Virtual patient identifier (vPID): Improving patient traceability using anonymized identifiers in Japanese healthcare insurance claims database

Objective: Japan's national-level healthcare insurance claims database (NDB) is a collective database that contains the entire information on healthcare services being provided to all citizens. However, existing anonymized identifiers (ID1 and ID2) have a poor capability of tracing patients' claims in the database, hindering longitudinal analyses. This study presents a virtual patient identifier (vPID), which we have developed on top of these existing identifiers, to improve the patient traceability. Methods: vPID is a new composite identifier that intensively consolidates ID1 and ID2 co-occurring in an identical claim to allow to collect claims of each patient even though its ID1 or ID2 may change due to life events or clerical errors. We conducted a verification test with prefecture-level datasets of healthcare insurance claims and enrollee history records, which allowed us to compare vPID with the ground truth, in terms of an identifiability score (indicating a capability of distinguishing a patient's claims from another patient's claims) and a traceability score (indicating a capability of collecting claims of an identical patient). Results: The verification test has clarified that vPID offers significantly higher traceability scores (0.994, Mie; 0.997, Gifu) than ID1 (0.863, Mie; 0.884, Gifu) and ID2 (0.602, Mie; 0.839, Gifu), and comparable (0.996, Mie) and lower (0.979, Gifu) identifiability scores. Discussion: vPID is seemingly useful for a wide spectrum of analytic studies unless they focus on sensitive cases to the design limitation of vPID, such as patients experiencing marriage and job change, simultaneously, and same-sex twin children. Conclusion: vPID successfully improves patient traceability, providing an opportunity for longitudinal analyses that used to be practically impossible for NDB. Further exploration is also necessary, in particular, for mitigating identification errors

Recommended configuration for personal health records by standardized data item sets for diabetes mellitus and associated chronic diseases: A report from Collaborative Initiative by six Japanese Associations

Abstract It is expected that a large amount of data related to diabetes and other chronic diseases will be generated. However, databases constructed without standardized data item sets can be limited in their usefulness. To address this, the Collaborative Committee of Clinical Informatization in Diabetes Mellitus was established in 2011 by the Japan Diabetes Society and Japan Association for Medical Informatics. The committee has developed core item sets and self‐management item sets for diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease in collaboration with the Japanese Society of Hypertension, Japan Atherosclerosis Society, Japanese Society of Nephrology, and Japanese Society of Laboratory Medicine, as well as a mapping table that aligns the self‐management item sets with the Japanese standardized codes for laboratory testing. The committee also determined detailed specifications for implementing the four self‐management item sets in personal health record (PHR) applications to facilitate risk stratification, the generation of alerts using information and communications technology systems, the avoidance of data input errors, and the generation of reminders to input the self‐management item set data. The approach developed by the committee may be useful for combining databases for various purposes (such as for clinical studies, patient education, and electronic medical record systems) and for facilitating collaboration between PHR administrators