Your Health and Identity

Your health belongs to you, and professional health services follow you up throughout your life. They create records stored in their filing systems, these will contain results of analyses, specialist observations and prescriptions used for treatments; some pieces of information might be crucial decades after they filed. Old records should be available today and in the decades to come.

Your medical records are labeled in a way that link them to you, but each generation of technology will contribute to the shaping of the label data, the identifier. Some few decades ago the labels were designed for use by humans, later they were to used by local computer systems, then national ones, and today we are facing demands for international use through Internet services and apps; many of us have lived through these technologial generations and need ability to handle the consequences.

Medical files on paper were probably labeled with birth date and name, they still exist but are normally not transferred to computer readable formats. Internal filing systems for clinics, hospitals and laboratories were using identifiers listed in internal patient registers to store and retrieve patient records; they could also be linked to health insurance numbers. However, they were not supported by look-up services on Internet.
Your health services can be be improved by use of Internet, information from different medical files can be accessed when needed, if shared patient identifiers are used; the term patient centric services becomes relevant. Unique patient identifiers for patient centric services have not yet been developed, but it can easily be imagined how such ones can open for the use of modern times’ apps in health services.

General person identity parameters have never agreed and standardized, different approaches have been made and might lead to a future solution for use in patient centric health care:

1 European Health Insurance Card: The blue cards used to ensure health insurance for members of national health insurance systems in EU and EFTA states carry national numbers issued by national health insurances. They have been designed for national coverage, and the systems have been federated, and not united, without verification on Internet; however, the identifiers have the technical quality to be subject for such use if maintained properly.

2 Passports contain person identifiers according to an international standard processed by issuing andmaintaining authorities, they are maintained by the issuers and do not meet the needs of health services.

3 Bank and finance have constructed EMV identifiers to give card holders access to accounts and credits; a system that can and is being used by private health insurance systems as well. Account numbers will change and they are not designed to serve as identifiers for biological bodies; however, infrastructure and maintenance might be considered to be adapted for health systems as well.

4 Indian authorities are using biometry to create individual UIDAI AADHAAR numbers which are used to tie persons to public services of different kinds. The system has capasity to be used for the world’s population.

New technology and Internet makes it possible to offer global patient centric services, and it should be foreseen that the market will accept and demand development of needed identifier systems. However, they will not be ready tomorrow and it is therefore important that system owners upgrade their use and maintenance of patient identifiers in a way that makes them able to meet further evolution.

Your health services will improve by use of net technology and its opening of information interoperability. Patient identifier systems are important, it is also crucial to have reliable identifiers for owners of existing medical file systems and for their professional specialists; even these are still lacking but demand should lead to and evolution of such standards as well.

Yourr health depend on service providers’ ability to implement identifier solutions that are and will remain subject to continued evolution.

 
Sverre Bauck
Sverre.Bauck@gremium.no
Glocal Health Informatics AB, Ideon Science Park, Lund, Sweden