Research Article OMICS International Chukwu, J Health Med Informat 2017, 8:3 DOI: 10.4172/2157-7420.1000267 Volume 8 • Issue 3 • 1000267 J Health Med Inform, an open access journal ISSN: 2157-7420 Journal of Health & Medical Informatics J o u r n a l o f H e a lth & M e d i c a l I n f o r m a t i c s ISSN: 2157-7420 Keywords: Master Patient Index (MPI); Digital identity; Patient identiier; ID; mHealth; Client registry; eHealth Introduction Health system in Nigeria is weak and faces many daunting challenges. Poor health indices persist despite huge investment in the last decade. Routine health [1,2] facility generated data oten cannot be relied on for planning or for critical decision-making. Health facilities are increasingly employing digital health tools with limited scalability. his holds true irrespective of any deinition of the word ‘scale’. Duplicate patient records have dogged the health system in general and digital tools in particular. Scalability of these tools has been hampered by lack of unique patient identity system [3]. Evidence show that the society’s most vulnerable remain the ones most without any form of Identiiers. hey are [4] oten inancially excluded, and do not have access to essential social beneits including health. Sustainable planning and deployment of other social services like housing, electricity, Internet, and water all requires citizen demographic information. here have been several cross- sector attempts to address this identity crisis in Nigeria and globally. his growing need was aptly highlighted in Sustainable Development Goal (SDG) target 16.9: “By 2030, provide legal identity for all, including birth registration” [5]. In addition, properly implemented and managed patient identiication schemes can signiicantly inluence attainment of under listed SDG targets amongst others. 1. Social Protection for the most vulnerable (SDG 1.3). 2. Access to economic resource including inance (SDG 1.4). 3. Assistance dealing with Shock and Social disaster (SDG 1.5). 4. Reduce Global MMR (SDG 3.1). 5. Ending preventable deaths of new-borns and under 5 (SDG 3.2). 6. Ending epidemics of AIDs, Malaria, neglected tropical diseases and combating hepatitis, water-borne and other communicable diseases (SDG 3.3). 7. Empower women (SDG 5a and SDG 5b). hese SDG targets afect directly or indirectly the health status of citizens. Digital identiiers have great potential in big data analytics, disease surveillance and other intelligent systems. Proper patient identiication ensures eicient care administration, and movement of patient information within and between healthcare organizations. Healthcare delivery involves many stakeholders with varying responsibilities. At the health facility level, wrong identiication has been linked to discharge of infants to wrong parents, testing errors, medication inaccuracies, wrong person procedures, and transfusion mistakes [6]. Without correctly identifying care beneiciaries, accountability will remain elusive. At organizational level, Health insurance claims and care administration continue to be prone to both errors and manipulation. A functional patient identiication system helps to ensure signiicant cost savings through waste reduction and duplicate treatments reduction. here are no accurate information on the cost and frequency of mismatch errors in health care delivery in Nigeria. What is clear is that a huge proportion of medical mistakes still occur in medical practice and most of are linked to this patient identity crisis. he UK government performed an audit on identity of patient and care administration in select hospitals, and found that 34% of patients did not have their identiiers on them [7]. he research found that even where identiiers exist, provider hand-overs and related communication challenges introduce chances of patient misidentiication. his readily points to the scale this can assume in low and middle-income countries most of which have not even deployed patient identiier strategy. Current Status Functional Identiication systems in Nigeria vary from civic registration of birth, election, inancial services, to mobile telephony identity schemes. At the same time, countries have various schemes for patient speciic identiiers depending on their level of advancement. *Corresponding author: Emeka Chukwu, M.Sc., Namek Solutions, Garki, Area 11, Abuja, Nigeria, E-mail: emekac@nameksolutions.com Received September 20, 2016; Accepted June 20, 2017; Published June 26, 2017 Citation: Chukwu E (2017) The Case for a Unique Digital Patient ID Scheme in Nigeria. J Health Med Informat 8: 267. doi: 10.4172/2157-7420.1000267 Copyright: © 2017 Chukwu E. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Uniquely identifying patients in the health system has eluded the Nigerian health sector players. Digital health tools are being deployed to address different challenges in the Nigerian health system with little showing any sign of scale. Despite global interest in digital identity system and its potential to improve health outcome, little progress has been registered in Nigeria. Nigeria has a convoluted patient identity system at the time of writing with patient identity local to health facility and sometimes department. Functional Identiication systems like civic registration of birth, election, and inancial services, to mobile telephony identity schemes are variously in place in Nigeria. These functional identity systems were reviewed for size of enrolees, data quality, and possibility of use as health functional identity system. Health sector stakeholders have two options to address the identity crisis. Either to adopt one of the existing functional identity systems or a combination of them or to setup a Master Patient Index (MPI) based client registry for the health system. This work having reviewed the factors necessary to adopt a functional identity system, recommends deployment of State based client registries as a way of addressing this challenge. The recommended framework of action is to develop a policy and strategy to guide implementation, implement as appropriate at different levels and then monitor while improving as appropriate. A good functional identity system will take into consideration necessary behaviour changes, staff workload, State autonomy, political interest, patient privacy, technology and return on investment concerns including total cost of ownership even for open source technology solutions. The Case for a Unique Digital Patient ID Scheme in Nigeria Emeka Chukwu* Namek Solutions, Area 11, Abuja, Nigeria