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\VUHIDdemo

Current Healthcare Environment Heterogeneous clinical automation environment No standards for patient identification Federal govt. continues to avoid healthcare identifier Increasing automation & information exchange 8-10% EMPI matching error rates Healthcare identity theft grew 112% in 2009 Lost information, duplicate records Inadequate privacy management Unique patient identifiers can address all of these needs 2

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 3

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 4

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

6 VUHID Identifier Syntax Prefix Identifier syntax Open identifier Delimiter Check digits Privacy class Private identifier Note: Private identifiers are anonymous Compact display

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 Open Identifier HIE logo here 7 Issuing Institution’s Logo here

8 Two Categories of Identifiers VUHID identifiers are either an OVID or PVID Open 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

9 Sample Identifiers for an Individual OVID for a person (color added for emphasis only) – Compact display of the OVID above – PVIDs for the same person – – – –

10 Six Critical HIE functions Hospital 1 Hospital 3 Hospital 2 EMPI and RLS Clinic MD office MD office MD office Long- term care 1.User authentication 2.Patient registration 3.Demographic matching 4.Identifier mapping 5.Record locator service 6.Information sharing policies

11 VUHID System Architecture VUHID

12 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 13

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 Barry Hieb, MD, Chief Scientist, GPII Elizabeth (Liddy) West, CPHIMS, Chief Marketing Officer, GPII 15 Thank you!