The Implementation of Federated Digital Identifiers in Health Care: Rapid Review

BackgroundFederated digital identifiers (FDIs) have been cited to improve the interoperability of data and information management while enhancing the privacy of individuals verifying their identity on the web. Many countries around the world have implemented FDIs in various s...

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Main Authors: Karishini Ramamoorthi, Vess Stamenova, Rebecca H Liu, Onil Bhattacharyya
Format: Article
Language:English
Published: JMIR Publications 2024-02-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2024/1/e45751
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author Karishini Ramamoorthi
Vess Stamenova
Rebecca H Liu
Onil Bhattacharyya
author_facet Karishini Ramamoorthi
Vess Stamenova
Rebecca H Liu
Onil Bhattacharyya
author_sort Karishini Ramamoorthi
collection DOAJ
description BackgroundFederated digital identifiers (FDIs) have been cited to improve the interoperability of data and information management while enhancing the privacy of individuals verifying their identity on the web. Many countries around the world have implemented FDIs in various sectors, such as banking and government. Similarly, FDIs could improve the experience for those wanting to access their health care information; however, they have only been introduced in a few jurisdictions around the world, and their impact remains unclear. ObjectiveThe main objective of this environmental scan was to describe how FDIs have been established and implemented to enable patients’ access to health care. MethodsWe conducted this study in 2 stages, with the primary stage being a rapid review, which was supplemented by a targeted gray literature search. Specifically, the rapid review was conducted through a database search of MEDLINE and Embase, which generated a list of countries and their services that use FDIs in health care. This list was then used to conduct a targeted gray literature search using the Google search engine. ResultsA total of 93 references from the database and targeted Google searches were included in this rapid review. FDIs were implemented in health care in 11 countries (Australia, Belgium, Canada, Denmark, Estonia, Finland, Iceland, Norway, Singapore, Sweden, and Taiwan) and exclusively used with a patient-accessible electronic health record system through a single sign-on interface. The most common FDIs were implemented nationally or provincially, and establishing them usually required individuals to visit a bank or government office in person. In contrast, some countries, such as Australia, allow individuals to verify their identities entirely on the web. We found that despite the potential of FDIs for use in health care to facilitate the amalgamation of health information from different data sources into one platform, the adoption of most health care services that use FDIs remained below 30%. The exception to this was Australia, which had an adoption rate of 90%, which could be correlated with the fact that it leveraged an opt-out consent model. ConclusionsThis rapid review highlights key features of FDIs across regions and elements associated with higher adoption of the patient-accessible electronic health record systems that use them, like opt-out registration. Although FDIs have been reported to facilitate the collation of data from multiple sources through a single sign-on interface, there is little information on their impact on care or patient experience. If FDIs are used to their fullest potential and implemented across sectors, adoption rates within health care may also improve.
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spelling doaj.art-c00666fa85374c7d8f67094ba1da42102024-02-08T15:45:34ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-02-0126e4575110.2196/45751The Implementation of Federated Digital Identifiers in Health Care: Rapid ReviewKarishini Ramamoorthihttps://orcid.org/0000-0002-7066-0560Vess Stamenovahttps://orcid.org/0000-0003-3252-7766Rebecca H Liuhttps://orcid.org/0000-0002-3946-4035Onil Bhattacharyyahttps://orcid.org/0000-0001-5219-7288 BackgroundFederated digital identifiers (FDIs) have been cited to improve the interoperability of data and information management while enhancing the privacy of individuals verifying their identity on the web. Many countries around the world have implemented FDIs in various sectors, such as banking and government. Similarly, FDIs could improve the experience for those wanting to access their health care information; however, they have only been introduced in a few jurisdictions around the world, and their impact remains unclear. ObjectiveThe main objective of this environmental scan was to describe how FDIs have been established and implemented to enable patients’ access to health care. MethodsWe conducted this study in 2 stages, with the primary stage being a rapid review, which was supplemented by a targeted gray literature search. Specifically, the rapid review was conducted through a database search of MEDLINE and Embase, which generated a list of countries and their services that use FDIs in health care. This list was then used to conduct a targeted gray literature search using the Google search engine. ResultsA total of 93 references from the database and targeted Google searches were included in this rapid review. FDIs were implemented in health care in 11 countries (Australia, Belgium, Canada, Denmark, Estonia, Finland, Iceland, Norway, Singapore, Sweden, and Taiwan) and exclusively used with a patient-accessible electronic health record system through a single sign-on interface. The most common FDIs were implemented nationally or provincially, and establishing them usually required individuals to visit a bank or government office in person. In contrast, some countries, such as Australia, allow individuals to verify their identities entirely on the web. We found that despite the potential of FDIs for use in health care to facilitate the amalgamation of health information from different data sources into one platform, the adoption of most health care services that use FDIs remained below 30%. The exception to this was Australia, which had an adoption rate of 90%, which could be correlated with the fact that it leveraged an opt-out consent model. ConclusionsThis rapid review highlights key features of FDIs across regions and elements associated with higher adoption of the patient-accessible electronic health record systems that use them, like opt-out registration. Although FDIs have been reported to facilitate the collation of data from multiple sources through a single sign-on interface, there is little information on their impact on care or patient experience. If FDIs are used to their fullest potential and implemented across sectors, adoption rates within health care may also improve.https://www.jmir.org/2024/1/e45751
spellingShingle Karishini Ramamoorthi
Vess Stamenova
Rebecca H Liu
Onil Bhattacharyya
The Implementation of Federated Digital Identifiers in Health Care: Rapid Review
Journal of Medical Internet Research
title The Implementation of Federated Digital Identifiers in Health Care: Rapid Review
title_full The Implementation of Federated Digital Identifiers in Health Care: Rapid Review
title_fullStr The Implementation of Federated Digital Identifiers in Health Care: Rapid Review
title_full_unstemmed The Implementation of Federated Digital Identifiers in Health Care: Rapid Review
title_short The Implementation of Federated Digital Identifiers in Health Care: Rapid Review
title_sort implementation of federated digital identifiers in health care rapid review
url https://www.jmir.org/2024/1/e45751
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