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VUHID Use Cases

These use cases describe typical experiences of a patient whose healthcare provider is using open voluntary identifiers (OVIDs) or private voluntary identifiers (PVIDs). These identifiers are created and managed as part of the Voluntary Universal Healthcare Identifier (VUHID) project which is the sole focus of Global Patient Identifiers incorporated (GPII), a non-profit initiative working exclusively to support healthcare-related identification capabilities.

Acquiring an Open Identifier

  • Pete Smith is a primary care physician participating in the Good Lifestyles Health Information Exchange (HIE) that uses an enterprise master person index (EMPI) for patient identification.
  • Sam Jones is a patient under the care of Pete Smith.
  • Sam Jones visits Dr. Smith and indicates that he wants to receive a universal healthcare identifier.
  • Dr. Smith's staff person collects Sam's demographic information and enters it into the Good Lifestyles EMPI to initiate a request for an open voluntary identifier (OVID).
  • The EMPI performs a demographic match and confirms Sam Jones' identity.
  • The EMPI submits an encrypted request for an OVID to the VUHID server1.
  • The VUHID server generates an OVID for the Good Lifestyles HIE EMPI. The identifier is stored in the VUHID database as a valid, active ID along with the date/time stamp indicating when it was created, and the fact that the Good Lifestyles HIE was the recipient.
  • The OVID is returned to the Good Lifestyles EMPI which associates it with Sam's records, other identifiers for Sam2, and links to record location services within the HIE.
  • The EMPI also creates an OVID identification card that is mailed to Sam Jones
  • The EMPI returns the OVID to Dr. Smith's office.
  • Sam can use the OVID card for all of his encounters within the Good Lifestyle HIE, ensuring that he is accurately identified within that provider network for all future encounters.

Using an OVID within a Health Information Exchange

  • Once Sam Jones has his card with a VUHID open identifier, he can use it with any Good Lifestyles caregiver with whom Sam chooses to freely share his information.
  • Sam visits his urologist and gives the staff his OVID card.
  • The urologist's staff person captures the OVID by either typing in the number or by swiping or scanning the card.
  • The OVID is sent to the Good Lifestyles EMPI which does a database search.
  • Upon finding an exact match, the EMPI returns to the urologist's staff Sam's demographic information, along with links to his clinical and insurance information as the Good Lifestyles HIE has configured its systems to share information.
  • The urology staff person views Sam's data on their workstation and asks Sam to verify two or three data items to make sure it really is Sam and not an imposter.
  • Upon receiving the correct answers from Sam, they proceed to provide his medical care based on information from encounters at any other Good Lifestyles HIE providers where Sam has been seen.

Acquiring a Private Identifier

  • Sam Jones visits his psychiatrist and indicates that he would like to keep his psychiatric information separate from his other medical data.
  • The psychiatrist's front desk staff person has been trained on open and private identifiers, so selects “psychiatric information – limited access” as the appropriate privacy class to protect Sam's information.
  • The staff members can use Sam's OVID or acquire his demographic information and send this to the Good Lifestyles EMPI.
  • The EMPI confirms Sam Jones' identity either using demographic matching or by looking up the OVID.
  • The EMPI submits an encrypted request for a ”psychiatric information – limited access” private identifier to the VUHID server.
  • The VUHID server generates a PVID for the requested privacy class and stores it in its database as a valid, active ID along with the date/time stamp when it was created and that the Good Lifestyles HIE is the recipient.
  • The PVID is returned to the Good Lifestyles EMPI which securely associates it with Sam's records, other identifiers for Sam3, and links to record location services within the HIE.
  • The EMPI returns the PVID to the psychiatrist's office.
  • The EMPI creates a PVID identification card and mails it to Sam Jones.
  • Sam can use the PVID card to support all of his psychiatric encounters within the HIE.
  • It is Sam's prerogative whether or not to reveal this PVID to Dr. Smith, his internist, and any of Sam's other caregivers.

Using Open Identifiers Outside the Good Lifestyles HIE

  • Sam Jones travels to Miami on a vacation and develops pneumonia.
  • He visits the Good Outcomes Urgent Care Center that is part of the Golden Sunshine HIE in Miami.
  • The Good Outcomes staff person acquires Sam's open identifier card and forwards the OVID to the Golden Sunshine EMPI along with a request for needed clinical information.
  • The Golden Sunshine EMPI does a database search for the OVID which fails because Sam is not a registered member of their HIE.
  • The Golden Sunshine EMPI sends a data location request to the VUHID server that includes Sam's OVID.
  • The VUHID server does a database search for the OVID and finds that it is a valid, active ID.
  • The VUHID server retrieves the URL(s) where data for that OVID reside and returns this information to the Golden Sunshine EMPI also indicating that the OVID is valid and active.
  • The VUHID server adds the Golden Sunshine EMPI as an additional source of valid data for this OVID.
  • The Golden Sunshine EMPI stores the OVID and associates it with whatever other data it may have on Sam Jones.
  • The Golden Sunshine EMPI or record locator service then contacts the Good Lifestyles system and initiates whatever interactions are needed to obtain the necessary information.
  • The VUHID server does not participate in any of the subsequent transactions between Golden Sunshine and Good Lifestyles once it has indicated the URL(s) where the data resides.

1 Note that the VUHID system is designed so that it never knows the identity, demographic information or clinical information associated with any VUHID identifier. Nor does it know any relationships between two identifiers. The EMPI request to the VUHID server is simply for a new OVID and does not identify Sam Jones in any way.

2 At the EMPI level, subject to local HIE policies (and perhaps eventually federal legislation), linkage may or may not occur between OVIDs, PVIDs, and other identifiers for Sam Jones such as hospital accession numbers. These linkages are never available to the VUHID system.

3 This linkage would occur assuming the policy, legal, and regulatory environment in which Good Lifestyles operates permits such linkage at the EMPI level.

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