IHI Rollout to National iPM System
Background:
Enabling the Individual Health Identifier (IHI) is a key component on the journey towards Shared Care Records, Electronic Health Records (EHRs) and Digital Solutions related to supporting patient
care.
HIDS (or the Health Identifiers Service) manage the delivery of the IHI across healthcare services. IHI was used extensively in COVID to support safe identification of persons – COVID Track & Trace, initial and booster Vaccinations via Centers, Pharmacists, GPs and in the digital COVID Cert, etc.
As Integrated Patient Management System (iPMS) is the first point of entry for patient demographic and transactional information and holds the Patient Master Index (PMI) which contains all
the personal information on all patients who attend the hospital, it was decided that seeding the iPMS system was the best way of getting the IHI into patient records. This was facilitated via a seeding utility developed by Dedalus. The project was a joint initiative between HIDS Business, HIDS Technical and the IPMS National Team.
Seeding Process:
A new tool with a UI was created by Dedalus and this contained the criteria for patient selection. The seeding utility selects patients based on defined criteria, and sends them to the IHI API to look for an IHI. These specific targeted cohorts are:
• Patients with future appointments
• Patients with recent A&E attendances
• Patients with appointments in the recent past
• Patients with recent admissions
• Patients with active referrals
• Patients with active Waiting Lists (IP and OP)
• Latest created / amended patients.
The following data is passed to try to identify the patients IHI number:
Core information
• Given Name
• Surname
• DOB
• Sex
Optional Additional Data
• Address Line 1
• Eircode
• PPSN
• Mothers Birth Family name
• Mobile Phone number
HIDS utilises combinations of 9 searchable data items to safely return an IHI and the greater the availability of these 9 data items, the higher the IHI match rate. The IHI infrastructure has been configured with complex matching algorithms which enable searching and accurate matching of records using alpha, phonetic and other searches. Where the data meets the matching criteria threshold, the IHI number is returned and the relevant patient record is updated with the IHI.
The seeding utility is installed on each application server and scheduled jobs run at regular intervals to select the patient cohort and send to the IHI API.
Current Status:
The IHI Integration process with IPMS commenced in Sept 2022, and has now almost completed a full run through of each database. While the overall match rates for instance vary from 40-55% the match rates are significantly higher for more recent active patients ranging from 60-80%. The match rates drop as we move through older legacy data.
What we have found during the seeding process is where mobile phone, Eircode and MBFN are populated in patient records this significantly helps improve IHI match rates. Also patients who are
actively engaging with the health service are getting higher match rates.
The IHI is now being included on all HL7 messaging along with other patient identifiers to downstream systems when a previously seeded record is updated in iPMS. The IHI is not currently displayed in any downstream systems or in the iPMS application. Display of IHI in IPMS will be reviewed at a later stage for front end iPMS users.
Next Steps:
An updated Seeding tool will be deployed to all iPMS instances – this will include more mobile numbers and patient IDs to help increase the match rates. It will also allow the updating of the PPSN number from the IHI Register when permitted. The HIDS Team and the iPM team will work together to improve the quality of data recorded at source to enable a continuous increase in the match rate of IHI’s.
The next version of iPMS (Version 8) will include a real-time lookup of the IHI and Eircode API’s which will also help to drive seeding of the IHI in patient records.