Mount Sinai's project doesn’t try to solve every piece of that puzzle at once. This project, for which development began about 2.5 years ago, focuses on data that's critical to urgent care, Contino says. Also, Mount Sinai's personal health cards don’t hold a complete medical history, just a medical snapshot that fits in 64K of memory. Over time, older data has to be rolled off the card to accommodate newer data.

What about privacy? Because the cards have tough triple DES-level encryption, plus require a PIN code, they're "useless" if lost, Contino says. While Mount Sinai's privacy officer was initially concerned about the smart card project, that changed when everyone involved agreed that a patient entering a PIN code while using the smart card met HIPAA requirements quite well, Contino says.

Mount Sinai offers patients the cards upon registration at the hospital, and at check-in time for follow-up visits.

For the hospital, the card system has the ability to reduce fraud, improve revenue cycles through the reduction of registration errors, and boost quality of patient care. For patients, the card has the ability to speed check-in and supply some peace of mind.

Why is positive identification so key for a hospital like Mount Sinai? One example: In densely-populated New York, where some names are very common, the hospital could have dozens of patients with the same name. When a patient named Maria Gonzales comes into the ER, they'd like to match her to the right history and paperwork. In other cases, patients may try to defraud the system by presenting someone else's insurance card.

Process-wise, Mount Sinai has some 40 systems into which medical records flow; getting those records right upon registration saves work later.

Adding to the potential for errors, registration staffers face a high workload, for one of the hospital's lower-paying jobs. The positions have high turnover rates.

The hospital has tried to improve the registration process by improving training, Contino says, but this didn’t pan out. "Training was a continuous burden," he says. "Doing more wasn't benefiting us." The smart cards, he says, made sense to these staffers. "Immediately, people saw the tremendous advantage," Contino says, both for saving time and preventing mistakes during patient check-in.

Connecting Hospitals Affordably

This pilot project isn’t just about Mount Sinai: From the start, the hospital saw benefit in sharing data with its local peers, Contino says. To date, Mount Sinai has signed up 10 tri-state area hospitals in an open network, called the HealthSmart Network, to use the cards to share patient data. One benefit of that network arrangement: If you are taken to Elmhurst Hospital in Elmhurst, Queens, suffering chest pains, and you had a heart attack at Mount Sinai's ER in Manhattan a month ago, the Elmhurst staff can know immediately, from reading the history on your card, Contino says.