Exchanging Patient Identification Within and Between Communities

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Adoption Level	Federally required	Cost	Test Tool Availability
Implementation Specification	IHE-PDQ (Patient Demographic Query)	Final	Production		No	Free	Yes Yes Yes
Implementation Specification	IHE-PIX (Patient Identifier Cross-Reference)	Final	Production		No	Free	Yes Yes Yes
Implementation Specification	IHE - XCPD (Cross Community Patient Discovery)	Final	Production		No	Free	Yes Yes
Implementation Specification	IHE-Patient Identifier Cross-reference PIX for Mobile (PIXm)	Balloted Draft	Production	Feedback Requested	No	Free	Yes Yes
Implementation Specification	IHE-Patient Demographics Query for Mobile (PDQm) Profile	Balloted Draft	Production	Feedback Requested	No	Free	Yes Yes
Implementation Specification	IHE-Patient Master Identity Registry (PMIR) Profile	Balloted Draft	Feedback requested	Feedback Requested	No	Free	No
Emerging Implementation Specification	Interoperable Digital Identity and Patient Matching	Balloted Draft	Feedback requested	Feedback Requested	No	Free	No

Limitations, Dependencies, and Preconditions for Consideration	Applicable Security Patterns for Consideration
See Section II: Patient Identification Management for more information about the HL7 2.5.1 ADT messaging standard and information about patient identity proofing. Consider use of HL7® FHIR® Patient $match operation for MPI-based query. The Patient Master Identity Registry PMIR Profile is a collaborative community-based system of cooperating patient identity sources maintaining a master identity for each patient. PMIR leverages the FHIR standard. See the IHE IT Infrastructure White Paper covering the PMIR Profile - https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html#54-patient-master-identity-registry-pmir. The Patient Demographics Query for Mobile (PDQm) Profile provides similar functionality as PDQ but uses the FHIR standard. PDQm can be a FHIR API backed by a PDQ query or a Cross-Enterprise Patient Discovery (XCPD) query. The PMIR, PDQm, and PIXm Profiles are used within the MHDS Profile to manage and find the patient’s identifier in that community as part of the Centralized Discovery and Retrieve environment. MHD, PDQm and PIXm also have test plan pages: MHD test plan page; PDQm test plan page; PIXm test plan page. See the IHE IT Infrastructure White Paper covering the methods of managing Patient Identities - https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html#5-patient-identity-management.	Feedback requested.

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

See Section II: Patient Identification Management for more information about the HL7 2.5.1 ADT messaging standard and information about patient identity proofing.
Consider use of HL7® FHIR® Patient $match operation for MPI-based query.
The Patient Master Identity Registry PMIR Profile is a collaborative community-based system of cooperating patient identity sources maintaining a master identity for each patient. PMIR leverages the FHIR standard.
See the IHE IT Infrastructure White Paper covering the PMIR Profile - https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html#54-patient-master-identity-registry-pmir.
The Patient Demographics Query for Mobile (PDQm) Profile provides similar functionality as PDQ but uses the FHIR standard. PDQm can be a FHIR API backed by a PDQ query or a Cross-Enterprise Patient Discovery (XCPD) query.
The PMIR, PDQm, and PIXm Profiles are used within the MHDS Profile to manage and find the patient’s identifier in that community as part of the Centralized Discovery and Retrieve environment.
MHD, PDQm and PIXm also have test plan pages: MHD test plan page; PDQm test plan page; PIXm test plan page.
See the IHE IT Infrastructure White Paper covering the methods of managing Patient Identities - https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html#5-patient-identity-management.

Feedback requested.

Comment

Submitted by juliemaas on 2022-09-29

Add HL7 Interoperable Digital Identity & Patient Matching IG

HL7's Interoperable Digital Identity & Patient Matching Implementation Guide is an Emerging Implementation Specification we recommend for inclusion in both the Patient Demographic Record Matching and Exchanging Patient Identification Within and Between Communities sections of the ISA due to its utility to both of these categories. -HL7 Interoperable Digital Identity & Patient Matching workgroup

Submitted by John Moehrke on 2021-09-08

IHE - Patient Demographics Query for Mobile (PDQm)

The Patient Demographics Query for Mobile (PDQm) Profile provides similar functionality as PDQ but uses the FHIR standard. PDQm can be a FHIR API backed by a PDQ query or a Cross-Enterprise Patient Discovery (XCPD) query.

Submitted by John Moehrke on 2021-09-08

IHE - Patient Master Identity Registry (PMIR)

The IHE Patient Master Identity Registry (PMIR) provides a collaborative community based system of cooperating patient identity sources maintaining a master identity for each patient. PMIR leverages the FHIR standard.

see the whitepaper - https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html#54-patient-master-identity-registry-pmir

For example, a consumer system may query the PMIR registry to receive the shared master Patient Identity (aka. golden identity) based on their local identifiers or based on the identifying characteristics of the patient (demographics). In this way a PCP office can discover the master Patient Identity so that it can communicate with the systems in that community using a known patient identifier. This query uses Patient Identity Cross-referencing for Mobile (PIXm) or Patient Demographics Query for Mobile (PDQm).

Patient identity source will feed create, update, or merge events to the PMIR registry, which will further propagate these changes to a set of patient identity consumers that have subscribed. Upon receiving a create, update, or merge event these subscribed consumers are expected to update their patient information accordingly. For example when a merge has been declared, the subscribed consumer will merge into the surviving identity any data that was known against the merged identity. This set of patient identity source keep the master identity accurate, using update when there are changes to the demographics.

The PMIR, PDQm, and PIXm Profiles are used within the MHDS Profile to manage and find the patient’s identifier in that community as part of the Centralized Discovery and Retrieve environment.

This is an introduction to the PMIR Profile use within MHDS. PMIR Profile includes other optional functions. Please reference the Profile for details in PMIR.

Submitted by John Moehrke on 2021-09-08

IHE - Patient Identity management

See the IHE whitepaper covering the many methods of managing Patient Identities.

https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html#5-patient-identity-management

Submitted by juliemaas on 2019-09-23

HL7 FHIR and the Patient/$match operation

Since STU3, HL7 FHIR has included the Patient/$match operation which allows for patient matching using MPI-based logic. When such a FHIR operation is performed within a community, this is comparable in functionality to the IHE standards already referenced. This is being actively explored in multiple stakeholder groups (e.g FAST). For this reason, we recommend that HL7 FHIR be included as an implementation specification in this sub-section with the $match operation called out specifically in the limitations, dependencies, & preconditions area. The match operation replaced a similar MPI query available in DSTU2.

Julie Maas, CEO, EMR Direct