Published March 2021
Dan Cidon, CTO, NextGate
After a year of masks, plexiglass partitions, cancelled events, and constant reminders to stay six feet apart, most people have had their fill of social distancing. In so many ways, the urgent need to remain physically separate has taken a toll on our relationships with one another, straining the bonds that make families, friendships, and businesses function.
But even in a time of unprecedented challenges, there is a silver lining. The sudden pressure to go contactless has forced us to get creative about conducting daily tasks at a distance – and we are discovering that some things might actually be better that way.
From curbside retail and tap-to-pay transactions to meetings that really could be virtual, the nation has quickly embraced technology-driven strategies to keep people safe while improving efficiencies.
Healthcare has had similar lessons to learn. The use of telehealth, texting, and other remote interactions has exploded in recent months. Early results indicate that both patients and providers are highly satisfied with remote care.
The idea of creating a digital-first healthcare environment is nothing new, but the trial-by-fire of COVID-19 pushed the industry to expedite major tech projects.
The undeniable convenience of these new strategies begs the question: why go back to certain complicated, time-consuming, high-risk activities when there is an easier way?
In order to continue developing better experiences while retaining high standards of safety, effectiveness, and compliance, we will need to ensure the building blocks of digital healthcare are firmly in place.
We must start by embracing innovative ways to generate, verify, manage, and share trustworthy digital patient identities.
By creating reliable “patient passports,” healthcare organizations can be sure that the right person is getting the right services in the most efficient manner – whether or not that person is physically standing in front of a check-in desk.
What could a digital patient passport do?
Even though healthcare providers have been using digital patient records for many years, it’s still incredibly difficult to avoid duplicated, incomplete, or incorrect patient profiles.
An error rate of 8 to 10 percent is commonly cited across the industry, although some organizations experience significantly more mistakes due to ineffective patient matching algorithms, fragmented data, and siloed health IT systems.
COVID-19 has exacerbated these issues as millions of Americans continue to fall ill with the virus and require testing. In order to care for patients correctly, providers need access to complete and up-to-date records that include pre-existing conditions and other risks that may affect treatment protocols.
And two-step vaccinations reach more communities, with many shots delivered by state entities outside the traditional primary care setting, the need to keep track of an individual’s healthcare interactions is even greater.
If we could collect clean, accurate, verified information into a single packet – and share that packet across disparate systems in a standardized manner – healthcare providers could enable an entirely new generation of safe, impactful services.
And by placing control of this information in the hands of the patient through a secure, private smartphone application, providers could meet emerging standards of patient data access and consent while simultaneously empowering individuals to take charge of their own care.
For example, fully vaccinated patients could use their passports to easily “unlock” certain experiences, such as an in-person visit with their physician, while reducing concerns about exposure for the patient and the staff.
Patients could use their passport app to send verified clinical questionnaires and insurance information to a new specialist before their appointment to speed up registration, reduce in-person contact time, and avoid duplicated or incorrectly merged records.
Or someday soon, with appropriate privacy and security in place, we could even use smartphone location data in conjunction with the digital passport to automate check-in from the parking lot and skip the waiting room all together and be called in when the exam room is free.
This is the near future of healthcare, but achieving these goals depends on widespread adoption of trusted digital identity technologies.
How can digital passports become a reality?
Healthcare organizations with enterprise master patient index (EMPI) tools in place already experience significantly fewer patient identity errors and higher patient matching rates.
EMPIs provide a consistent platform to integrate multiple data sources into a single record of an individual’s journey through the care continuum. With a unique identifier and sophisticated record location and matching algorithms, organizations can be confident that newly generated data is being associated with the correct file.
The use of the EMPI as an accurate patient directory is a critical tool in the creation of the patient passport. But in order to transcend barriers between health systems, we need a portable, privacy-preserving way of dealing with patient identity beyond the boundaries of individual healthcare organizations.
That’s where blockchain comes in. Much more than just the backbone of cryptocurrency, blockchain can be used as a public ledger to store and manage the life cycle of decentralized identifiers (DID). These globally unique DIDs are used as the anchor points for verifiable health credentials, such as insurance cards, test results, and vaccination records. Using this concept, a trust network between issuers, holders and verifiers of credentials can be established. With these features, blockchain could be a game-changer for identity management and verification at key stages where patient data errors often occur—during enrollment and at registration, all while maintaining strict patient privacy.
In addition, coupling a decentralized identifier with detailed consent policies allows patients to share or restrict access to specific data when necessary, keeping individuals in charge of who sees what data at what time. In the healthcare setting, this decentralized approach to identity management has the potential to improve privacy while simultaneously strengthening the ability to verify patient identities across participating members of the care continuum.
By placing patients in control of their identity and consent preferences, healthcare organizations could enhance patient engagement and offer attractive virtual experiences while leapfrogging many of the challenges of patient identity verification.
Massive changes in healthcare delivery are driving the need to introduce new innovations in patient identification to achieve 100 percent matching accuracy. As organizations pivot to value-based care and continue to grapple with Covid-19, the need for an accurate and authenticated view of every patient becomes increasingly critical to avoid redundant or unnecessary procedures, billing inaccuracies, administrative burdens, denied claims and lost revenue.
As we get closer to reducing the widespread threats of COVID-19, we are not likely to retain all of the changes the virus has forced upon us. Restaurants and entertainment venues will reopen, family gatherings will return, and offices will welcome back workers.
But hopefully, the pandemic will leave more than a few lasting lessons, including the idea that some virtual experiences are better than their in-person counterparts.
With healthcare organizations continually under pressure to improve quality, engage patients, and reduce burdens on providers, the digital patient passport could be just what we’re looking for to move forward in the right direction.
Daniel Cidon is CTO of NextGate, the global leader in healthcare enterprise identification.
