Patient ID Caregiver IDRelaunch Christian Hay 10th January 2011
Overview GS1 is the most widely used supply chain standards system in the world As a JIC Project Passthroughpre-existing Business Requirements Collect and evaluateusecases to support BR AdaptGlossary & consider ISO/DTS 22220 Discussstatements
JIC : SDO Harmonization Joint Harmonization Initiative
Objectives • Engage stakeholders, share communications between SDOs • Encourage standards developed by one SDO to become harmonized to work with standards of other SDOs • Support SDOs working together producing one harmonized standard fit for purpose • Promote usability of standards
GS1 and JIC GS1 has been asked to become part of the Joint Initiative in Autumn 2009 As a new member of the Initiative, GS1 has been asked to propose a joint work CEN representatives asked GS1 to address Patient ID as a joint work item
New Work Item Proposal • NWIP Patient ID, Caregiver ID has been approved as a work item by all the SDOs. • For the first time, the work is concentrated into one single SDO (GS1), following its rules (GSMP) • Experts from the other SDO are invited to join the GSMP WG – a special status has been adopted for them • Although work is done @ GSMP WG, each SDO can involve its appropriate working teams, to participate through their representative (inputs, comments in public review, etc.)
New Work Item Proposal • End goal is that the deliverable adopted by the GSMP WG (thus, a possible change in the GS1 General Specifications) becomes an ISO standard
Status today • 2 Monthly conf calls since early October • Good participation • Participation fom various SDOs • Co-chair election January 2011 • On track regarding timeline
Gathering Business Requirements Over 60 business requirements have been gathered. Their source vary from ASTM Standard Guides, WHO (Patient Identification Solutions) and user expertise.
Patient Identification in Sweden/1 • The personal identity number is the Swedish national identification number. • Issued by Swedish Tax Agency as part of the population register • The link between a person and the identity number is established • through Swedish identity documents, like ID cards • through the widespread use of the number in various contacts with authorities etc. • They are necessary for personal service at banks, authorities, health care • most people are familiar with their full number and those of e.g. family without hesitation,
Patient Identification in Sweden/2 • The most important use of the PIN in Swedish health care is however to trace patients and their medical records. • enables efficient handling of referrals and referral letters, • Means of identifying patients handled by different health care staff such as physicians, nurses, occupational therapists, physiotherapists etc. • reduces the risk of duplication errors,
Patient Identification in Sweden/3 However: • This number is controversial at the moment because the advocates feel that it is the best way to identify a patient and all hospital systems are based on it. Some argue that a non significant number would be better so that unauthorized people cannot link the patient to e.g. a disease. E.g. housing for abused women now want to use a unique non-significant number such as GSRN • Many hospitals are starting bed side scanning and I guess we should investigate the dangers of just putting the 10 digit number in a bar code as it might collide with other numbers (since no qualifier that this is a patient id being scanned).
About ISO/TS 22220Identification of subjects of health care This Technical Specification covers a wide spectrum of aspects around “Patient Identification”:
About ISO/TS 22220Identification of subjects of health care A number or code assigned to a person by an organisation, establishment, agency or domain in order to uniquely identify that person as a SOC within that healthcare organisation, establishment, agency or domain A code representing the geographic area within this identifier is used (1- Local subject identifier; 2- Area, region or district identifier, 3- State/province/territory identifier, 4- National identifier) Patient Identifier Assigning Authority : the organisation, agency or provider that allocates a SOCi designation. Identifier type code: the type of the identifier within the organisation (e.g. unique patient identifier, healthcare card, pension card). Example of codes include : 01 (unique identifier within this organisation –to be used where only one number is used for identification within the organisation): 02 (Medical record number, etc.)
The 3 pillars (to be used in BRAD’s introduction) • There are three pillars that need the establishment of a solid link between objects, Subject of Care, Individual Provider and Healthcare Provider. The three pillars are not of the same importance, but they all need to refer to unique (master) ID in order to function. • Safety: correct patient and care giver identification is an essential step in the safe delivery of care; accurate documentation about care provided (as EHR) is part of this requirement • Efficiency: efficiency aims at providing the best quality of care at the best cost. • Finance and governance: this area covers healthcare governance, whiteboards and billing, such as fee-for-services and DRG’s.
Master Patient Index: it is all the same patient MPI „The patient“ Hans MeierMPI ID 473 HC Provider B Healthcare Provider A Hans Meier CIS-A ID 64 Hansi Meier Lab-A ID 98 Hannes Meier ERP-AID 12 Hans Meier CIS-B ID 255 Hans Meyer ERP-BID 223 25 25
Requirements for successful AIDC Discuss what these statements imply • Patient ID captured from identification band must be unique in the activity domain (i.e. within Healthcare Provider X) • the aim is to have a single identifier for the Healthcare Provider, ultimately for the region / country • Patient ID captured from identification band issued by Healthcare Provider A, must be readable and its origin linked to A, when Healthcare provider B is capturing it • Using a kind of a filter (some sort of international identifier for the issuer); or append a 2nd field for issuer identification • AIDC solution is not related to MPI (Master Patient Index). MPI is useless in AIDC process.
Requirements for successful AIDC • Subject of Care identification requires distinction: • between an attribute (Diabetic i.e. one who suffers from diabetes.., haemophiliac) -fix relationship • and an episode (broken leg) – relationship limited in time • Example: NHS number identifies as a person • fix relation to diabetes, etc. • It is dangerous to use condition-specific identifiers (because identification is meaningful; the patient may be cured; privacy issues) • Ex. Pregnancy is a temporary condition • – attributes to Subject of Care Identification is preferable
Requirements for successful AIDC • Successful AIDC is challenged by inappropriate practice, as : • Within a single Healthcare Provider, identification bands may carry different IDs for the same patient, depending on the Department • At the same Healthcare Provider, an identification band issued by Department A should be readable and its origin linked to A, when Department B is capturing it • Healthcare Provider should strongly adopt single Subject of Care identification for all its Departments • Discuss what these statements imply
Requirements for successful AIDC In a data capture process, the system must be able to document that the ID has been captured from an identification band, or from an order form, sample tube, etc. (source : ISBT 128 technical specifications § 4.2.25; would be great to find examples of implementation) Discuss what this statements implies
Requirements for successful AIDC When an identification band has to be replaced (damaged, incompatible with radiology, etc.), the system must document if the ID has been captured from the first or from the following identification band We need more to document about this requirement Discuss what this statements implies
Contact Christian Hay Sr Consultant Healthcare Tel +41 (0) 21 825 32 19 Mob +41 (0) 76 369 10 54 firstname.lastname@example.org