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Synthesis of Plenary and Group Presentations

Synthesis of Plenary and Group Presentations. Purpose of Unique Identifiers. Unique identification of clients accessing multiple health facilities Link data across facilities Longitudinal record to facilitate chronic care M&E for improvement of services – effectiveness, efficiency, equity,.

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Synthesis of Plenary and Group Presentations

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  1. Synthesis of Plenary and Group Presentations

  2. Purpose of Unique Identifiers • Unique identification of clients accessing multiple health facilities • Link data across facilities • Longitudinal record to facilitate chronic care • M&E for improvement of services – effectiveness, efficiency, equity,

  3. Local Experiences • 5 institutions implementing Unique ID system: • Serialized number: • National ID by NRB – also linked to finger prints • AAR Member No. – preceded by country codes • Block number: PIN and driving licence by KRA • Quasi-unique: IPRS number

  4. Assignment of Unique ID • Centralized ID Production Centre • Vetting Committees for verification • Linked to national ID • Networking for access from multiple sites

  5. Challenges • Duplicate IDs to same individual • Retrieval of records if missing patient card • Quasi-unique: Some IDs assigned to multiple individuals • Not linked to family tree • Resistance to biometric information • Restricted to nationality and > 18 years of age • Fraud

  6. Recommendations • Assign IPRS at birth • Eliminates need for national ID • Linked to family tree • Tighten controls to minimize duplication • All EMRs to adopt the Unique ID • Online enrolment • Inter-linkages to existing databases

  7. Four options • National ID 1. National ID assigned to all adults e.g. NRB • National ID assigned at birth to all e.g. IPRS • Health ID • ID for health and social services by central body e.g. NHIF

  8. Option 1: National ID for Adults Background: derived from colonial history; for > 18 years Pros: majority of adults; finger print; good infrastructure; minimal duplication Cons: used in-country only; excludes < 18 years; delayed acquisition; stigma Modification: legislation; institutional; infrastructure; Conclusion: Not viable

  9. Option 2: National ID Issued at Birth - IPRS • Purpose: link patient records, ease of reporting, longitudinal tracking, minimize duplication • Pros: Government-led, captures all Kenyans, kids, aliens; multichannel access, mechanisms for update • Cons: ready Jun 2010, photo 3 yearly • Modifications: WAN, infrastructure, hardware, legislative, technical support, financial support (WB currently) • Conclusion: Workable but will take time • Issues: Changing district codes; DOB unknown, universal coverage, uptake and use; who has access to data; regulation of data;

  10. Option 3: National Health Identifier by Centralised Body • Pros: functioning system, upgraded; primarily for formal sector & dependants, no duplicates, • Cons: Pre-register prior to health seeking, limited coverage; potential loss of med history • Modifications: policy, legislation, infrastructure, human resources, collaboration, financial • Conclusion: Workable with major modifications • Issues: Age limits for national ID

  11. Option 4: Health ID Issued by Health Facility: Block ID using MFL • Pros – simple, immediate, all-inclusive, acceptability by patient/provider • Cons – duplication by different sites, not compliant to international standards • Modifications: governance, set standards; health systems strengthening, security/back up • Requirements: legislative, infrastructure, HR, • Timeline: 6-12 months • Conclusion: Workable with modifications • Issues: clients accessing multiple sites;

  12. Desired Features • Easy and quick acquisition • Universal coverage • Multichannel access • Wide acceptability • Multiple usage • Confidentiality

  13. Consensus • Ned a lifetime multi-purpose national unique ID: for health, social services, banks, etc. • Purpose: quality of care, planning and management • Standards based • Best option: Majority IPRS: 14-digit • Century, DOB, District, Birth ID, Check digit

  14. Issues not Addressed • Design • Managing authority • Confidentiality and security • Allocation: central or decentralised

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