The Standard

The Official Blog of Health Level Seven® International


Scaling Patient Identity Solutions: The Role of FAST Interoperable Digital Identity and Patient Matching Implementation Guide

[fa icon="calendar"] Jun 18, 2024 11:24:49 AM / by FAST Project Management Team

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In the realm of healthcare, accurately managing patient identities across various systems is pivotal. The FHIR at Scale Taskforce (FAST) has developed the Interoperable Digital Identity and Patient Matching implementation guide (FAST Identity IG) to address these challenges effectively. This blog delves into the nuances of this implementation guide and encourages participation in its continuous improvement. 

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Exploring the FAST Identity Implementation Guide 

The FAST Identity IG aims to enhance the FHIR patient $match operation for use in cross-organizational workflows. It serves as a comprehensive set of best practices not only for transactions directly invoking $match but also for other healthcare transactions that require robust identity matching and management.

The FAST Identity IG has developed three distinct types of Patient Resource profiles designed to enhance patient-matching workflows across various healthcare settings. These profiles incorporate different levels of demographic information, all of which must be verified prior to use in matching processes. To ensure clarity and effectiveness in patient matching, an output score is also generated to explicitly communicate the strength of each match. This structured approach aims to standardize patient matching procedures and improve their reliability. 

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Key Components of the Guide 

The FAST Identity Implementation Guide has introduced critical enhancements in the realm of patient identity management. A significant aspect of this guide is the establishment of the HL7 Digital Identifier, a new standard aimed at reducing matching errors by focusing on digital identifiers rather than demographic data. This identifier is highly reliable for person matching because it is uniquely associated with an individual and is the result of identity verification at a strong level of identity assurance, providing a higher confidence level in matching and identity resolution. 

Furthermore, the guide specifies how the HL7 Digital Identifiers, along with other types, can be utilized within health records to enhance the accuracy of matching processes. It also sets forth identity assurance levels that are appropriate for both individual and organizational credentials as part of the broader FAST Security Implementation Guide framework. This approach not only streamlines patient matching but also fortifies the security and integrity of digital identities in healthcare. 

 The FAST Identity IG's STU2 efforts focus on refining patient identity management strategies and improving interoperability through ongoing discussions and developments: 

  • Differentiating User and Patient Roles: Ongoing discussions aim to address and manage the distinct roles of users and patients, particularly concerning patient representatives. 
  • Organizational Identity Representation: Exploring how organizational identities can be represented using digital certificates containing verified attributes and unique identifiers, bringing transparency and confidence to transactions through identity verification events incorporating this standard. 
  • Enhanced Historical Data Usage: Guidance is being developed on utilizing historical demographic data to fill gaps and further improve matching by emphasizing the importance of a longitudinal address record for successful patient matching, particularly helpful when older records are sought. 
  • Testing and Collaborative Review: The recent FHIR Connectathon tested the new RI and scripts. The team is preparing to review overlaps between the FAST Identity IG and the Da Vinci HRex member match profile, seeking insights into their similarities to enhance future updates. Please email if you’re interested in collaborating on this review.  

Implementation and Use Cases 

The guide outlines various healthcare scenarios, including provider-to-provider exchanges, vaccine credential initiatives, and consumer-directed healthcare data access. These scenarios emphasize the importance of secure and reliable patient identity management.  

Join Us in Testing!  

To further refine the FAST Identity Implementation Guide, we invite stakeholders to participate in upcoming Connectathons. This is an excellent opportunity for healthcare professionals, IT experts, and organizations to contribute to advancing patient identity management. 

The FAST Identity Implementation Guide is a crucial step toward more secure and efficient healthcare systems. By taking part in the Connectathon, you can contribute to shaping the future of healthcare interoperability and patient safety. 

For more information or to participate in the Connectathon, please reach out to the FAST team at We’re also noting implementer adoption levels and appreciate any information you can share about where FAST Identity appears on your product roadmap. 

Your insights and knowledge can help enhance the guide and ensure it meets the evolving needs of the healthcare industry. Join us in this important endeavor! 

Topics: FHIR, FHIR Accelerator, FAST, FHIR Implementation Guides, FHIR Community, HRex, FAST Security, FAST Identity

FAST Project Management Team

Written by FAST Project Management Team

The FHIR at Scale Taskforce (FAST) identifies HL7 Fast Healthcare Interoperability Resources (FHIR) scalability gaps, defines solutions to address current barriers, and identifies needed infrastructure for scalable FHIR solutions.

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