ANSI - American National Standards Institute
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New Draft Standard for Healthcare Identification Cards Lays a Foundation for Future Medical Applications


New York, Aug 23, 2002

Responding to a call for action from the prescription drug industry and state legislatures, the InterNational Committee of Information Technology Standards (INCITS) and its Technical Committee B10 have launched a revision of ANSI INCITS 284-1997, Health Care Identification Cards.

While most people are familiar with the magnetic stripe cards used for banking and retail purposes, encoded identification cards have also been used for years in the healthcare industry, especially in relation to insurance and prescription drug plans. Today, usage is rapidly expanding. A July 2002 Wall Street Journal article explained how one hospital, Memorial Health Services in Long Beach, California, is using identification cards to cut emergency room wait time and improve patient care. The cards they issue, which currently utilize a magnetic stripe, allow doctors and nurses to access a database with vital patient information simply by swiping the card into a computer.

INCITS B10 stresses that the scope of INCITS 284 is to specify identification information only; the document does not propose carrying demographic, diagnostic, prescriptive, medical history or other data about the cardholder on the card-though such applications are possible. However, the committee recognizes that as the uses of healthcare ID cards evolve so must the technologies associated with them.

As a case in point, the National Council for Prescription Drug Programs (NCPDP), an ANSI member, lobbied INCITS to update the 1997 version of INCITS 284 so as to increase the information storage capacity beyond that currently available through existing magnetic stripe technologies. Additional pressure was applied by the 15 states that have already enacted legislation mandating machine-readable health ID cards. Because this legislation was based in part on an NCPDP implementation guide that cards issued in accordance with INCITS 284 do not meet, the States are pushing for a revision of the standard before the January 2003 implementation deadline some of the legislatures face.

B10 wants the standard to be more flexible, said committee member Peter Barry, so that there is room for market forces to determine the storage technology that will best meet the health industry's needs.

According to Mr. Barry, the new draft of INCITS 284, which is currently under public review [Editor's note: Reference Standards Action, Vol. 33, #26 - August 9, 2002. Comments are due to ANSI by September 23, 2002], provides for greater flexibility and allows for the possible incorporation of future technologies now under development. Though the explicit requirement for a magnetic stripe on the card has been eliminated, the option to include this feature remains. Thus, a new, high-capacity magnetic stripe technology that is expected to emerge mid-2003 might be included on future cards. Other options that might be used instead of the magnetic strip include a two-dimensional symbol commonly referred to as "PDF417" (ANSI MH10.8.3M, ISO/IEC 15438). Though it looks similar to the "traditional" bar code used for most retail products, a PDF417 symbol contains extensive information encoded within the symbol itself and does not rely on real-time links to larger databases.

Currently, different hospitals and healthcare plans around the country use different cards with different technologies. There are, however, benefits that could be reaped from a standard patient information card that can be read by any hospital anywhere. A person from Vermont who has an accident while vacationing in Florida, for example, could receive more immediate and effective care if the doctors in the Florida hospital had instant access to the same information about the patient that his doctors in Vermont have.

With concerns about security and liability surrounding the developing area of medical identification cards, it will be some time before industry, the government and the public determine if the use of such cards will extend widely beyond current insurance and prescription drug plan applications, and what technology will be used if they do. The revisions to INCITS 284, however, may make it flexible enough to serve as a foundation as future applications emerge.

ANSI Nanotechnology Standards Panel