Alliance Outlines Need For Smart Card-Based Healthcare Identity Management Infrastructure Leveraging Existing Federal Standards

  • Oct 09, 2009

Government policy makers and healthcare stakeholders looking to establish electronic medical records (EMRs) to improve the U.S. healthcare system should look first to defining the identity management infrastructure for securely identifying patients, medical providers and anyone else handling the records, stated the Smart Card Alliance Healthcare and Identity Councils in a position paper issued recently. To this end, the Councils recommend the use of existing federal standards for smart cards to create a trusted identity management infrastructure.

The passing of the American Recovery and Reinvestment Act of 2009 (ARRA) and HITECH Act gave impetus for the Smart Card Alliance to create the paper to elevate the discussion about identity management before the federal government begins to invest over $19 billion in healthcare information technology. This investment will provide significant incentives for healthcare providers to implement EMR systems over the next five years. The Alliance argues that these plans that emphasize electronic health record exchange are putting the cart before the horse, and effective identity management is needed first.

“As we move away from paper-based medical records that are controlled by physical access to buildings, rooms, and files, we need to have a healthcare infrastructure that supports strong identity and security controls,” said Paul Contino, chair of the Smart Card Alliance Healthcare Council and vice president of information technology with Mount Sinai Medical Center “The issues with establishing identity are compounded as electronic medical records are used by many different organizations at the regional, state, and national levels. There must be a way to uniquely and securely authenticate each person across the healthcare infrastructure, whether that interaction is in person or over the Internet.”

The Smart Card Alliance paper discusses the current challenges facing the healthcare IT infrastructure and details why smart cards provide the most cost efficient, secure, and user-accepted method for solving the healthcare identity management problem. It also explains how smart card technology can help make the critical capabilities needed in the healthcare infrastructure both possible and cost-effective. It can also provide an ideal way to achieve HIPAA compliance and meet the more stringent regulatory requirements of ARRA / HITECH.

“The lack of consistent and uniform identity management is at the root of the challenges faced by the healthcare industry today -- lowering administrative costs, preventing medical identity theft and fraud, protecting patient privacy, and enabling healthcare data exchanges. In fact, of the 195,000 deaths in the United States that occur annually due to medical errors, 60 percent of those were because of failure to correctly identify the patient,” said Randy Vanderhoof, executive director of the Smart Card Alliance. “Creating a healthcare identity management infrastructure based on smart card technology directly addresses these problems because it enables the ability to properly identify patients and healthcare providers, match healthcare records, and identify individuals and healthcare providers that have authorized access to them.”

In addition to the use of smart cards, the Healthcare and Identity Councils advise the healthcare industry to take the opportunity to leverage and build upon existing federal initiatives and standards, such as the NIST Federal Information Processing Standard (FIPS) 201 and the Personal Identity Verification (PIV) card, which are already in use by numerous government agencies. These existing standards are proven technology solutions and an established set of best practices for smart card-based identity management and authentication that can be adapted to healthcare.

“NIST standards, and the Federal Identity, Credential, and Access Management (F/ICAM) committee vision and framework on identity management provide the foundation for the healthcare industry to jump-start the definition of a national healthcare identity management infrastructure and provide a proven model for interoperability across multiple organizations,” Vanderhoof said

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