Identity Management Systems in Healthcare: The Issue of Patient Identifiers

Abstract

Abstract. According to a recent recommendation of the European Commission, now is the time for Europe to enhance interoperability in eHealth. Although interoperability of patient identifiers seems promising for matters of patient mobility, patient empowerment and effective access to care, we see that today there is indeed a considerable lack of interoperability in the field of patient identification. Looking from a socio-technical rather than a merely technical point of view, one can understand the fact that the development and implementation of an identity management system in a specific healthcare context is influenced by particular social practices, affected by socio-economical history and the political climate and regulated by specific data protection legislations. Consequently, the process of making patient identification in Europe more interoperable is a development beyond semantic and syntactic levels. In this paper, we gives some examples of today's patient identifier systems in Europe, discuss the issue of interoperability of (unique) patient identifiers from a socio-technical point of view and try not to ignore the 'privacy side' of the story.

Grand Duchy of Luxembourg: a case study of a national master patient index in production since five years

“…To this end, one of the best-documented approach requires the implementation of identity directories, allowing unequivocal patient identification through different applications and/or health departments. To set up such a system, we decided to employ a hierarchical federated identity management model that is based on a national MPI application [30,46]. A correct patient identification represents a key prerequisite for a reliable functioning of a national eHealth platform.…”

“…Used alone, the SSN is not suitable for primary identification as it has no photograph or any other physical description of the person. Furthermore, due to the fact that the SSN was not explicitly developed as a specific identifier for the medical sector, and following the general European and international approaches [45][46][47], we decided to utilize a second unique identifier (FID), which has been specifically established for the identification of patients in healthcare related matters. Additionally, the existence of a second unique identifier is fundamental to allow the identification of the minority of people that do not have a SSN.…”