Recent National E-Health implementation added additional identifiers IHI, HPI-I and HPI-O can be used for an individual and provider on top of existing identifiers such as Medicare, Insurance etc. Different identifiers are used for different purposes for example insurance identifier is used when sending insurance information to identify specific individual, IHI number used when accessing PCEHR, organisation may use one Medicare number for billing purposes and other for administrative purposes.
Australian standards provided new set of guidelines in 2014 to accommodate these identifiers in the health systems.
Every identifier should be associated with the following when stored
- Identifier designation : This refers to the actual identifier code
Example: IHI number or Medicare number
- Identifier Issuer: Name or HPI-O of the issuing authority
Example: Medicare, Centrelink, 8003621566684455
- Identifier usage : The purpose of using the identifier
Complete list of identifier usages
110 – Individual Healthcare Identifier (IHI)
112 – Healthcare Provider Identifier—Individual (HPI-I)
113 – Healthcare Provider Identifier—Organisation (HPI-O)
114 – Virtual smart card identifier (CSP)
120 – Family Identifier
200 – Billing Identifier
300 – Business or Individual Taxation or Social Security Identifier
400 – Special Service Identifier (e.g. diagnostic services)
410 – Laboratory Services
420 – Radiology Services
480 – Other Diagnostic Services
500 – Individual Provider Identifier—other than the national number
600 – Organisational Provider Identifier—other than the national identifier
700 – Professional Registration Identifier
800 – Other
900 – Unreliable
- Identifier Usage Start Date: Start date of the identifier usage, the date on which using this identifier began or will begin.
- Identifier Usage End Date: End date of the identifier usage, the date on which using this identifier ended or will end.
- Identifier Status : Status of the identifier
Examples: Active, Inactive
- Identifier Group : Group of the identifier
Examples: F (Family), T(Treatment), O(Other)
I think it is essential for all the health systems in the current market used by providers (practice management, EMR, EHR etc) to accommodate these identifiers to meet the identification standards. It will be interesting to see how the existing health systems such as ZedMed, Communicare etc. conforms these standards.
Healthcare identifiers (HI) Service developed by the federal, state and territory governments that uniquely identifies healthcare providers and consumers. These identifiers are important building blocks of E-Health in Australia and used to enable PCEHR system and are used on medical documents, patient wrist bands, tokens etc.
The HI service is mainly used by
- public and private sector hospitals
- general practice
- clinical specialist
- community health
- healthcare administrators
- allied health
- aged care settings
Healthcare identifiers are categorised into the following
- Individual Healthcare Identifiers (IHI) – For individuals receiving health care
- Healthcare Provider Identifier – Individual (HPI-I) – For healthcare providers and personnel involved in patient care
- Healthcare Provider Identifier – Organisation (HPI-O) – For organisations that deliver healthcare (hospitals or medical practices)
Further IHI is classified into the following
- Verified – Evidence of Identity(EOI) completed through TDS(Trusted Data Sources) or HI service
- Unverified – Not verified by EOI process
- Provisional – Not known to healthcare facility and expires in 90 days
- Deceased – Indicates death of an individual
- Retired – IHI has been inactive for 90 days and Fact of Death Data received from Registrar of Births, Deaths and Marriages.
Each identifier is a unique number adhered to ISO7812: AS 3523.1&2-2008 standards and is of 16 digits in length. It doesn’t contain any identification information such as age, location etc. and never be re-used.
The first 1-6 digits contains issuer identification number (for example medicare) and 7-15 digits contains a unique reference number that identifies an individual. The last digit 16 is reserved as check digit which can calculated from issuer identification and individual reference number.
The main functions of a HI service are
- Allocating IHIs, HPI-Is, and HPO-Is,
- To allow authorised users to search, retrieve and validate IHIs, HPI-Is, and HPO-Is
- To allow authorised users to maintain and publish certain data (allowed only with HPI-Is and HPO-Is)
- To provide digital certificates for access
- Retiring identifiers
E-Health software systems engaged in health care uses HI service to issue, assign and maintain national healthcare identifiers for consumers and providers. These systems access HI service directly or indirectly ( depends on the other systems which have direct access to HI). All the systems should undergo conformance testing(CCA) performed by NATA recognised laboratories to prove it supports clinical safety, security and privacy.