Risk Assessments/Management, Identity

Health care needs to modernize and embrace digital identities

For nearly three decades, the Internet has done more than just connect us with new people in faraway places. It has also changed how we connect with our own shifting identities.

In most cases, our phones and laptops now hold significantly more sensitive information about us than our bi-fold wallets or family filing cabinets. The keys to our financial lives, professional lives, and social lives are now far more accessible on screens than they are on paper. 

Some of our most fundamental day-to-day interactions don’t even exist outside the internet anymore, often leaving us frustrated when the paper-based world collides with our new digital reality. Who hasn’t scrambled to unearth a snail-mail utility bill when interacting with legacy systems?

Healthcare has become one of the areas where we feel this friction the most. Our heavy reliance on clipboards, signatures, and plastic ID cards can cause significant problems for patients and providers: Incorrect patient matching, medical errors, repeated services, and poor communication, just to name a few.

Despite the heightened privacy and security concerns of healthcare, there are enormous opportunities to better integrate our unique digital identities into the healthcare process and reduce many of these concerns. 

By learning from the successes of partners and peers across other sectors, we can create a safe, secure, digitally-driven future for patients and providers. Let’s start by asking three basic questions:

What is a digital identity?

There’s no universal standard definition of the term “digital identity.”  In the broadest terms, an individual’s digital ID functions as any set of data attributes that can be reliably associated with that person. These attributes may include consumer and behavioral data, criminal records, health records, web histories, email accounts, employment, and education histories.

In the sense widely used by government agencies and regulators, a digital ID tends to incorporate some aspect of a person’s legal identity, such as a digital driver’s license, identification number, or e-passport. These digital IDs tend to focus on uniquely identifying attributes of an individual such as their legal name, date of birth, gender, and physical address.  

We can use digital identities as online access mechanisms by employing multifactor authentication, certificates and keys, and even blockchain to provide robust security while granting authorization to approved individuals to conduct tasks or access services.

Unique, verified digital IDs have many benefits. They are largely trustworthy yet users can authenticate them remotely, making many transactions faster and simpler. 

Further, verified digital IDs can help healthcare organizations combat fraud prevention and identity theft. The Medical Identity Fraud Alliance finds identity theft cost patients an average of $13,500 out-of-pocket. Medical identity theft can have a negative impact on a healthcare organization’s reputation and today’s consumers expect their providers to prevent and detect identity fraud.

How are unique digital identities influencing countries around the world?

Lawmakers and consumers in the United States have been very hesitant to explore digital identification, particularly in the realm of healthcare. After decades of banning funding for a national patient identification number (NPI), Congress only recently took the first steps toward allowing healthcare stakeholders to develop an NPI strategy.

Meanwhile, over 1 billion people in India regularly use Aadhaar, a biometric ID system to access public benefits, facilitate banking, and engage with certain government and private services. The system has faced numerous privacy complaints, but it’s still widely used in many areas of life.

Nearly 70 other countries around the world use similar national eID cards, including Germany, China, the Philippines, Cyprus, South Africa, and Nigeria.  Other countries are exploring e-passports, while a few U.S. states are even piloting digital driver’s licenses.

India has also made a push into a digital health ID that aggregates records and streamlines access to care by mirroring many of the same principles as Aadhaar.  As Indian authorities face privacy concerns and low uptake, they may want to look to the tiny, Baltic nation of Estonia about how to succeed.

In 2016, Estonia made waves in the health technology world by integrating blockchain into its national digital patient health record system to provide extra security for tracking and verifying the integrity of its data.

The project further supports Estonia’s ranking close to the top of the UN’s E-Government Development Index. A whopping 99% of government services are available online 24/7. The Estonian e-residency program lets residents conveniently and securely obtain a digital ID card from wherever they are, and to gain access to all of the e-services available.

What can the United States learn from other countries?

Estonia and India have very different experiences with healthcare and its data integrity challenges. But we can certainly learn from those two countries – and the dozens of other governments blazing trails in digital identity management – about the benefits of going digital in our fragmented, unreliable system.

Unique identifiers, backed by blockchain or other sophisticated verification tools, can zero out our unacceptably high rates of patient matching errors and duplicate records, which often result in clinical mistakes and poor patient experiences. With trustworthy digital identities we have a chance to crank our patient identification accuracy up to 100%.

In addition, consumers could take a more empowered role in decision-making.  They could view and share their records as they wish or access verified online directories to easily identify and connect with high-quality providers that have proven performance records, thereby slashing unnecessary spending and improving patient safety and outcomes.

Patients would maintain control over their own digital identity and how their data gets used. With secure apps for conducting interactions, sharing data, and providing consent, patients could unlock an entirely new range of healthcare tools from their smartphone without having to dig through a purse for yet another insurance card.

These types of interactions are happening around the world today as governments and consumers adopt digital identity management tools.  It’s possible to bring the same experiences to healthcare in the United States very soon. 

Unique digital identities are the next step for the healthcare industry. As society moves more of its services online, healthcare must develop private, secure, and consumer-friendly digital ID strategies so we can join the revolution. 

Daniel Cidon, chief technology officer, NextGate

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