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Patient Identification Policy and Implementation Workshop

Join our workshop in Dar Es Salaam, Tanzania on December 9-10, 2008 to discuss the policy and implementation of patient identification systems. Learn about generating unique IDs, de-duplication processes, handling legacy numbers, and reference data. Understand the benefits, challenges, and prerequisites of implementing a national health identification system.

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Patient Identification Policy and Implementation Workshop

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  1. Patient IdentificationWorking group sessionData Use WorkshopDar Es Salaam, TanzaniaDecember 9-10, 2008

  2. Policy I • An individual should be able to access all health services using the same unique ID • You must be able to generate the unique ID at the initial point of service • Some patient or consistently available parameters should be used to generate/seed the patient ID

  3. Policy II • Put systems in place to ensure compliance • Reference ASTM 1714 for attributes of the numbering system • Follow available international standards where available and applicable • ID template

  4. De-duplication I • De-duplication is important to do, but we recognize that you can never completely solve the problem of duplicate IDs • Might have same ID for two or more people - what process do you use to split them apart

  5. De-duplication II • in situations where there is no national ID so this can happen frequently. People come for care, then stop, then person with same ID shows up again later, if there is an apparent difference, eg gender, name, then the person is asked if they are the same or not, otherwise the record gets expanded using someone else's data.

  6. De-duplication III • Is it worth it to de-duplicate? for some treatment programmes like HIV care definitely! • Need to understand the cause of the identifier duplication

  7. Legacy Numbers I • What do you do with the legacy numbers that you had before you developed or assigned the unique ID • Import legacy numbers into a list of “alternate IDs” for a record and link that to the actual unique ID so that you can search using these values and get the right record with the right ID • Some identifiers are in active use, so a patient may have multiple live ids

  8. Legacy Numbers II • Some systems wont get updated and enforce the old ID format so you have to keep using it instead of the new one • Correct technical requirements on the specification and construction of new systems need to be provided

  9. Reference Data • National reference data sets - services, geo-locations • List of facility IDs • Code sets for patient identification that are easily readable by the patient

  10. Meta data for identifiers I • Names • Age- DOB (this should critically standardized by using a system of either birth date and the system converting it into the birth date • Initial point of service entry-facility ID • sex-captured as part of the demographic info • Geographical locator-district, state,country or birth place/address

  11. Meta data for identifiers II • Individual national Numbers-these could be serial numbers generated at the site level • Family identifiers-DOB like parent's birth dates,mothers maiden names etc • Nationality at birth

  12. Other Issues • Cost of implementation of system • Tie costing into policy • Depends on type of implementation • Social acceptance of identification system • Public awareness for both clients and providers in the system

  13. Benefits I • Improves individual patient management • Easy referencing of data on patients in data bases • Continuation of care for an individual • Patient safety. • integration of patient records across different systems • Counting patients, facilitate the planning from one facility to another

  14. Benefits II • Fraud reduction • Facilitate transfer of patients from one facility to another

  15. Challenges I • Just doing the change to a national ID system • Dealing with the legacy identifiers - need to identify all of them and how they link to patients • Getting buy-in from patients • Overcoming the fear/concern of the national government having personal information

  16. Challenges II • Deal with potential stigma of rolling out the identification system inappropriately as well as having your information flowing around - confidentiality issues

  17. Prerequisites • National consensus that this needs to be done • It has to be a UNIVERSAL health identifier, not limited any particular group (like HIV patients)‏ • National executive champion in government that provides appropriate resourcing to meet the requirements in terms of people as well as financial

  18. Prerequisites II • Need to ensure that the identifier system plan complies with social norms, legislation, and other agreements relating to privacy, confidentiality, and sharing of personal data • Facilities themselves must have nationally unique identifiers first • Carefully thought out technology strategy that doesn't require that everyone have a computer

  19. Prerequisites III • Quality control/verification plan should be in place before roll-out • Training before and after adoption of the system

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