Patient Matching PSS

1a. Project Name Improving identity assurance and patient match quality through interoperable Digital Identity and Patient Matching capabilities 1b. Project ID 1717 1c. Is Your Project an Investigative Project (aka PSS-Lite)? No 1d. Is your Project Artifact being Reaffirmed or proceeding to Normative directly after being either Informative or STU? No 1e. Today's Date 1f. Name of standard being reaffirmed 1g. Project Artifact Information 1h. ISO/IEC Standard to Adopt 1i. Does the standard include excerpted text from one or more ISO, IEC or ISO/IEC standards, but is not an identical or modified adoption? 1j. Unit of Measure 2a. Primary/Sponsor WG Patient Administration 2d. Project Facilitator Carmen Smiley, Julie Maas 2e. Other Interested Parties (and roles) HL7 Community Based Care and Privacy WG HL7 Public Health WG HL7 Payer/Provider Information Exchange WG 2f. Modeling Facilitator 2g. Publishing Facilitator TBD 2h. Vocabulary Facilitator N/A 2i. Domain Expert Representative 2j. Business Requirements Analyst Jim St. Clair 2k. Conformance Facilitator David Pyke 2l. Other Facilitators 2m. Implementers Optum (TBD), EMR Direct, Lumedic (TBD) 3a. Project Scope Patient Identity Management in Healthcare today relies primarily on Patient Matching approaches with the relatively newer trend of Digital Identity Management picking up momentum, especially in the last year. While these two approaches have been largely considered distinct and separate, there is an opportunity to develop guidance on how implementers and organizations can leverage their Patient Matching and Digital Identity capabilities together to improve match quality and overall identity assurance in FHIR transactions. The Operation-patient-match - FHIR v4.0.1 (https://www.hl7.org/fhir/operation-patient-match.html) today is primarily focused on Patient matching within an organization frequently using a Master Patient Index approach. This project will develop artifacts to profile the Patient match operation for use across organizations, incorporating elements of identity verification and the use of digital identities in workflows and information exchange. These workflows include exchanges between patients and organizations, with or without the use of an intermediary. The information exchanged and resultant matching must meet the following requirements: - Consistent with regulatory requirements for Patient Access and other permitted purposes, etc. - May occur as part of a synchronous workflow - Meets practical business needs of providers/payers/vendors that require patient identity confidence in their workflows Existing SMART authentication workflows with OpenID Connect enable some information about the fhirUser to be conveyed, but there are gaps which limit a responder's ability to perform a high quality match. Additionally, registration and check-in practices achieve some level of identity assurance today, but this could be better characterized, variability harmonized, and stronger assurance could be indicated when appropriate. This project is intended to develop artifacts (FHIR implementation guides, guidance documentation, reference implementations, etc.) to inform and or/execute a cross organizational or internal patient match via FHIR when requested for a permitted purpose or authorized by the Patient directly or by the Patient’s delegate. This will include identity verification guidance, best practice matching recommendations, and match workflow examples, to enable those who are requesting a match in health records to securely share or make discoverable attributes such as verified address(es), email address, mobile number, date of birth, facial photo, and possibly other attributes and identifiers. The IG may incorporate elements from other industry best practices, as this group will seek to harmonize identity and matching efforts already under way elsewhere in the industry and in the broader global community. Representative Use Case: A patient holds physical and/or electronic pieces of identity evidence, which can be used to verify their unique identity and generate a corresponding digital identity. Applications could also bind authenticators to such identities and leverage best practice methods for authentication and proof of possession. These digital identities could be used as alternatives to the physical identity evidence and deployed in increasingly digital workflows. This IG would provide a reference for practices that can be used across organizational boundaries to communicate about these digital identities and associated attributes, enabling their best use and increasing confidence in cross organizational matching while preserving patient privacy and data security. The effort will focus on the US Realm, intending to be compatible with NIST 800-63-3. This FHIR implementation guide will use the US Core profiles. If this FHIR implementation guide is unable to use a US Core profile, we will follow the Cross Group Projects WG's variance request process, and provide the US Realm Steering Committee an approved rationale for deviation in the implementation guide where applicable. Attachments 3b. Project Need This project is intended to enhance interoperability among patient matching and digital identity management approaches. It will leverage and build on existing and emerging standards and augment with best practices for identity verification. This is currently a gap not addressed directly by other identity related efforts. 3c. Security Risk No 3d. External Drivers 3e. Objectives/Deliverables and Target Dates Connectathon May 2021 Connectathon September 2021 Ballot for STU1 January 2022 Reconciliation for STU1 – Jan - April 2022 Publication STU1 – May 2022 Ballot for STU2 – Jan 2023 Ballot Reconciliation – Jan – April 2023 Publication – May 2023 Ballot for Normative – Jan 2025 Ballot Reconciliation – Jan-April 2025 Publish Normative – May 2025 3f. Common Names / Keywords / Aliases: FAST Identity / Patient matching / Digital Identity / record linkage / Patient Identifiers / unique patient identification / identity resolution 3g. Lineage 3h. Project Dependencies 3i. HL7-Managed Project Document Repository URL: https://confluence.hl7.org/display/PA/Interoperable+Digital+Identity+and+Patient+Matching+Capabilities 3j. Backwards Compatibility N/A 3k. Additional Backwards Compatibility Information (if applicable) 3l. Using Current V3 Data Types? N/A 3l. Reason for not using current V3 data types? 3m. External Vocabularies No 3n. List of Vocabularies 3o. Earliest prior release and/or version to which the compatibility applies 4a. Products FHIR Implementation Guide 4b. For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to? FHIR R4+ 4c. FHIR Profiles Version 4d. Please define your New Product Definition 4d. Please define your New Product Family 5a. Project Intent Implementation Guide (IG) will be created/modified 5a. White Paper Type 5a. Is the project adopting/endorsing an externally developed IG? No 5a. Externally developed IG is to be (select one) 5a. Specify external organization 5a. Revising Current Standard Info 5b. Project Ballot Type STU to Normative 5c. Additional Ballot Info 5d. Joint Copyright No 5e. I understand I must submit a Joint Copyright Letter of Agreement to the TSC in order for the PSS to receive TSC approval. no 6a. External Project Collaboration ONC FHIR at Scale Taskforce (FAST), Vaccination Credential Initiative, CARIN Alliance, Good Health Pass, PACIO Project, ONC Advancing Social Determinants of Health (SDOH) Health IT Enabled Tools and Data Interoperability project, Trust Over IP Foundation 6b. Content Already Developed 10% 6c. Content externally developed? No 6d. List Developers of Externally Developed Content 6e. Is this a hosted (externally funded) project? Yes 6f. Stakeholders Clinical and Public Health Laboratories, Immunization Registries, Quality Reporting Agencies, Regulatory Agency, Standards Development Organizations (SDOs), Payors, Other 6f. Other Stakeholders Public Health Organizations, Trust networks/HIEs, Consumer and Privacy Advocates, state agencies, federal agencies 6g. Vendors Pharmaceutical, EHR, PHR, Equipment, Health Care IT, Clinical Decision Support Systems, Lab, HIS, Other 6g. Other Vendors Medical Device (including wearables) 6h. Providers Clinical and Public Health Laboratories, Emergency Services, Local and State Departments of Health, Medical Imaging Service, Healthcare Institutions (hospitals, long term care, home care, mental health), Other 6h. Other Providers Care Delivery, Care Management and Care Coordination Organizations Social Services, Community Health Services 6i. Realm U.S. Realm Specific 7d. US Realm Approval Date Jun 22, 2021 7a. Management Group(s) to Review PSS FHIR 7b. Sponsoring WG Approval Date Jun 09, 2021 7c. Co-Sponsor Approval Date 7c. Co-Sponsor 2 Approval Date 7c. Co-Sponsor 3 Approval Date 7c. Co-Sponsor 4 Approval Date 7c. Co-Sponsor 5 Approval Date 7c. Co-Sponsor 6 Approval Date 7c. Co-Sponsor 7 Approval Date 7c. Co-Sponsor 8 Approval Date 7c. Co-Sponsor 9 Approval Date 7c. Co-Sponsor 10 Approval Date 7e. CDA MG Approval Date 7f. FMG Approval Date Jun 16, 2021 7g. V2 MG Approval Date 7h. Architecture Review Board Approval Date 7i. Steering Division Approval Date 7j. TSC Approval Date