Patient ID Caregiver ID
Relaunch
Christian Hay
10th January 2011
Overview
As a JIC Project
Pass through pre-existing Business Requirements
Collect and evaluate usecases to support BR
Adapt Glossary & consider ISO/DTS 22220
Discuss statements
GS1 is the most widely used supply chain
standards system in the world
©2008 GS1
PATIENT ID, CAREGIVER ID
TO BECOME A JIC PROJECT
©2008 GS1
JIC : SDO Harmonization
Joint
Harmonization
Initiative
©2008 GS1
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
©2008 GS1
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
©2008 GS1
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.)
©2008 GS1
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
©2008 GS1
Status today
•
•
•
•
•
2 Monthly conf calls since early October
Good participation
Participation fom various SDOs
Co-chair election January 2011
On track regarding timeline
©2008 GS1
PASS THROUGH PRE-EXISTING
BUSINESS REQUIREMENTS
©2008 GS1
Gathering Business Requirements
Over 60 business requirements have
been gathered. Their source vary from
ASTM Standard Guides, WHO (Patient
Identification Solutions) and user
expertise.
©2008 GS1
COLLECT AND EVALUATE
USECASES TO SUPPORT BR
©2008 GS1
SCENARIO E
©2008 GS1
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,
©2008 GS1
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,
©2008 GS1
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).
©2008 GS1
ADAPT GLOSSARY
& CONSIDER ISO/DTS 22220
©2008 GS1
Glossary (new terms required)
Term
Definition
Source
Patient
Individual who is a
subject of care
SKMT
Subject of care
any person who uses or ISO/TS 22220
is a potential user of a
health care service,
subjects of care may
also be referred to as
patients, health care
consumers or subject of
cares
Subject of care identifier unique number or code
issued for the purpose
of identifying a subject
of (health) care
ISO/TS 22220
«SOCi»
©2008 GS1
Glossary (new terms required)
Term
Definition
Source
Episode of Care
An Encounter or series SKMT
of Encounters related to
the detection and
subsequent care for a
particular healthcare
requirement.
Visit
An episode of care at a
healthcare facility.
Encounter
situation on the
uninterrupted course of
which one or more health
care professionals delivers
health care services to a
subject of care
SKMT
©2008 GS1
About ISO/TS 22220
Identification of subjects of health care
This Technical Specification covers a wide spectrum of aspects
around “Patient Identification”:
©2008 GS1
About ISO/TS 22220
Identification of subjects of health care
SOC identifier
(SOCi)
SOCi
designation
SOCi
geographic
area
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, 4National identifier)
Patient Identifier Assigning Authority : the organisation,
agency or provider that allocates a SOCi designation.
SOCi issuer
SOCi
identifyer
type
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.)
©2008 GS1
About ISO/TS 22220
Identification of subjects of health care (examples)
SOCi value
SOCi geo area
SOCi issuer
SOCi type
998765432
1 (local)
AB1345 (Hospital
X)
01 (unique identifier
for issuer)
NCB 913452
1 (local)
AB1345 (Hospital
X)
02 (speciality
number –
pathology)
XYZ123
2 (area)
ABC4 (Northern
Area Health
Service)
01 (unique identifier
for issuer)
998AAB990
4 (national)
SSA (Social
Security Agency)
01 (unique identifier
for issuer)
99812341
3 (state/province)
ABC (ABC State
DoH)
01 (unique identifier
for issuer)
3344 2256 2235 3
4 (national)
DOHAU (National
Department of
Health Australia)
01 (unique identifier
for issuer)
©2008 GS1
REVIEW OF STATEMENTS
CONFIRM – REVIEW – DISCUSS (ADOPT?)
©2008 GS1
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.
©2008 GS1
Master Patient Index: it is all the same
patient
MPI
„The patient“
Hans Meier
MPI ID 473
Hans Meier
Hansi Meier
Hannes Meier
Hans Meier Hans Meyer
CIS-A
ID 64
Lab-A
ID 98
ERP-A
ID 12
CIS-B
ID 255
Healthcare Provider A
ERP-B
ID 223
HC Provider B
©2008 GS1
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Requirements for successful AIDC
1. 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
2. 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.
Discuss what these statements imply
©2008 GS1
Requirements for successful AIDC
1. 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
2. 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
©2008 GS1
Requirements for successful AIDC
Successful AIDC is challenged by inappropriate practice,
as :
1. Within a single Healthcare Provider, identification
bands may carry different IDs for the same patient,
depending on the Department
2. 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
©2008 GS1
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
©2008 GS1
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
©2008 GS1
Contact
Christian Hay
Sr Consultant Healthcare
Tel +41 (0) 21 825 32 19
Mob +41 (0) 76 369 10 54
christian.hay@gs1.org
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