Private Universal Unique Person Identifier

Identify For Health and Well being

Our journey began in 2009 as a Non Profit which established a track record in 3 complementary areas of healthcare: providing healthcare, health technology, and health research.

We built a network of 25 healthcare facilities serving a population of over 30,000. We built a health technology information platform (Stone HMIS) to enable and track these health services and their outcomes, manage business processes and comply with regulatory standards. Stone HMIS was installed in 13 more Government and Faith Based facilities reaching 530,000 potential users of these facilities.

We could not uniquely and universally identify patients over the geographical stretch these facilities covered. We used NIST Biometric Imaging Software (NBIS) to design and build the private unique universal person identifier (PUUPID). We integrated PUUPID into Stone HMIS and have uniquely identified over 4000 individuals.

PUUPID is a numerical identifier that can be attached to any set of unique biometric features of an individual. It is designed to run in a batched manner between multiple client agents at facilities and a central cloud based implementation. With PUUPID, it is possible to secure, link and share health records and transactions supporting the interoperability of electronic health records (EHR) systems. PUUPID has the advantage of being used for automated, anonymous sub-population identification without undue territorial or administrative encumbrance as is often required in the delivery of healthcare. PUUPID empowers health services users to access, secure and authorize the use and sharing of their health information.

We aim to expand the use of PUUPID in healthcare, particularly with EHR, by introducing mobile device identification and use of card based verification for remote places where internet connectivity is not reliable.

We are have used existing NIST Biometric Imaging Software (NBIS) to create an automated identification and verification system for health services and applications where there is need for anonymous linked sub-population identification without undue territorial or administrative encumbrance. Our solution is built to integrate particularly into Electronic Health Records to facilitate interoperability of medical information systems.  

The central design tenet of PUUPID is de-identification of users for health services to facilitate the access, securing and sharing of data in electronic health record systems. There is no centralised storage of personally identifiable information, and any information that is stored in such a manner is minimal in accordance with the Safe Harbor method. Furthermore, where individual identity is required, at the point of care, expert identification method is required and has to be built into electronic medical record systems.

PUUPID is a numeric construct with at a minimum 19 digits constructed from a combination of numerical coding of year of birth, gender, country Global Administrative Units Layer (GAUL) code and a variable timestamp fragment at the time of identification. PUUPID is not designed to be remembered by its holder but to be retrieved by linkage with acquired biometric images from a card that requires biometric authentication.  

PUUPID is designed for integration to implementer identification and verification needs. It does not store core information that may vary from one place to the next such as name, place of residence or birth, biological correlates and so on. Such information can be collected, stored and linked at implementer level. PUUPID is a unique numerical identifier that is returned on providing a matching biometric image. These requests come from client agents that are recognized and authenticated to the PUUPID system. Thus individual countries and organizations can design a system that collects and submits biometric images to the system, which will process and return a numerical identifier. This numerical identifier can be written into cards that can be carried by individuals. To ensure that the cards are not faked, PUUPID should be written to a card that is read and authenticated using a biometric reader.  

Some programming skills are required for integration. PUUPID application programming interface consumes some basic information and biometric image needed in identity. Implementers can design a web-based or a desktop solution to consume the API. Solutions can be built to interface directly with the cloud implementation, or have a client server for batch processing and minimal polling of the central server. Data returned from the central can be stored for local identification and verification. Desktop or mobile clients can interface with a single client server via a web interface. Verification can be done using mobile biometric card readers.

PUUPID is designed to work with ANSI biometric standards, utilizing devices that are open and produce non-proprietary image to avoid vendor lock-in since the core need is to allow for interoperability of electronic medical records systems for secure access and sharing information. All the API are open and protected through Open Authentication protocol and require that devices that interact with the system be registered and known. For Stone HMIS, PUUPID is central to the implementation of shared medical records in line with the Fast Health Interoperability Resources (FHIR), underlining interoperability as the key driver in the design and implementation.

PUUPID operates in remote settings with unreliable internet connectivity. The process of identification and/or verification is batched, to overcome intermittent connectivity. A client server retains identification records that it has requested, minimising polling the central server. Identification, verification, sharing of medical records occurs asynchronously in batch mode. Use of mobile device identification and verification with biometric-based cards readers will enhance efficiency. Because PUUPID is not designed to be remembered but to be retrieved by linkage with acquired biometric images from a card with biometric authentication, it does not place any demand on low numeracy and literacy populations.  

We will avail PUUPID more widely available through Stone HMIS that already integrates the solution and will ensure its sustainability.

We will make it easier for verification using biometric enabled cards.

We aim to position PUUPID as a central resource for digital health interoperability, helping power shared health records.

We will continue our collaboration with the Ministry of Health and Counties, and with makers and distributors of devices that produce and write open ANSI standards for biometric images.  

Duke University, Fuqua School of Business,to define a business model for Stone HMIS;

International Transaction Clinic, Michigan: to draw up the legal and administrative structures for the hybrid relationship between Afya Research Africa and Ubuntu Health;

Turkana County, Homa Bay County, National Ministry of Health (Kenya) and County Innovation Challenge Fun: to pilot Stone HMIS and PUUPID and define interoperability strategies for eHealth solutions;

Integrated biometrics supply us with affordable and rugged biometric devices;

Google: providing cloud computing services for PUUPID

Afya Research Africa has build a reputable record of working with difficult to reach population in increasing access to healthcare. This is a facilitated by a diverse team of professionals: medical doctors, clinical officers, monitoring and evaluation, computer programmers, finance and supply chain, administrators and community health workers.

The developer team has 4 computer scientists and 2 medical doctors skilled in design, building and integration of hardware and software systems , and health informatics and epidemiology;

Afya Research Africa has an active board of management chaired that meets regularly to appraise the progress and strategy of the organization.

Afya Research Africa has diversified portfolio that compliment each other. We have set up 25 health facilities in partnership with communities. These facilities have been the primary consumers of our innovative solutions. To ensure sustainability, they are twinned with complimentary enterprises that include financial services (table banking and savings co-operative). Stone HMIS, our electronic medical records system, has credible leads of purchase by County Government Departments of Health. The revenue model includes licensing with annual prescription fees for Government establishment; perpetual license for private health providers and facilities on a freemium model with for purchase of premium services like PUUPID. Thirdly, have developed Stone consumer health based applications that will help providers connect and retain clients, but also clients to access relevant health information. The revenue model is based on fees for linking clients with health providers and earnings from advertisement by providers and health product dealers. These applications will need PUUPID for secure access, linkage and sharing of information. These applications and Stone HMIS will generate big data that will be used by providers to improve business intelligence and biomedical researchers at a premium.  

Potential partnership and networking from the challenge will be important in accessing technical and financial resources that we need in the growth of PUUPID

It will provide a forum to understand and align PUUPID with international standards on data security, ownership and sharing that is critical for health information communication technology. 

We will have an opportunity to learn from industry leaders and experts in digital identity.

Our capacity to implement a competitive digital identity for health will improve significantly

The are unclear standards and regulations specific to digital identity that can be overcome through policy and legal development

Devices for digital identity are expensive and trying them requires significant financial resources. Partnership with manufacturers and funders can help overcome this.

There is lack of skills due to paucity of implementation and low demand for digital identity. This can be alleviated by building capacity of system developers to build and integrate digital identity and policies to spur demand.

There is a general fear of digital identity associated mainly with the possibility of information theft. Positive media engagement can alleviate this.