID

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Data Location Request Processing

VUHID Request

Validation

Response

VUHID Benefits

Consistent syntax and semantics for patient ID

Globally unique identifiers – no identification errors

Ability to embed privacy constraints

Lifetime identification for a patient

Ability to terminate if fraud/error detected

Reduce identity theft

Concurrent support for multiple policies & technologies

Counterfeit resistance

Language independence/internationalization

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HIE Value from VUHID Identifiers

Internal– Reduce duplicate records, save time, eliminate lost data,

improve medical outcomes, eliminate cost and waste, better achieve meaningful use, reduce duplicate tests

External– Improve accuracy and efficiency of information exchange,

enable longitudinal medical records, enable data sharing for research and reporting

Both– Reduce medical identity theft, improve privacy management,

support multiple languages, eliminate counterfeiting

Contact Information

www.gpii.info

Barry Hieb, MD, Chief Scientist, GPII

bhieb@vuhid.org

520-320-6220

Elizabeth (Liddy) West, CPHIMS, Chief Marketing Officer, GPII

ewest123@msn.com

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Thank you!