DirectTrust has launched an initiative to develop a new standard to support a voluntary nationwide patient credential and matching ecosystem. DirectTrust is a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information.

The goal of the Privacy-Enhancing Health Record Locator Service (PEHRLS) Ecosystem Consensus Body is to identify existing standards, profile existing standards and create new standards as needed for a privacy-enhancing record locator along with the interactions of associated actors.

Defining electronic interactions

The new standard will define electronic interactions among identity providers, electronic health record systems, health information exchanges, health information networks and a record locator service.

"Managing identity and health information interoperability in healthcare is a special problem unlike other identity and identifier topics," said Scott Stuewe, DirectTrust president and CEO. "To be useful as a mechanism for assembling a longitudinal health record, a system also needs to enable access to the locations where records are available for the individual.

"DirectTrust is ideally suited to be leading this effort," he contended. "We are at the intersection of identity assurance and health information exchange; our members represent the actors that would have to implement such a solution. This effort dovetails well with our focus on consumer credentials – it adds identifiers to federated identity topics already being addressed in collaboration with the CARIN Alliance."

While there is broad agreement that the only way to improve patient matching and health record location to near 100% is with a universal patient ID, the prohibition against government action on such a solution has remained in place since HIPAA was enacted.

Improve efficiency and reduce costs

The new standard will define a model that could be deployed either voluntarily by the private sector or with the support of government funding or encouragement in the future, DirectTrust said. Deployment of such a standard could improve efficiency and reduce costs for query-based exchange, direct exchange and patient-mediated exchange by reducing infrastructure requirements and computing costs, the company added.

Most important, such a model could enable the long-sought-after goal of reliably assembling a longitudinal health record for patients, DirectTrust said.

The anticipated benefits of the PEHRLS Ecosystem Standard include the following, according to DirectTrust:

• A privacy-enhancing record locator and shared identifier service that can be deployed incrementally at low cost to support, potentially, 100% patient-matching success.
• Identity assurance provided by identity providers that identity-proof and issue credentials and enable access to the shared identifier service.
• Patient access to their own records from multiple locations with a single credential and match reliability that will convince reticent data holders of its safety.
• Rights of access for all parties, enabling the assembly of a longitudinal patient record with existing mechanisms for exchange.
• Improved fidelity of patient matching for all mechanisms of exchange.

DirectTrust Standards also announced it is seeking Consensus Body members from healthcare, government, healthcare payer, consumer and general interest, information technology, and interoperability and systems integration sectors. Those interested in joining the PEHRLS Ecosystem (DS2022-05) Consensus Body are asked to contact standards@directtrust.org.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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