September 18, 2014 | Written by: Lorraine Fernandes
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There are some universal truths (you can’t avoid death and taxes), and the universal challenge of managing patient identities is one. If you’ve read some of my other blogs, you’ll note that I frequently bring the patient identification challenges back to the basics—people, process, and technology. That’s true for this global discussion, with regulations added to the mix.
Here’s a preview of what Michele O’Connor and I will be sharing September 30 at the AHIMA 2014 Annual Convention in San Diego. We will explore these topics, and share our personal experiences and perspectives.
- The importance. Creating the single view of a patient/citizen’s data is vital to care coordination, data exchange between care sites, and analytics. These drivers have long existed, but have gained much higher importance as health and wellness strategies become patient-centric, and the historical silos of data are broken down. Strategies to create a wellness oriented, seamless healthcare system will vary from country to country, but the need for patient-centric data is unwavering.
- Common challenges. Typographical errors, data transposition, lack of high data quality for the patient identification attributes, are just a few of the common contributing factors. Even countries with national identifiers face challenges, as the identifiers were likely created for financial or citizen identification/tracking purposes. Using these identifiers for care delivery may be prohibited, or the identifier may have data accuracy or fraud issues, thus the identifier is not “the silver bullet” to identification and achieving strategic goals.
- Country approaches
- Canada – Early in the Canada Health Infoway strategic planning timeframe (approximately 2001 they addressed identification. Canada made the decision not to create a national identifier for patient/clients or providers. Instead each province has executed a client registry to serve as a virtual solution that matches patient identities within the province. Ultimately, pan-Canadian data linkage may happen, but it’s not present today
- China – While China has a national identifier that is used for many purposes, healthcare organizations do not consistently capture or use this data element. And, many provinces have adopted provincial specific initiatives to integrate health, education, and citizen services, thus the scope of the identifier and the associated citizen services has dictated probabilistic matching also be used
- Australia – Over the past five years Australia has attempted to execute their Patient Controlled Electronic Health Record (PCEHR) initiative. A unique identifier was assigned to all Australians, although use of this was restricted as the patient had to opt in. PCEHR has had poor uptake, and a new strategy is being developed
- Singapore – A strong national identifier is broadly adopted and used for many citizen services. However, health data is linked with the national identifier and augmented with probabilistic matching, as data quality issues exist.
- Wales – The data quality challenges experienced by all countries are evident in Wales, along with governance implications. Thus NHS Wales’ Informing Health Care Programme augments the unique NHS identifier with probabilistic matching
If you’re at the AHIMA Annual Convention, please join us as we explore the challenges, approaches, and governance practices of select countries. We’ll also overview recent patient identification activities in the United States. Let’s have an active discussion of lessons learned from around the world, and their potential implications for the US!!