Two advocacy organizations are calling for adoption of existing federal standards for smart cards before investing stimulus funds in electronic health records adoption via the Medicare and Medicaid incentives.
Plans under the American Recovery and Reinvestment Act that emphasize electronic health record exchange are putting the cart before the horse because effective identity management is needed first, contends the Smart Card Alliance's Healthcare Council. 
"As we move away from paper-based medical records that are controlled by physical access to buildings, rooms and files, we need to have a healthcare infrastructure that supports strong identity and security controls," says Paul Contino, chair of the council and vice president of information technology at Mount Sinai Medical Center in New York. "The issues with establishing identity are compounded as electronic medical records are used by many different organizations, at the regional, state and national levels. There must be a way to uniquely and securely authenticate each person across the healthcare infrastructure, whether that interaction is in person or over the Internet."
The Smart Card Alliance, along with Identity Councils, a separate organization that works to address the challenges of securing identity information and reducing identity fraud, have published a position paper on how smart cards can support the requirements and goals of the stimulus law. Creating a health care identity management infrastructure based on smart card technology, leveraged with existing standards, would enable proper identification of patients, providers and records, according to the position paper.
The paper is available at
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