ANALYSIS OF UNIQUE PATIENT IDENTIFIER OPTIONS

FINAL REPORT

November 24, 1997

Prepared for THE DEPARTMENT OF HEALTH AND HUMAN SERVICES

by Soloman I. Appavu











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Table of Contents

Part One: Executive Summary

Introduction
Objective
Method of Analysis
Report Template
Functions and Objectives of Unique Patient Identifier
Required Components of Unique Patient Identifier
Privacy, Confidentiality & Security
Unique Patient Identifier Options
Result of the Analysis
I. General Findings
II. Compliance Summary
Available Courses of Action

Part Two: Patient Identifier

Introduction
Patient Identifier - An Integral Part of the Delivery of Patient Care
Patient Identifier - A Critical Component of Patient Care
Information and Management
Typical Uses of Patient Identifier
Current Method of Patient Identification used in Healthcare Organizations
Impact of Information and Communication Technologies on the Patient Identifier
The Various Levels of Patient Identifier Usage

Part 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

Part Four: Privacy, Confidentiality & Security

Privacy, Confidentiality and Security of Patient Care Information
Unique Patient Identifier's Role in Protecting the Privacy of Patient 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

Part Five: Method of Analysis

Scope and Method of Analysis

Part Six: Unique Patient Identifier Options and Alternatives

Unique Patient Identifier Options
Non Unique Patient Identifier Options
Alternatives to Unique Patient Identifier

Part Seven: Analysis of Unique Patient Identifier Options

Report Template
Manual Process

1. 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 and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

2. 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 and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

3. 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 and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

4. Cryptography-based Patient Identifier

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 Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

5. 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 and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

6. 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 and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

7. Lifetime Human Service & Treatment Record (LHSTR) Number based on Birth Certificate

I. Description of the Identifier
II. Author/Proponent and Documentation
III. Compliance with ASTM Conceptual Characteristics
IV. Compliance with Operational Characteristics and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

8. 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 Operational Characteristics
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

9. Identification based on Medical Record Number and Provider Prefix

I. Description of the Option
II. Author/Proponent and Documentation
III. Compliance with ASTM Conceptual Characteristics
IV. Compliance with Unique Patient Identifier's Operational Characteristics and Readiness
V. Compliance with Unique Patient Identifier's Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

10. 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 Operational Characteristics
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Unique Patient Identifier's Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

11. 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 and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

12. 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 and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strength and Weaknessess
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers

13. Directory Service

I. Description of the Option
II. Author/Proponent and Documentation
III. Compliance with ASTM Conceptual Characteristics
IV. Compliance with Operational Characteristics and Readiness
V. Compliance with Unique Patient Identifier Components Requirements
VI. Compliance with Basic Functions Criteria
VII. Strengths and Weaknesses
VIII. Potential Barriers & Challenges to Overcoming the Barriers
IX. Solutions to the Barriers:

Part Eight: Central Trusted Authority Options

Part 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 and Basic Functions Requirements

Part Ten: Available Courses of Action

An Ideal Unique Patient Identifier
Available Courses of Action
The Need for Leadership

Part Eleven: References & Acknowledgments

References
Acknowledgments

Part Twelve: Author's Biography