Nashville Hospital Sings Praises of Smart Patient ID Card

June 3, 2005
Card not only facilitates check-in, but also ensure security of records

Typically, health care institutions and insurance providers issue plain plastic cards with a patient's bare-bones information printed on the face. This leads to patients having to fill out lengthy forms when checking into the hospital or seeing a new doctor.

To ease this time- and paper-intensive process, Saint Thomas Hospital in Nashville, Tenn., is issuing smart cards that store a patient's personal information. To ensure privacy, the data can only be accessed after a cardholder enters a personal identification number at a card reading station, says Chris Young, CIO.

The main purpose of the cards is to facilitate patient check-in. Instead of the 20 minutes it typically takes a patient to fill out the proper forms, the smart card can populate the information in seconds. There also are fewer errors, because hospital clerks need not reenter data from the patient's form. "We want to get the upfront information as accurately as possible," Young says.

Since announcing the new program, insurance carriers, provider organizations, financial institutions and others have approached Young about adding functionality to the card. "The consumer slant to this is very good," he says. "There could be an interesting tie-in with banking." Consumers, for instance, could add bank card information to the smart card and have insurance co-pays automatically charged or debited.

Insurance providers are interested because the program could potentially hinder fraud, Young says. Because a patient's photo is printed on the card, the patient would not be able to give it to someone else for access to medical care. Further, the PIN offers another form of authentication for a cardholder and would unlock the information stored on the card and in the central database.

But it may be some time before additional applications are added to the card. Saint Thomas wants to make sure the basic functionality works first. For now, the new cards store a patient's demographic, insurance and emergency contact data, and basic medical information, such as allergies, Young says. All the information is entered through a Web-based interface and then loaded on the card.

The card body includes the patient's photo and name. While information will be stored on the card, some data will remain in an electronic database, he says. The card will act as an electronic key to access the records.

Thus far, 300 cards have been issued, primarily in the Women of Heart program. All told, 2,000 cards will be issued in the pilot program. The pilot is scheduled for three to six months, with a decision on a full rollout expected around October. The pilot is voluntary but patient reception has been positive, Young says. "They really feel that this is a time saver."

The program has attracted a bit of media attention in the Nashville area and some patients have been calling to inquire about enrollment. Men have even indicated a willingness to carry the not-so-masculine purple card with the Women of the Heart logo, Young says. But the project so far has been limited to the Women of Heart program, which screens women over 40 for heart disease.

At first, the cards will be used only at the hospital or affiliate heath care centers. But eventually Saint Thomas will give patients smart card readers and allow them to use the card for online access to check medical files and gain access to other information, Young says. The hospital might also include biometrics in future card rollouts in a couple of years.

To date, Saint Thomas has spent $100,000 on the project, with the majority of the cost related to developing applications for the cards, Young says. For a full rollout, including future advancements, the project is expected to cost between $600,000 and $700,000, he says.

The hospital has been experimenting with different size memory on the chips, Young says. He is working with Nashville-based JV Powers & Co., a systems integrator, on developing the program.

Young says other technologies also were examined before deciding to go with smart cards. Magnetic stripe cards didn't have enough storage capacity and an online database would have been difficult to protect and maintain, he says. USB tokens were considered but deemed impractical. "If it can't fit in your wallet, patients don't want it," he says.

Saint Thomas plans to offer its partners, such as financial institutions and insurances companies, the ability to add applications to the card, Young says.