1.4. Patient/subject identification in CamCOPS

1.4.1. Overview

CamCOPS is intended for use in a variety of situations, ranging from anonymous or pseudonymous use (in which subjects are identified only by a code) through to full identifiable clinical data (in which subjects must typically be identified by multiple identifiers for safety).

We can use the phrase “identification policy” to describe what set of information is required in a particular scenario.

A single instance of CamCOPS supports multiple groups, and each group can have its own identification policies. Thus, for example, a pseudonymous research study can co-exist with identifiable records. See Groups for more detail.

1.4.2. Patient identification fields

CamCOPS includes the following patient identification/information fields. Not all need be used.

  • Forename
  • Surname
  • Sex (one of: M, F, X)
  • Date of birth
  • ID numbers(s), which are flexibly defined (see below)
  • Address (free text)
  • General practitioner’s (GP’s) details (free text)
  • Other details (free text)

All may be selected as part of the minimum patient identification details. What counts as the minimum is configurable. Furthermore, the meaning of the ID numbers is entirely configurable. Below we explain the purposes of this system.

When writing an ID policy, use the following terms:

Term Meaning
idnum<n> The ID number of type n, e.g. idnum3 means ID number type 3
anyidnum Whether any ID number type is present
otheridnum Whether any ID number type is present, that is not specifically mentioned in the policy
forename Forename
surname Surname
dob Date of birth
sex Sex
address Address
gp GP details
otherdetails Other details

New in version 2.2.8: otheridnum, address, gp, and otherdetails were added in CamCOPS v2.2.8.

1.4.3. Configuring the meaning of the ID number fields

Your institution will use one or more ID number fields. For example, in the UK NHS, every patient should have a unique nationwide NHS number. Most NHS institutions use their own ID as well, and some specialities (such as liaison psychiatry) operate in multiple hospitals. Research studies may use a local, idiosyncratic numbering system. Configure the meanings of up to 8 numbering systems (see server configuration.)

The first ID number is special in only one way: the web viewer’s drop-down ID selector will default to it. So, pick your institution’s main ID number for this slot; that will save your users some effort.

Todo

Have the default ID number type configurable per group?

1.4.4. Uploading and finalizing policies

The server supports two ID policies: an upload policy – the minimum set of identifying information required to upload information to the server – and a finalizing policy – the minimum set of identifying information required for a tablet to “sign off” and transfer all its information to the server (after which the tablet app can’t edit that information).

The policies you require depend on your institution. Some examples are given below.

You can configure the policies using brackets ( ), AND, OR, NOT, and any of the fields listed above. Some examples are shown below. Configure the policies using the Group management option on the server main menu.

New in version 2.2.8: NOT was added in CamCOPS v2.2.8.

1.4.5. Examples

1.4.5.1. Example 1: clinical, multi-site

Suppose we have a mental health NHS Trust – call it CPFT – with its own hospitals that provides liaison psychiatry services in four other hospitals. We might use the following IDs:

ID number Description Short description
1 CPFT RiO number CPFT RiO
2 NHS number NHS
3 CPFT M number CPFT M
4 Addenbrooke’s number Add
5 Papworth number Pap
6 Hinchingbrooke number Hinch
7 Peterborough City Hosp number PCH

and these policies:

Upload policy

forename AND surname AND dob AND sex AND anyidnum

Finalize policy

forename AND surname AND dob AND sex AND idnum1

This would allow users to enter information while sitting in Addenbrooke’s Hospital and in possession of the forename, surname, DOB, sex, and Addenbrooke’s hospital number. Equally, the same would be true at any other of the hospitals; or the NHS number could be used.

The user could then print out the information (from the CamCOPS webview PDFs) for the Addenbrooke’s records, or store an electronic copy.

Once back at a CPFT office, the CPFT number(s) could be looked up, or created, and entered into the CamCOPS tablet application (by editing that patient’s details).

Only once this is done will the CamCOPS software allow a “final” upload (an upload that moves rather than copies).

“Final” records would then conform to a hypothetical CPFT policy of requiring a CPFT RiO number for each record, as well as basic information (forename, surname, DOB, sex).

An alternative organization might standardize upon NHS numbers instead, and edit its finalizing policy accordingly.

1.4.5.2. Example 2: research

Suppose we’re operating in a very simple research context. We don’t want patient-identifiable data on our computers; we’ll operate with pseudonyms (codes for each subject). We might have a separate secure database to look up individuals from our pseudonyms, but that is outside CamCOPS. We might have the following identifiers:

ID number Description Short description
1 Research ID number RID

Upload policy

sex AND idnum1

Finalize policy

sex AND idnum1

This requires users to enter the subject’s sex and research ID only.

1.4.5.3. Example 3: research hosted by a clinical institution

Suppose you’re a research group operating within a clinical institution, but collecting data (under appropriate ethics approval) for research purposes. You may want to use patient-identifiable data or pseudonyms. You will want full read access to your data (likely at the SQL level), but you shouldn’t have full read access to all patients at that institution.

There are at least three possible approaches. You could set up a new server, or you could add a second CamCOPS database to your existing server, or you can simply add a new group to your CamCOPS server. The last is likely to be quickest and best.

1.4.5.4. Example 4: research where personal identifying data (PID) is prohibited

Compare example 2, but now you want to try to enforce a “no PID” rule. This is not completely enforceable by a computer, because some CamCOPS tasks allow free text, and wherever there is free text, somebody could type in sensitive information. However, the following method can certainly help:

sex AND idnum1 AND NOT (otheridnum OR forename OR surname OR dob OR address OR gp OR otherdetails)

This will stop users uploading information with any PID in the Patient table, if idnum1 is a non-identifying pseudonym for the study.

New in version 2.2.8: NOT and some other tokens were added in CamCOPS v2.2.8; see above.

1.4.6. Minimum details required by the tablet software

The tablet’s internal minimum identification policy, which is fixed, is:

sex AND ((forename AND surname AND dob) OR anyidnum)

This allows either a named (forename, surname, DOB, sex) or an anonymous/pseudonym-based system for research (sex plus one ID number), or any other sensible mixture as above.