MDM and National Identifiers: A Winning Combination

RHIA,Global Healthcare Industry Ambassador, IBM Information Management

As I travel around the world talking with healthcare clients, I’m frequently engaged in conversations about why master data management (MDM) is needed when a national identifier or a national healthcare identifier exists. The topic has surfaced repeatedly in the past year due to jurisdictional initiatives to improve population health through analytics. And, the national identifier debate is raging again in the United States.

To frame the discussion, let’s review master data management principles.

  • Master data is the high-value, core information used to support critical business processes across the enterprise
  • Master data is business-critical information about customers, suppliers, partners, products, materials, employees, accounts and more
  • Master data is at the heart of every business transaction, application and decision

Let’s examine some of the identifier challenges and why jurisdictions with an established identifier are adding MDM to their big data analytics and data sharing strategies.

Backporting. Adding a new field, such as a national identifier, to legacy data is not easy, and in many systems, impossible. Therefore, when defining the value the identifier will bring, one has to consider how long it will take to have a capture rate that will be meaningful. I’d suggest it will be at least a decade before the identifier will reach a point to be truly useful. One thing that can speed up this process is the use of MDM technologies to link existing data that doesn’t have identifiers to data that does.

Security and Privacy. Many jurisdictions mandate that the national identifier only be used for direct care purposes; therefore, it’s not available to underpin data sharing across care settings or analytics. Obviously the laws and regulations can be changed, but this debate faces challenges when safeguarding privacy in our Internet world is getting high priority.

Errors in Identifier Assignment. I am amazed at the stories I hear about errors in identifier assignment. Whether an identifier was recently assigned or has been used for decades, I hear stories about millions of erroneous assignments. As the debate in the United States heightens, we would do well to make sure that accuracy in identifier assignment is given highest priority if a health identifier is produced. Using MDM in the assignment process will aid in reducing these errors.

Lack of Capture of Identifier. Countries that have had an identifier for decades may just be adding this field to their healthcare system now, or collection may be voluntary. Thus, these jurisdictions face the backporting challenge discussed above or limited value, since the identifier may be voluntary. Perhaps in a voluntary world the chronically ill will recognize the value an identifier can have in underpinning data sharing, but this theory has not been tested. Thus the question must be asked, “What value is a voluntary identifier if you can’t build your data sharing or analytics strategy on this bedrock?”

Fraud. I have to chuckle when I talk with European colleagues or read articles that say you can purchase a national ID card on any street corner in London or Paris for a few Pounds or Euros. Adding MDM to a national identifier means the associated demographic data is evaluated in the context of the identifier, and discrepancies can be identified and investigated for potential fraud.

Do identifiers help in the linking of data across care sites or in a warehouse or big data environment—Yes! The presence (or absence) of an identifier can be weighted appropriately in sophisticated algorithmic processes that MDM uses. But, the above reasons highlight why MDM with a national identifier is the winning combination and a solid strategy for big data initiatives that will truly transform healthcare.

On March 3, I am heading down New Orleans for HIMSS13, the largest healthcare conference of the year, where I’ll be listening to the continued discussion about a national identifier. You’ll be able to find me at the IBM booth #1841.

Let’s grab a “cupa” and we’ll talk.

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