• Health, Standard 05/10/2016

The identification of individuals and healthcare providers requires identifiers that are created for a specific purpose as well as other identifying information to support healthcare needs.

The Identification in healthcare cluster includes data elements that define information about the identifier, such as its designation (that is, the unique number or code assigned to an entity in healthcare); the way the identifier is to be used; the issuer of the identifier; and whether the identifier is for a group to which the individual belongs. Three data elements—'Identifier designation', 'Identifier issuer' and 'Identifier usage'—can be combined to form a globally unique identifier.

It also provides information about the status of the identifier such as whether the identifier is active or has been replaced; the dates of the changes in status; the replacement identifier used for an entity; and the identifier of the organisation or provider that has authorised the use of the replacement identifier. These data elements can be used when an identifier is no longer in use, or where multiple registrations have accidentally occurred for a single entity. In this case an identifier can be retired and point to the replacement identifier.

The cluster also provides a flag to indicate whether an identifier is a potential duplicate or an intertwined record (when more than one entity is assigned the same identifier) and requires further investigation; and optional data element clusters for duplicate records, similar but different entities (records that are similar enough to be the same person or organisation, but that relate to a different entity) and intertwined records.

The use of identifiers in healthcare are based on the following principles, outlined in AS 4846:2014 Person and provider identification in healthcare:

• identifiers are unique for a purpose, and connected to an entity (usually a person or organisation)
• family group identifiers can also be used and are unique to the family
• identifiers are not recycled or re-used
• each entity should have a single active identifier from a given issuer for a specific use at any point in time.

It is common for an entity to have many identifiers issued by different organisations for different purposes. This cluster has been designed to allow systems to manage multiple types of identifiers without the need to change the system structure. It reflects the use of many numbers in healthcare, and means that a single generic structure can be used to collect, use and represent a wide range of other identifiers.

Examples of healthcare client and provider identifiers are:

• Person identifier
• Medical Record Number (MRN)
• Local client identifier
• Health (care client) identification number
• Unit Record (UR) number
• Enterprise identifier
• Area identifier
• State/territory health identifier
• Unique Identifier (UID)
• Unique Health Identifier (UHID)
• Medicare Provider Number
• Employee number (payroll system number)
• Individual Healthcare Identifier (IHI)
• Healthcare Provider Identifier–Individual (HPI-I)
• Healthcare Provider Identifier–Organisation (HPI-O).

Australian Institute of Health and Welfare

Standards Australia 2014. AS 4846:2014 Person and provider identification in healthcare. Sydney: Standards Australia.