Note: This event was conducted under Chatham House Rules resulting in no attribution of the conversation
On Tuesday, November 5, the One World Identity (OWI) team headed to Boston with their partners Uniken to discuss the future of digital identity in healthcare
The healthcare conversation is always more personal than other forum topics on the schedule. We all care about our personal health and the well-being of our loved ones. And digital identity in healthcare remains the fundamental roadblock to innovation. Whether it’s user experience, the secure sharing of data and patient information, quickly verifying a patient's identity, all of these challenges are addressable with improved digital identity processes and technologies.
However, there remains a myriad of challenges that make improved user experiences difficult to implement. HIPAA compliance requires higher data privacy standards for patients and physicians. Healthcare access is for everyone, so building new technologies needs to be inclusive for the elderly, underserved, and disabled. Additionally, patient experiences are more intimate than almost any other transaction, placing increased pressure and sensitivity for all parties.
At the KNOW Identity Forum in Boston, we brought together industry experts that are building new technologies and workflows to mitigate these challenges and improve the healthcare experience for everyone. The KNOW Identity Forum dove straight into these tough and controversial topics with a fireside chat featuring Blake Hall, Founder and CEO of ID.me, Dr. Thomas Sullivan CSO and CPO of DrFirst, and our very own Cameron D’Ambrosi Principal at One World Identity. Here is what we learned.
Healthcare as a unique challenge
The panel kicked off the session with a contextual overview of the healthcare industry and some of the industry's most pressing challenges.
The main problem facing the industry today is the persistent prevalence of manual records that prevents interoperability. Patients want to be able to visit the doctor of their choosing and have their medical records easily and securely transmitted. Additionally, physicians want to implement the most efficient onboarding process to free up more time spent with their patients. In the early 2000s, the industry came together and agreed the digitization of health records could facilitate interoperability.
Under the Obama Administration, the American Recovery and Reinvestment Act was enacted in 2009. As part of this regulation, incentives — both positive and negative — were levied against physicians to adopt Electronic Health Records (EHR) by 2015. This new mandate spurred rapid growth of the Electronic Management Software (EMS) giants such as Epic.
The panel commented on the nightmare of the EMS migration journey. Instead of taking the time to rebuild an IT infrastructure on a single platform, most medical practices kept both their legacy system and the new software online to preserve the medical histories and records of their patients. Each entity also used the migration as an opportunity to build in custom workflows, incorporating payment apps, separate indoc software, patient management systems, and more. Unfortunately, the popularity of customization resulted in incredibly siloed workflows. It’s possible that a physician is responsible for remembering identity authentication credentials for multiple platforms.
Moreover, doctors are now responsible for managing their digital identities for each hospital where they see patients. For physicians in urban areas who frequent multiple hospitals, they could easily find themselves managing logins for dozens of applications.
That brings us to today. The panelists discussed how digital identity in healthcare is focused on remediating mistakes of the past and trying to move forward with the best possible solutions.
Benchmark against our current state
The panel was asked about the frequent challenges of trying to sell products to healthcare buyers. The panel expressed frustration with benchmarking a product’s performance off an ideal state and not the performance of the current state process. For example, if a hospital currently has a first-time successful patient identity verification rate of 53 percent and a new solution has the potential of raising that match rate to 90 percent, buyers still have the tendency to push the issue of why the match rate isn’t 100 percent.
In this scenario, the buyer is benchmarking the new product of a theoretical state instead of the institution’s reality. The panel warned this mentality will prevent progress and innovation in the long run. The goal ought is to provide better experiences for as many customers as they can to free up resources to dedicate to the more difficult marginal use cases. In healthcare, where the stakes are high, letting perfect get in the way of better is a big obstacle.
Future healthcare trends
Healthcare data exchanges are coming to the forefront. For those unfamiliar, the concept of a healthcare data exchange is the coordination of medical institutions abiding by agreed upon standards to facilitate the sharing of patient data upon their request. This system would facilitate the secure exchange of patient records from doctor to doctor and help unify a patient’s medical history, among many other benefits.
Industry experts have been discussing the viability and benefits of interoperability for over a decade. However, a meaningful data exchange requires large scale institutional participation and agreed upon standards of data collection, security, and sharing. All of these conditions present an array of challenges that are difficult to solve. Nevertheless, the industry is at a breaking point.
Medical errors continue to be the third leading cause of death in the United States, according to Martin Makary, a professor in the department of surgery at John Hopkins. And manual processes, specifically mistakes in data entry, lead to missed results, incorrect reporting, unreliable information, and high administrative costs. Roughly 38 percent of healthcare costs are dedicated to administrative overhead. Both patients and physicians are feeling the repercussions of inefficient processes, and the panel expects more focus on the development of data exchanges to happen in 2020 and beyond.
Additionally, the panel noted that B2C pharmaceutical pickup is ready for disruption. The current identity authentication process for prescription pickup is verbally providing your name, DOB, and address. Originally implemented for accessibility, pharmacies acknowledge this paradigm is insufficient. Especially with the opioid crisis and increased focus on the pharmaceutical industry, identity professionals should consider how their products could help companies like Walgreens and CVS easily and securely facilitate prescription pickup.
The KNOW Identity Roadshow Continues
Many thanks to the speakers and attendees who participated in the Boston KNOW Identity Forum! And a special thanks to our partner Uniken for their continued work in the digital identity and security space. At the front lines of innovation, they continue to push the conversation forward and provide the industry with best-in-class solutions. We’re looking forward to continuing conversations like these at our next Forum in Atlanta, Seattle, and London. The KNOW roadshow culminates in the annual KNOW Identity Conference in April 2020. We hope to see you there!