Patient as a User - becoming "known to a practice"

The current practice is ‘in person proofing’… as the first encounter with the patient is as a … patient… Now many patients are not at their ‘best’ when they first appear, so the understanding of their identity evolves over the first hours and days and weeks. Thus in healthcare practice we often know the patient by many identifiers that we have either merged or linked. And there are cases where a merged or linked patient needs to be unmerged or unlinked. Very messy business. Ultimately the patient gets billed for the services they have received, and the identity gets confirmation that they paid, thus stronger. This is just a discussion of the patient id, not the patient as a user.  See my topics on Patient Identities.

Patient as User

The patient as a User usually starts with this in-person relationship. Most often the healthcare organization uses the identity they know, and the billing address to send them postal-mail (covered by strong fraud laws). This kickstarts an online confirmation workflow that binds the human patient identity to a user identity. Unfortunately this often is by way of a hospital managed user account, and not an internet friendly OAuth identity.

There are increasing cases where an internet friendly OAuth identity is used. However these (Facebook, Google, etc) are very low assurance identities, as anyone can claim to be anyone. To use these in healthcare we elevate the LoA using the above described online confirmation workflow so that the result is an identity that the patient wants to use, elevated to a higher assurance level through the healthcare driven identity confirmation workflow.See my User Identity topics.   Specifically getting to mHealth solutions - real People

User Identity and Authentication 

• HEART profiles for review, comment, and approval  
• mHealth Identities using trusted intermediary
• getting to mHealth solutions - real People
• getting to mHealth solutions - Users
• Internet User Authorization: why and where
• IHE efforts in RESTful security
• IHE-IUA - Internet User Authentication for HTTP profiles
• Identity Proofing and Authentication -- Patient vs Provider
• Level setting on Level of Assurance 
• etc...

Patient Identity

• PDQm - Patient Demographics Query for Mobile API
• Policy needs to get out of the way of good Patient Identity management
• HIE Patient Identity problem
• Identity Proofing and Authentication -- Patient vs Provider
• Patient Identity Matching
• Universal Health ID -- Enable Privacy
• The Basics of Cross-Community Patient Discovery (XCPD)
• NwHIN-Exchange use of XCPD for Patient Discovery
• Direct addresses- Trusted vs Trustable
•  etc...