1. NHID/mRegistry Workshop | 16 September 2014 1 |1 | Implementation of a National Health ID (NHID) Registry and Index Mark Landry, WHO (landrym@wpro.who.int)

2. NHID/mRegistry Workshop | 16 September 2014 2 |2 | Outline Summary of National Health ID (NHID) Issues What is a Registry? Importance of investing in a NHID Registry and Index for immediate benefits and to address future purposes Potential use of Open Enterprise Master Patient Index (OpenEMPI) software for building up and maintaining the Cloud-based NHID registry and index

3. NHID/mRegistry Workshop | 16 September 2014 3 |3 | Seven Key National Health ID Issues Think about existing health records and how to index them to the new ID Allow for and implement strong matching and de-duplication protocol Avoid embedding any data in the number Use a check digit at the end of the ID in order to catch many keypunch mistakes The ID number will be in use for 300+ years, so size it appropriately Evaluate universal versus health only ID Identify multiple ID registration points, such as during pregnancy, at birth, at issuance of drivers license, in the hospital OPD, passport registration, police departments, etc.

4. NHID/mRegistry Workshop | 16 September 2014 4 |4 | What is a Registry? Consumer of data – Indexing platform Reconciler of data – ID match and reconciliation Producer of data – Allocation of unique ID (NHID) Organizer of data – standard representation of person profile data Provider of data – integration with downstream systems/apps Other key functions: –Administration – merges, data integrity, reporting –Verification – Biometrics and identity lifecycle management

5. NHID/mRegistry Workshop | 16 September 2014 5 |5 | Future Use of NHID Registry? Health Information Exchange (HIE) Diagram courtesy of OpenHIE

6. NHID/mRegistry Workshop | 16 September 2014 6 |6 | Adoption of National Health Identifier (NHID) Registry and Index Pursue alignment of unique IDs coupled with ID verification (photo, fingerprint, other biometric marker) Focus on PMRS 10-digit ID (use of 9 randomized digits with 10 th check digit) which complies with good practice guidelines Phased implementation of Cloud-based NHID registry and index—gradually aligning existing IDs from current databases with PMRS IDs and the national ID scheme in the future

7. NHID/mRegistry Workshop | 16 September 2014 7 |7 | NHID Registry and Index Development Design NHID web-services and database model –Map all existing ID schemes from current registries, applications, databases (NCHADS, DPHI, partner-supported systems, etc) –Consider PMRS 10-digit ID as the core or ‘proxy’ national health ID for starters and develop Internet access point to PMRS or extend functionality (Health Equity Fund/ID Poor database) – DPHI Map, analyze, de-duplicate, develop automated quality checks and protocols, etc. for indexing IDs and consolidating into a NHID database model Use Open Enterprise Master Patient Index (OpenEMPI) or other tools to build and maintain the NHID registry and index

8. NHID/mRegistry Workshop | 16 September 2014 8 |8 | OpenEMPI key features Flexible architecture with extensibility and performance being the key requirements Provides pluggable models for: –Matching algorithms –Blocking algorithms –String matching algorithms Currently includes 2 matching algorithms (highly configurable) –Deterministic –Probabilistic

9. NHID/mRegistry Workshop | 16 September 2014 9 |9 | OpenEMPI Architecture

10. NHID/mRegistry Workshop | 16 September 2014 10 | Perform localized and manual cross-database ID matching analysis and development for individuals in demonstration area (Battambang) Explore cost-sharing services between NCHADS and DPHI on Internet access and Cloud-based hosting services across increasing array of Web-based applications and services Initiate NHID development program through MoU agreements and stepwise approach towards convergence of a NHID in the future (considering patient data security, confidentiality, and privacy protocols) NHID Registry and Index Development (continued)

11. NHID/mRegistry Workshop | 16 September 2014 11 | Consider how current and future systems will interact with the NHID registry and patient master index Prepare for future indexing with National ID By the end of December, develop Cloud-based NHID Registry and Index requirements and database model ready for deployment—develop the business case Explore mainstreaming NHID registry and index into HSP3 sector-wide assessment, planning, and costing in 2015 NHID Registry and Index Development (continued)

12. NHID/mRegistry Workshop | 16 September 2014 12 | Health Information Exchange (HIE) Diagram courtesy of OpenHIE

13. NHID/mRegistry Workshop | 16 September 2014 13 |