Frequently asked questins abut health identifiers August 2015 1 P a g e
Questins abut individual health identifiers What is an individual health identifier r IHI? An individual health identifier r IHI is a number that uniquely and safely identifies each persn that has used, is using r may use a health r scial care service in Ireland. Yur IHI will be assigned t yu and will nt be re-used, even after yur death. It is nt the same as an electrnic health recrd, which is an electrnic versin f a patient s medical histry. Why d I need an individual health identifier? An individual health identifier will uniquely identify every individual accessing health and scial care services. The main benefit f having an individual health identifier is t ensure patient safety. Being able t uniquely identify each user will imprve patient safety by reducing the number f adverse events that may happen, such as giving the patient incrrect medicatin r vaccinatins r admitting the wrng persn fr surgery. Yur IHI is different frm an electrnic health recrd, which is an electrnic versin f yur medical histry. The IHI is ne f the key enablers required t implement electrnic health recrds and ehealth slutins such as eprescribing. The IHI has the fllwing benefits: Benefits fr service users: imprved accuracy in identifying yu and yur medical recrds will lead t safer and better care being prvided t yu yur recrds acrss different healthcare rganisatins may be accurately assciated with yu yur health infrmatin can be shared safely and seamlessly between public and private health service prviders, fr example referral letters sent frm a public hspital t a private sectr GP health identifiers enable electrnic transfer f yur health infrmatin, which results in faster care fr yu. Benefits fr general practices: accurately links service users t their recrd identifies patients in all cmmunicatins with ther health and scial care prviders enables safe transfer f patient recrds electrnically enables electrnic referrals, discharge summaries and electrnic prescriptins t be sent, resulting in mre timely exchange f imprtant infrmatin. 2 P a g e
Benefits fr healthcare prviders: helps create and maintain a cmplete recrd fr each patient enables patient infrmatin t be shared safely within and acrss rganisatinal bundaries imprves efficiency in administrative tasks. Benefits fr scial care prviders : accurately and safely identifies peple wh use scial care services helps create a cmplete recrd f a persn s care by its inclusin n recrds that may span different health and scial care rganisatins safe and efficient crdinatin f scial care with healthcare. Hw will my IHI be used? Yur IHI can be stred n yur health services prvider s cmputer system r n paper if n electrnic system exists. It will be used in yur medical recrd at the health services prvider that yu attend. Here are sme examples: After yu attend yur general practitiner (GP), yur IHI will be stred n their lcal system in yur medical recrd, whether paper r electrnic. Any time yur GP cmmunicates with anther health service prvider n yur behalf, yur IHI will be included n that cmmunicatin. Shuld yu require a bld test, fr example, yur GP will include yur IHI with this request. The hspital will return bth yur IHI and the result f the bld test t yur GP. This allws yur GP t safely identify yu when they receive the result. Yur IHI will be recrded n yur medical recrd in the hspital s cmputer system if yu attend an emergency department. When the hspital sends a discharge letter t yur GP, yur IHI will be included in that cmmunicatin t yur GP. The discharge letter may be paper r electrnic. This allws yur GP t safely identify yu when they receive the discharge letter. What data is stred in my health identifier recrd? A health identifier recrd is a cmbinatin f yur individual health identifier and ther persnal data that is used t safely identify yu. The Health Identifier Act 2014 3 P a g e
allws fr the fllwing data t be cllected and stred in yur health identifier recrd: Data in yur health identifier recrd: Surname Frename Date f birth Place f birth Sex All frmer surnames Mther s surname and all her frmer surnames Address Natinality Persnal public service number (if any) Date f death in case f a deceased individual Signature Phtgraph Hwever, initially nly a subset f what is legally allwed t be stred in yur health identifier recrd will be stred. Is my IHI the same as my persnal public service number (PPSN)? N. Yur IHI is nt the same as yur Persnal Public Service Number. Yur individual health identifier will be a unique number that is different t yur PPSN. Culd my PPSN nt be used instead? N, yur PPSN culd nt be used instead. In 2009, the Authrity published Recmmendatins fr a Unique Health Identifier fr Individuals in Ireland. (1) Based n internatinal best practice, ne f the recmmendatins made t the Minister is that the current PPSN is nt used as the identifier in health and scial care. The Authrity recmmended that the safest and mst cst-effective ptin fr an IHI in Ireland is a new healthcare-fcused identifier. Evidence frm ther cuntries tells us that fr many reasns, including privacy and patient safety, it is better t have a specific number t identify yu when yu are accessing health related services. Als, yur PPSN was created and primarily used t access varius services acrss the Irish public sectr. Yur IHI will be used acrss the public and private health sectrs. Fr example, yur IHI will be included in written cmmunicatins between yur public hspital and yur GP, wh wrks in the private sectr. 4 P a g e
Why is the PPSN number stred as part f my health identifier recrd? The Authrity cnducted an internatinal review f hw ther cuntries set up their IHIs and the majrity f cuntries reviewed take data frm existing trusted surces in rder t get the best use f existing public infrastructure. An example f a trusted surce fr the Natinal Register f Individual Health Identifiers is the database f the Public Service Identity (PSI) dataset (which includes the PPS Number) maintained by the Department f Scial Prtectin. The reasns why the PPSN is included in yur health identifier recrd is t allw the central IHI cmputer system t be created and subsequently updated frm existing trusted surces (see Appendix 2 fr mre detail n trusted surces) t get the best use f existing public infrastructure. Can smene use my individual health identifier t lk up my PPSN? N, it will nt be pssible fr anyne t lk up yur PPSN number using yur individual health identifier. Hwever, yu may prvide yur PPSN t yur health service prvider t allw them t retrieve yur IHI frm the Natinal Register f Individual Health Identifiers. Yur PPSN will never be prvided t yur health service prvider when they lk at yur IHI recrd and therefre will nt be included in yur health care recrds. Is medical infrmatin stred n my health identifier recrd? N, medical r clinical infrmatin will never be stred n yur health identifier recrd. Hwever, it is intended that health services prviders will use yur IHI when cmmunicating with ther health service prviders abut yur care. Wh will be issued with an individual health identifie r? Any persn, wh has used, is using r may use a health and scial care service in Ireland will be given an individual health identifier. Individual health identifiers can be used in bth the public and private sectr. Can I pt-ut f having an individual health identifier? Individual health identifiers are being implemented t imprve patient safety, s it is t yur advantage if an IHI is used when yu access health r scial care services in Ireland. Under the Health Identifiers Act 2014, yu will be autmatically assigned an 5 P a g e
IHI. Since intrducing a system f individual health identifiers drives imprvements in patient safety, it is t yur advantage t use yur IHI when yu access health r scial care services in Ireland. D I need t knw my individual health identifier t receive care? N. Yur individual health identifier is nt related t yur eligibility fr care. Yu d nt need t knw yur individual health identifier t receive health r scial care in Ireland. What srt f access will service prviders have? Hw can I be sure that they will use my infrmatin respnsibly? Health service prviders will have access t a natinal register f individual health identifiers t: btain yur IHI send requests t update yur health identifier recrd. T request yur IHI frm the Natinal Register f Individual Health Identifiers, yur health services prvider will need t knw ther persnal details - fr example yur name, address, and date f birth. Health identifier recrds need t be kept safe and secure under legislatin bth the Data Prtectin Acts and the Health Identifier Act 2014 apply. Penalties apply if it is discvered that yur IHI is nt adequately prtected r used incrrectly. Is this new system supprted by legislatin? Yes. A new law called the Health Identifiers Act 2014 was passed in 2014 and allws tw new natinal data cllectins called the Natinal Register f Individual Health Identifiers and the Natinal Register f the Health Services Prvider Identifiers t be set up. These are tw central cmputer systems which manage the IHI in Ireland as guided by legislatin. Wh will lk after my health identifier recrd? The Health Identifier Act 2014 allws the Minister fr Health t delegate specific functins under the act t the Health Service Executive. A business unit within the Health Service Executive (HSE) will be set up t manage yur health identifier recrd, which cnsists f yur IHI and ther persnal data. This business unit will be knwn as the health identifiers peratr. 6 P a g e
Are there safeguards in place t stp the sharing f an IHI r using the number inapprpriately? Yur IHI is cnsidered t be persnal data under the meaning f the Data Prtectin Acts. This means that the health identifiers peratr must fllw the eight rules f data prtectin, as fllws: btain and prcess infrmatin fairly keep it nly fr ne r mre specified, explicit and lawful purpses use and disclse it nly in ways cmpatible with these purpses keep it safe and secure keep it accurate, cmplete and up t date ensure that it is adequate, relevant and nt excessive retain it fr n lnger than is necessary fr the purpse r purpses give a cpy f his and r her persnal data t an individual, n request. In additin under the Health Identifiers Act 2014, penalties will apply if yur IHI is used incrrectly. Hw will the central IHI register be set up? The plan is t initially ppulate the Natinal Register f Individual Health Identifiers frm existing reliable data surces knwn as trusted surces. It is likely that the database f the Public Service Identity (PSI) dataset maintained by the Department f Scial Prtectin may be used t d this since its data has been verified as accurate. Mre infrmatin n what rles different rganisatins are respnsible fr can be fund in Appendix 2, while mre infrmatin n trusted surces can be fund in Appendix 2. Can health insurance cmpanies access the Natinal Register f Individual Health Identifiers? N. Health insurance cmpanies d nt have access t the Natinal Register f Individual Health Identifiers r yur full health identifier recrd. 7 P a g e
Can health insurance cmpanies use my IHI? Yes. Yur IHI will be included in crrespndence frm yur health services prviders t health insurance cmpanies. This is t ensure that yu are safely identified. This helps t verify that any claims submitted relate t care that yu have received. Wh will gvern what ther agencies have access t the IHI? The Minister fr Health is ultimately respnsible fr ensuring that nly thse wh are allwed access t the IHI can access it. I am wrried abut identity theft as many f my persnal details will be included in my health identifier recrd. Are there safeguards in place t prevent this happening? Yur health identifier recrd is cnsidered persnal data within the meaning f the Data Prtectin Acts, and must be treated apprpriately by the health identifiers peratr. Under the Health Identifiers Act 2014, penalties will apply if yur IHI is used incrrectly. Wh will access my individual health identifier? Primarily, yur IHI will be accessed by yur health services prviders, bth public and private, when they prvide a health r scial care service t yu. Under the Health Identifier Act 2014, ther agencies can have access t the Natinal Register f Individual Health Identifiers, as fllws: List f agencies wh can have access t the Natinal Register f Individual Health Identifiers: Chief Inspectr f Scial Services Child and Family Agency Health Research Bard Irish Bld Transfusin Service Irish Medicines Bard Mental Health Cmmissin Natinal Cancer Registry Bard State Claims Agency Sme rganisatins may use yur IHI fr a particular secndary purpse, such as health prmtin, health service management r research. Secndary use invlves using yur number withut having direct access t the register. It may be that they 8 P a g e
are prvided with yur number in crrespndence with yur health service prvider. These rganisatins are listed in the Health Identifiers Act 2014, as fllws: List f agencies wh can use yur IHI fr a secndary purpse: Brd na Radharcmhastóirí Central Statistics Office A crner Dental Cuncil Health Infrmatin and Quality Authrity Health Insurance Authrity Inspectr f Mental Health Services Irish Medical Cuncil Natinal Treatment Purchase Fund Bard Nursing and Midwifery Bard f Ireland Pharmaceutical Sciety f Ireland Pre-hspital Emergency Care Cuncil A registratin bard established by r under the Health and Scial Care Prfessinals Act 2005 An undertaking authrised t perate a scheme f health r health-related insurance under the Health Insurance Act 1994. Will using my individual health identifier change the way my health infrmatin is shared? N. Having an individual health identifier n yur medical recrds will nt change hw and when health services prviders share infrmatin abut yu. Yur health infrmatin is cnsidered t be persnal data under the meaning f the Data Prtectin Acts. This means that the eight rules f data prtectin must be adhered t. 9 P a g e
Questins abut health services prvider identifiers What is a health services prvider identifier? A health services prvider identifier is a unique number that is assigned t a health services prvider, such as a hspital, clinic r a healthcare practitiner. It can be shrtened t HSPI. Wh will be given a health services prvider identifier? A HSPI will be given t health services prviders wh are defined as any persn, rganisatin, part f an rganisatin, and emplyees f persns r rganisatins that deliver health r scial care services. Health services prviders are required t access the Natinal Register f Individual Health Identifiers t btain IHI fr their service users, and t send requests t update their service users health identifier recrd. Within the Health Identifiers Act 2014, a healthcare practitiner is defined as being: a registered medical practitiner a registered dentist a registered pharmacist r registered pharmaceutical assistant a registered nurse r registered midwife a registered ptmetrist r registered dispensing ptician a persn wh is registered with the apprpriate registratin bdy f a designated prfessin within the health and scial care sectr. The Health and Scial Care Prfessinals Act 2005 defines designated prfessins as: clinical bichemist, dietician, medical scientist, ccupatinal therapist, rthptist, physitherapist, pdiatrist, psychlgist, radigrapher, scial care wrker, scial wrker, and speech and language therapist registrant within the meaning f Sectin 3(1) f the Health and Scial Care Prfessinals Act 2005 a persn whse name is entered in the register f pre-hspital emergency care practitiners. 10 P a g e
What is the Natinal Register f Health Services Prvider Identifiers? The Natinal Register f Health Services Prvider Identifiers will cntain a health services prvider identifier fr each prvider that ffers health r scial care services in Ireland. A health services prvider is any persn, rganisatin, part f an rganisatin and emplyees f persns r rganisatins that deliver health r scial care services. The Health Identifiers Act 2014 sets ut what infrmatin can be stred in the Natinal Register f Health Services Prvider Identifiers. The Natinal Register f Health Services Prvider Identifiers cnsists f five parts. Nt all parts f the register are mandatry. Different parts are ppulated depending n whether the health services prvider is a healthcare practitiner r a healthcare rganisatin. The five parts are: Part A Health practitiner Health services prvider identifier Surname Frename Business address and if different, the place and name f emplyment Name f prfessinal regulatry bdy that the health practitiner is registered with Registratin number Other relevant particulars in the pinin f the Minister Part B Healthcare rganisatin Health services prvider identifier Legal name and trading name if applicable Business address Lcatins at which it prvides health services Descriptin f health services it prvides Other relevant particulars in the pinin f the Minister Part C Emplyees f health practitiners r healthcare rganisatins Health services prvider identifier Surname Frename Capacity in which he r she is an emplyee Place f emplyment Name and HSPI f his r her emplyer Other relevant particulars in the pinin f the Minister Part D Agent f a health practitiner Health services prvider identifier 11 P a g e
Surname Frename Capacity in which he r she is an agent Place f emplyment Name and HSPI f his r her principal health practitiner Other relevant particulars in the pinin f the Minister Part E Agent f a healthcare rganisatin Health services prvider identifier Legal name and trading name if applicable Business address Capacity in which it is an agent Place and HSPI f where it is an agent Name and HSPI f the health services prvider wh is its principal Other relevant particulars in the pinin f the Minister Wh will lk after the Natinal Register f Health Services Prvider Identifiers? The Health Identifier Act 2014 allws the Minister t delegate specific functins under the act t the Health Service Executive. A business unit within the Health Service Executive (HSE) will be set up t manage the Natinal Register f Health Services Prvider Identifiers, which cnsists f yur HSPI and ther required data. This business unit will be knwn as the health identifiers peratr. Will the current prfessinal register remain with the respective prfessinal regulatry bdy? Yes, the current prfessinal register will remain with the respective prfessinal regulatry bdy. Hwever, the Health Identifiers Act 2014 stipulates that each prfessinal regulatry bdy will be required t prvide relevant infrmatin t the health identifiers peratr n behalf f persns cntained in the register s that the Natinal Register f Health Services Prvider Identifiers is set up and maintained apprpriately. Als, health practitiners are required t supply relevant infrmatin t the health identifiers peratr n behalf f its emplyees s that the Natinal Register f Health Services Prvider Identifiers is set up and maintained apprpriately. 12 P a g e
Wh can view the cntents f the Natinal Register f Health Services Prvider Identifiers? The Natinal Register f Health Services Prvider Identifiers will be publicly available t view, under prvisins cntained in the Health Identifiers Act 2014. Can health services prviders pt-ut f having a health services prvider identifier? Health services prvider identifiers are being implemented t imprve patient safety, s it is t yur advantage if the HSPI is used in cnjunctin with yur IHI when yu access health r scial care services in Ireland. Under the Health Identifiers Act 2014, yur health services prvider will be autmatically assigned the apprpriate HSPI(s). Are individual healthcare prfessinals (fr example, each dctr in a GP surgery) given a health services prvider identifier? Can care be attributed t specific healthcare prfessinals? Each healthcare prfessinal will be given a health services prvider identifier. The health services prvider identifier must be included n letters (such as referrals, discharges and s n) that are shared between health services. Fr example, if yu are referred frm yur GP t an utpatient service, yur GP s health services prvider identifier must be included n the referral letter. Hwever, if yur healthcare prfessinal currently has an identifier frm a prfessinal regulatry bdy, which must already be used n crrespndence r in medical recrds, that number can be used instead f the health services prvider identifier. Fr example, a registered general practitiner (GP) currently has a registratin number which allws them t practice medicine. This registratin number currently must be included n cmmunicatin between the GP and ther health r scial care services, and can be used instead f the HSPI. The HSPI is used where n ther healthcare prfessinal registratin number is available fr use. 13 P a g e
What are the benefits f having a health services prvider identifier (HSPI)? The HSPI is anther ne f the key enablers required t implement electrnic health recrds (EHRs) and ehealth slutins, such as eprescribing. The benefits f implementing EHRs include: Benefits fr service users: supprts the secure and effective exchange f health infrmatin by uniquely identifying bth healthcare prfessinals and rganisatins when infrmatin is being exchanged, which aids transparency, and may result in speedier referrals and shrter waiting times assists administratrs f health infrmatin systems t manage wh can access these systems acts as an enabler t supprt the intrductin f natinal electrnic health systems, such as eprescribing supprts audit trails in natinal electrnic health systems. Fr example, in England it is pssible fr service users t bk and alter appintments themselves in utpatient clinics. This service wuld nt be pssible withut having unique identifiers fr health service prviders. Benefits fr healthcare practitiners: facilitates secure transmissin f service user infrmatin, such as labratry results r discharge letters reduces administrative effrt prvides easier access t infrmatin held abut health services prviders in a natinal health infrmatin resurce. Benefits fr healthcare rganisatins: supprts the intrductin f a statutry licensing system that applies t bth publicly and privately funded healthcare services prvides a single authritative surce f healthcare practitiners and rganisatins, which will remve the need fr multiple cmputer systems t maintain their wn cpy f this data, in turn saving time, resurces and administrative effrt. Benefits fr service planners and researchers: reduces administrative effrt, by having a single authritative surce rather than multiple systems cntaining similar data supprts the ability t measure and analyse hw resurces, including the wrkfrce are used t prvide health and scial care services enhances the ability f health agencies t plan services. 14 P a g e
Hw will the HSPI be used? When yur health services prvider shares infrmatin with anther health services prvider abut yu, the health services prvider s HSPI must be included n each cmmunicatin. Fr example, when a labratry returns yur bld test result t yur GP, the HSPI f the labratry will be included in the labratry reprt. This increases accuntability and transparency since the health services prvider will be uniquely identified in the cmmunicatin. 15 P a g e
Appendix 1 Organisatins invlved in intrducing health identifiers t Ireland Many rganisatins within the health and scial care sectr need t wrk tgether t successfully intrduce health identifiers. These are: Department f Health Health identifiers peratr Health Infrmatin and Quality Authrity Health service prviders Trusted surces (see Appendix 2 fr mre detail n trusted surces) The fllwing illustrates what the rle f each f these rganisatins is, as health identifiers are intrduced in Ireland. Department f Health Develp legislatin: Health Identifiers Act 2014 The Minister is respnsible fr delegating specific functins f the Health Identifiers Act 2014 t the HSE The Minister als has respnsibility fr ther elements cntained in the Health Identifiers Act 2014 Health Identifiers Operatr Establish and manage the Natinal Register f Individual Health Identifiers Establish and manage the Natinal Register f Health Services Prvider Identifiers Health Infrmatin and Quality Authrity Develp and mnitr standards that supprt the intrductin f health identifiers in Ireland Health service prviders Use health identifiers t uniquely identify service users and health services prviders (bth prfressinals and rganisatins) Trusted surces Ppulate and update the Natinal Register f Individual Health Identifiers Ppulate and update the Natinal Register f Health Services Prvider Identifiers 16 P a g e
Appendix 2 What is a trusted surce? A trusted surce is a data surce that is cnsidered highly reliable and is used t ppulate r update the natinal registers. An example f a trusted surce fr the Natinal Register f Individual Health Identifiers is the database f the Public Service Identity (PSI) dataset maintained by the Department f Scial Prtectin. An example f a trusted surce fr the Natinal Register f Health Services Prvider Identifiers is the Register f Medical Practitiners, which is maintained by the Irish Medical Cuncil. A health services prvider is either a health r scial care prfessinal r rganisatin. Health services prviders will use the natinal registers as part f their day-t-day wrk t either btain health identifiers r request updates t them. Figure 1 illustrates this relatinship. Figure 1: Hw trusted surces are used t ppulate r update the natinal registers Yur IHI infrmatin can be lawfully shared with health services prviders under prvisins in the Health Identifiers Act 2014. Yur IHI infrmatin can als be btained frm trusted surces under prvisins within the Health Identifiers Act 2014. 17 P a g e
Reference List (1) Health Infrmatin and Quality Authrity. Recmmendatins fr Unique Health Identifiers fr Healthcare Practitiners and Organisatins. 2011. Accessed n: 9 June 2015. 18 P a g e