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DirectTrust Launches Privacy-Enhancing Health Record Locator Service Ecosystem Consensus Body

Seeks members for participation in development of new Standard

DirectTrust announced it has launched an initiative to develop a new standard to support a voluntary nationwide patient credential and matching ecosystem. DirectTrust is a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information.

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The goal of the Privacy-Enhancing Health Record Locator Service (PEHRLS) Ecosystem Consensus Body is to identify existing standards, profile existing standards, and create new standards as needed for a privacy-enhancing record locator along with the interactions of associated actors. The new Standard will define electronic interactions among Identity Providers, Electronic Health Record (EHR) systems, Health Information Exchanges (HIEs), Health Information Networks (HINs), and a Record Locator Service (RLS).

“Managing identity and health information interoperability in healthcare is a special problem unlike other identity and identifier topics,” stated Scott Stuewe, DirectTrust President and CEO. “To be useful as a mechanism for assembling a longitudinal health record, a system also needs to enable access to the locations where records are available for the individual. DirectTrust is ideally suited to be leading this effort. We are at the intersection of identity-assurance and health information exchange, as well as our members represent the actors that would have to implement such a solution. This effort dovetails well with our focus on consumer credentials – it adds identifiers to federated identity topics already being addressed in collaboration with the CARIN Alliance.”

While there is broad agreement that the only way to improve patient matching and health record location to a near 100% solution is a universal patient ID, the prohibition against government action on such a solution has remained in place since HIPAA was enacted. The new standard will define a model that could be deployed either voluntarily by the private sector, or with the support of government funding or encouragement in the future. Deployment of such a standard could improve efficiency and reduce costs for query-based exchange, Direct exchange, and patient-mediated exchange by reducing infrastructure requirements and computing costs. Most importantly, such a model could enable the long sought-after goal of reliably assembling a longitudinal health record for patients.

The anticipated benefits of the PEHRLS Ecosystem Standard include:

  • A privacy-enhancing record locator and shared identifier service that can be deployed incrementally at low cost to support, potentially, 100% patient-matching success.
  • Identity-assurance provided by Identity Providers (IdPs) that identity-proof, issue credentials, and enable access to the shared identifier service.
  • Patient access to their own records from multiple locations with a single credential and match reliability that will convince reticent data holders of its safety.
  • Rights of access for all parties, enabling assembly of a longitudinal patient record with existing mechanisms for exchange.
  • Improved fidelity of patient matching for all mechanisms of exchange.
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Anupam Goel, MD, Medical Director, Care Solutions, Accolade, Inc. commented: “As a patient-focused digital health company, Accolade is deeply concerned about current approaches of using patient demographics to match records across institutions. The best patient record-matching algorithms using probabilistic matching with demographic information have a failure rate around four percent. Even if the matching process was nearly perfect, any process that requires disclosing demographic information for every new medical center should be re-examined in the 21st century. Since nearly all patients receive care at more than one institution over the course of their lifetime, developing a highly reliable process to match records without disclosing personal identifying information should be a priority for everyone working in the American healthcare system.”

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Barry Hieb, MD, Chief Scientist for Global Patient Identifiers Inc. stated:

“Patient-controlled privacy is a critical complement to accurate patient identification. With a fully accurate patient identification methodology it’s possible to devise a novel strategy that enables each patient to not only construct an accurate longitudinal medical record, but to also ensure it fulfills whatever privacy constraints their medical situation requires. The combination of these capabilities will revolutionize what is possible to achieve using healthcare interoperability.”

Lisa Bari, CEO of Civitas Networks for Health, commented: “Civitas’ regional and statewide HIE members have developed significant expertise in patient matching over the past decade out of necessity, but they are limited by the bounds of probabilistic matching. Developing a potentially more comprehensive and privacy-enhancing record locator service to improve matching efforts aligns well with Civitas’ goals to support trusted, comprehensive health information exchange in the US. We are pleased that our partners and members at DirectTrust are leading the way.”

DirectTrust Standards also announced it is seeking Consensus Body members from healthcare, government, healthcare payer, consumer and general interest, information technology, and interoperability and systems integration sectors.

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