Multiples and software identity management

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Categories Childcare, Family, Parenting

My husband Jon works in an increasing popular sector of software development called identity management. If you’ve ever been billed by a hospital, you know you can end up as a patient in the hospital database, the surgeon database, the customer care database, on and on.  This happens in many situations, not just hospitals, because software systems are not always integrated (their computer systems can not talk to each other). Jon’s company’s software helps customers determine unique people in those databases – for example, this person in the surgeon database is the same person in the customer care database – and links the databases together so they can communicate.

Since I share a small home office with Jon, I overhear a lot of his (boring) conversations. The most frequent conversation is what makes a person unique. In most software systems, name, date of birth, gender, mother’s name, and social security number (SSN) make a person unique. Many of his work conversations turn to twins.

In most cases, twins share a date of birth and mother. Their SSNs are usually so similar that a one digit difference could be someone fat-fingering the number. If there is no SSN available, most systems use the mother’s SSN, further confusing matters. Gender is the same for same-sex twins, but even boy-girl twins could be a user entry error. Frequently, the most unique item about a same-sex twin… from the standpoint of a computer system… is their name.

One real-world example of similarly-named multiples is boy-girl twins Alexandro and Alexandra. In that case, they were different genders but their names were so similar it could have been a typo. In the computer system, this was flagged as “possibly the same person” and someone had to manually review the record. In a less complex computer system, these two patients could be considered one person. That’s scary to me from a medical standpoint!

This can happen with differently-named multiples when software systems rank date of birth as “more unique” than name. Cynthia mentioned in a post last week that she always has an issue at her pharmacy filling prescriptions for both twins because they consider her boys the same person. Her twins are named Aaron and Brady – not even close!

In an era where computers are used to manage everything from billing records to patient history to school grades, I found this a fairly thought-provoking real-world application of having twins.

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7 thoughts on “Multiples and software identity management”

  1. I’m happy to say we’ve had no problems at all so far – either with the hospital billing at the beginning or with other medical issues later on. But as their SSN is only one digit off, I can see it happening at some point.

  2. I had my twins on the same date (imagine that!), they are boy and girl, their names begin with M and the other with H. In addition to the financial analyst and risk management hats that I wear at work, I also wear the one for benefits administration. In other words, I DO/CHOOSE THE INSURANCE. So you can bet I had everything planned ahead of time with the brokers when the kids were born. So within a week of their birth, I received updated insurance cards with both their names on them. Check the box for Accomplished. Soon after, they both developed acid reflux. I got an Rx from the doc for Prevacid. They called it in. When I went to pick it up, I paid $25 for M’s prescription, and $175 for H’s. Why? Because the Rx plan, the plan under the same company as their medical insurance, couldn’t find that H existed. The same H that they had sent me an insurance card for. We got it worked out (and I got reimbursed), but crazy!

  3. I work in Identity Management too. We’ve had cases where one person gave us their sibling’s social security number, and the wrong person was admitted to our university. We had one case where our staff spent a couple of days determining someone was one person or two, because they had the same last name and birthdate, but different first names. They turned out not to be boy-girl twins, but a person born male who’d undergone surgery to become female. I have to explain to people on a daily basis that a name alone isn’t enough to uniquely identify people in a system that tracks millions of people. In Texas, Maria Gonzalez is a really common name!

    Every time my girls get their shots, I have to call the state to explain to them that there are TWO people and that they did in fact receive copies of the shot records and should really really look at the first names. But hey, the joys of identity management keep me on my toes!

  4. It is scary. My insurance company denied all the charges for one of my twins when he was born…they claimed the hospital had double billed everything. So then the hospital tried to collect from me. It took AGES for me to get it all cleared up: yes, there were double charges…because there were TWINS!

    Now I’m getting asthma education information addressed to my son who DOESN’T have asthma. I’m sure, somewhere along the line, they keyed in the asthma information for the wrong twin. I’m still weaving my way through the insurance maze to get that one corrected.

  5. Okay, yet another reason I am glad my twins do not share the same birthday. They are only an hour apart, but on either side of midnight.

  6. My mom and I actually have the same name, and my middle name is her maiden name, and she carried me on her health insurance, so there was confusion. What’s even better is that I found some of her old credit cards on my credit report. It didn’t seem possible that I could’ve opened a Sears card when I was 8! So do your kids a favor, give them their own identity.

  7. We had Finn and Reid circumcised one day prior to their discharge. For whatever reason, they denied Reid’s circumcision (but covered Finn’s) on the grounds that ‘circumcisions are only performed once’. It took me nearly 3 months to straighten the mess out.

    We’ve had several incidences (when both kids get antibiotics, etc.) where having more than one kid on the same day really messes with insurance coverage.

    Can Jon fix it? :)

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