>>About the PID concept, also named MPI, the following was taken from the openhealth list:
>>"State of the art may be in the eye of the beholder, but we have a
>>component out of which an MPI can be built. It is an implementation of
>>the Person Identification Service (PIDS) specification of the OMG.
>>... It is available at http://OpenEMed.org as part of the OpenEMed"
Thanks for this. I will try to look into the said resource. The above passage sounds to be more of a promotional ads than an info though
Probably it is. I was not endorsing as I (and my team) do not have any experience with it.
I prefer to call it PID and to mean Person ID not Patient ID.
And you are right at that. Because any person may become a patient.
Unfortunately, there is no way, that I know of, to assure that a person working in a hospital do not become a patient... :-)
So, in a hospital it does not make much sense to talk about patients and personnel as if they were totally separated things. Also it does not make much sense to talk about Person ID (to id patients) vs. Employee ID (to id employees). Aren�t employees also persons? Also, in some countries the concept of a person ID are either unlawful or not well taken by those countries citizens.
So the general consensus seems to be to call any person that becomes a user of a healthcare organization just... a USER.
Most of these persons are just users. They are healthy, they do not have diseases, they are not patients and they do not go there to be treated. That's why in many national healthcare systems the Patient IDs are referred to as *UID*, meaning User ID.
> Using anonymized data systems, global statistics can be made (not only for healhcare related
matters).
Just think of the value of a real time, anonymized, database of clinical data from a few million patients.
Just think on the value of that for scientific investigation and for the progress of biomedical sciences.
And as a source of income: how much would pay, for instance, the pharmaceutical industry for accurate and on time patient information?
I wish somebody could tell me why it was not considered a clever idea.>> Lets say the first 4-digit group is exclusively for coding the country where
>>It seems that VISA, among other tests also tried that and it showed to
be not practical.
I also wish that somebody could explain why it showed to be impractical.
I am afraid that, at this time, I cannot help you with that. Those are very old news and one would have to dig documents from a couple of decades ago. But we will have more on that bellow.
The link to the credit card anatomy showed that the first few digits are related to ISO country standard.
Not really. We do not need large number theory to understand that ISO country coding is not the most efficient way of coding regional information. In fact neither VISA nor other Credit Card explicitly use it. Instead they use a variation of the "High-low strategy", i.e., the identifier is formed by two logical parts: A unique HIGH value that you obtain from a defined source and an N-digit LOW value that a second entity locally assigns itself. Each time that a HIGH value is obtained the LOW value will be set to zero.
Lets see the facts behind a VISA card number like 4207 1059 5473 7860:
1. The maximum length of a credit card number is 19 digits. VISA uses 16 digits.
2. The first digit of your credit card number is the Major Industry Identifier (MII), which represents the category of entity which issued your credit card.
0-ISO/TC 68 and other industry assignments, 1-Airlines, 2-Airlines and other industry assignments, 3-Travel and entertainment, 4-Banking and financial, 5-Banking and financial, 6-Merchandising and banking, 7-Petroleum, 8-Telecommunications and other industry assignments, 9-National assignment.
3. The first 6 digits of your credit card number (including the initial MII digit) form the Issuer Identifier. This means that the total number of possible Issuers is a million (10 raised to the sixth power, or 1,000,000).
4. Digits 7 to (n - 1) of your credit card number are your individual account identifier. In VISA the maximum length of the account number field is 16 - 7, or 9 digits. Each issuer therefore has 10 raised to the 9th power (or 1,000,000,000) possible account numbers.
5. The final digit of your credit card number is a check digit, akin to a checksum. The algorithm used to arrive at the proper check digit is called the Luhn algorithm, after IBM scientist Hans Peter Luhn (1896-1964), who patented the technique in 1960.
As you see, it has more than 40 years... very old news indeed... But it must be reliable, or it would not be used anymore.
Btw: I am very satisfied with VISA. (this is not an advertisement).
Me too. But in order for it to work in the health milieu it would be needed a... VISA organization.
It would be something big... very global, very agile, very professional... very rich. Perhaps Micro$oft? :-)
That organization would issue and control the *issuer identifiers*, as VISA does now.
The World Health Organization has consistently failed almost every single attempt to act as a certifying organization.
That is true. If there is a successful global healthcare numbering system out there already, then we follow it.> .../... Where can we find such a system to copy?
Norway? They have a simple, universal and very practical system. It seems to work very well for them.
If people see the advantages of a global unique PID (if there is any), then the acceptance will not be that difficult. If some countries dont accept it due to any reason beyond normal logic, then just leave them.Well, they do have to deal with country specific idiosyncrasies at identifying patients, do they?
The economical implications of just changing a UID are immense. You would not imagine. But, for instance, for a country like Germany it would be in the order of hundreds of millions of Euro. Just think of all those IT systems that rely on the old numbers and that would need to be re-programmed. It would be like the "year 2000 bug" all over again, but this time with the added need to replace all kinds of individual plastic and paper cards that have already been issued...
Still, I am looking for concrete works and results related to this matter. Any hints and pointers are welcome.
But we could make Care2x internally work over a VISA-like UID numbering system.
Depending of the acceptance of the Care2x HIS it could, sometime in the future, become a "de facto" standard.
But, in order to make it credible, it would need at least to consider:
1. The maximum length of the *CUID* (Care2x User ID) would be 16 digits. That was also the option of VISA, as it is a nice number that also lends itself for good bar coding.
A similar system has been working for many years in my own country national healthcare system, so I know that it works.
2. The first digit of the CUID would be the Major Industry Identifier (MII), which represents the category of the entity which issued the CUID card. It could be:
0-ISO/TC and other industry assignments,
1-National Public Healthcare Organizations (NPHO),
2-National Non Governmental Healthcare Organizations (NNGHO),
3-National Private Healthcare Organizations (NPHO),
4-National Private Healthcare Organizations (NPHO),
5-Supra National Public Healthcare Organizations (SNPHO),
6-Supra National Non Governmental Healthcare Organizations (SNNGHO),
7-Supra National Private Healthcare Organizations (SNPHO),
8-Supra National Private Healthcare Organizations (SNPHO),
9-National assignment.
In this setting "Public" would mean state owned or controlled. Likewise "Non Governmental" would mean that while not being exactly Public it would have social and public interest beyond the mere "Private" status.
For instance, British National Health Service would be a type 1, International Red Cross HS would be type 6, NATO HS would be type 5, etc.
In this context it becomes clear why ISO country codes become less meaningful. How would one code all the possibilities of types 5 to 8 ?
3. The first 6 digits of the CUID (including the initial MII digit) form the Issuer Identifier. This means that the total number of possible issuers is a million (10 raised to the sixth power, or 1,000,000).
Wouldn't we like to, someday in the future, register an Issue Identifier of 612345 to Red Cross International?
4. Digits 7 to 15 of the CUID are the individual User Identifier (UID). In VISA the maximum length of the account number field is 16 - 7, or 9 digits. Each issuer therefore has 9 digits, meaning 10 raised to the 9th power (or 1,000,000,000) possible account numbers. That would most certainly even cover China and India, for the next n years.
5. The final digit of the CUID would remain a check digit. The algorithm used to arrive at the proper check digit would also be the Luhn algorithm.
How is that for a start? Does it seem pragmatic enough?
J. Antas
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