Mt. Sinai Medical Center looks to open standards for patient smartcards

Mt. Sinai Medical Center in New York City, which five years ago pioneered the practice of giving out a smartcard to patients to store identity and healthcare records, is realigning its focus to support open standards that could get other hospital systems supporting smartcards, too.

"Patients have wanted the cards and consider them an important credential," says Paul Contino, vice president of information system at Mt. Sinai Medical Center, which has issued about 14,000 of the smartcards to patients through the pilot program that started at the Elmhurst Hospital Center affiliated with Mt. Sinai's School of Medicine. Mt. Sinai Medical Center now plans a redesign of its patient smartcard to adhere to an open standard known as the "Continuity of Care Record" (CCR) with the anticipation that other medical institutions in the New York area and elsewhere might support patient smartcards, too.

The Mt. Sinai-issued smartcard, which stores the patient's personal information, lab results and other medical records, is updated every time the smartcard is placed in a card reader with access to the specialized database of the hospital information system which acts as the smartcard data repository.

"The idea now is to make this card-agnostic," Contino says, adding that the next effort is taking Mt. Sinai in the direction of open standards and the federal government's Personal Identity Verification (PIV) card now widely used by government employees.

If the federal government approved the idea, Mt. Sinai would like to be able to put a standards-based healthcare application on a PIV card, Contino says.

The immediate effort, though, entails Mt. Sinai switching to an XML-based standard called CCR that was jointly developed by several organizations, including ASTM International, Massachusetts Medical Society and HIMSS.

CCR isn't a federal-government standard but it is the most promising method that Mt. Sinai sees for storing patient medical records, Contino says.

Contino says Mt. Sinai will be steering its patient smartcard project toward using CCR, with the goal of also encouraging other hospital systems to adopt it in order to establish a multi-hospital system where different healthcare providers one day will be able to accept each other's issued patient smartcards for purposes of sharing patient-related data.

To date, there appear to be few patient smartcard projects in the United States, Contino says, but the potential is there to get hospitals to support them more widely through adherence to open standards.