Patient Demographics/Information

CDC comments for draft USCDI v8

CDC recommends the inclusion of Mother's Maiden Name in USCDI v8 as a patient demographic data element supporting immunization message exchange, for these reasons:
•    Established immunization core data element: Mother's Maiden Name is a core demographic data element used in CDC's IIS Core Data Elements framework, where it functions to validate patient identity and support accurate matching during immunization message exchange. It functions as a reliable additional attribute that improves identity resolution when used alongside other demographic data, particularly for neonates and infants who may not yet have stable or fully assigned identifiers.
•    Reduces duplication and misidentification: This element helps reduce duplicate records and mitigate misidentification risk, particularly in cases involving common names or shared birthdates.
•    Already mature, low-burden: Because it is already established as a core demographic data element in immunization information systems, its capture and exchange is both feasible and low-burden to implement.

Recommendation to ONC: Include Mother's Maiden Name in USCDI v8 as a required (rather than optional) data element, consistent with its treatment as a required element in immunization informatics. Standardize its capture to improve consistency and data integrity, and address edge-case handling (e.g., unknown, inapplicable, or withheld values) in accompanying implementation guidance. 

Additional comments from NCIRD-We recognize that a similar comment was previously submitted by NCIRD for USCDI v7, and that USCDI currently includes a "Previous Name" data element (Level 2) in the Patient Demographics/Information data class. We want to clarify why a distinct Mother's Maiden Name element is still needed:

"Previous Name" identifies a prior name of the patient themselves (e.g., following marriage, divorce, or legal name change). It cannot represent Mother's Maiden Name, which refers to the patient's mother — a separate individual — and is used specifically to support patient identity matching, particularly for neonates and infants who may not yet have stable identifiers of their own. Mother's Maiden Name is also a core demographic data element in CDC's IIS Core Data Elements framework, used to validate patient identity and support accurate matching during immunization message exchange, a use case "Previous Name" does not serve.

We recommend Mother's Maiden Name be included as a distinct data element from "Previous Name" for this reason, and continue to recommend it be treated as required, consistent with its role in immunization informatics, with implementation guidance addressing edge cases (unknown, inapplicable, or withheld values).

Level 2: Captured/stored/accessed in multiple production EHRs or other HIT modules from more than one developer

Use Case: Mother's Maiden Name plays an important role in immunization message exchange, where it functions as a core demographic data element used to validate patient identity and match records across Immunization Information Systems (IIS), EHRs, and other reporting sources. It is particularly valuable in neonatal and early-life care, where infants may not yet have stable or fully assigned identifiers, and in cases involving common names or shared birthdates, where it serves as an additional differentiator to reduce duplicate records and misidentification.
Because immunization records are reconciled across independently operated systems — providers, IIS, and public health agencies — this element strengthens data integrity and supports more effective coordination of immunization efforts, directly benefiting public health surveillance, reporting, and outbreak response activities that depend on accurate, deduplicated patient records.

Supporting artifacts links:

HL7 Version 2.5.1 Implementation Guide for Immunization Messaging (Release 1.5) — PD1 (Patient Demographic) segment, which includes the mother's maiden name field: https://www.cdc.gov/vaccines/programs/iis/technical-guidance/downloads/hl7guide-1-5-2014-11.pdf 

CDC IIS Core Data Elements — Patient Demographics/Information: https://www.cdc.gov/iis/core-data-elements/patient-demographics-information.html  

FHIR Mother's Maiden Name extension (base FHIR, not part of US Core): http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName   

Additional comments from CDC: Supporting links:
- HL7 v2.5.1 Implementation Guide for Immunization Messaging (PD1 segment): https://www.cdc.gov/vaccines/programs/iis/technical-guidance/downloads/hl7guide-1-5-2014-11.pdf 
- CDC IIS Core Data Elements — Patient Demographics/Information: https://www.cdc.gov/iis/core-data-elements/patient-demographics-information.html 
- FHIR Mother's Maiden Name extension: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName

CDC's comment for inclusion in USCDI v7

CDC recommends the inclusion of Mother's Maiden Name in USCDI v7. The inclusion of Mother’s Maiden Name is important for strengthening patient matching, particularly in neonatal and early-life care where infants may not yet have stable or fully assigned identifiers. The Mother’s Maiden Name is also a required immunization history core data element, as it is an important key to assuring an accurate match during immunization message exchanges. In these scenarios, it serves as a reliable additional attribute that improves identity resolution when used alongside demographic data.

This data element helps reduce duplicate records and mitigate misidentification risks, especially in cases involving common names or shared birthdates. It is already captured in many registration workflows, supporting its feasibility and implementation across systems.

Given ongoing challenges with patient matching and the need for more precise identification, Mother’s Maiden Name should be included as a required data element rather than optional, for better alignment with required standards practices in the immunization informatics field. Standardizing its capture would improve consistency, enhance data integrity, and support safer, more efficient information exchange across healthcare systems.

We strongly support its inclusion in USCDI v7 with appropriate guidance to ensure consistent and secure use.

CDC's comment for proposed inclusion in USCDI v7

We propose the inclusion of "Mother’s Maiden Name" as a data element in USCDI v7 due to its critical role in enhancing patient matching protocols, particularly in neonatal care where infants may not yet have an assigned name. This identifier serves as an essential reference point that improves the precision and reliability of patient identification across healthcare systems, especially in situations where standard identifiers, such as names or birthdates, may be insufficient.
The use of "Mother’s Maiden Name" is particularly valuable in mitigating misidentification risks, which can occur when patients share common names or birthdates. By providing an additional layer of identification, this data element helps ensure patient safety and reduces the likelihood of errors in clinical settings.
Incorporating "Mother’s Maiden Name" into patient records significantly reduces the incidence of duplicate records, a prevalent challenge that undermines administrative efficiency, data integrity, and clinical outcomes. As healthcare delivery becomes increasingly integrated and reliant on seamless information exchange, robust patient identification mechanisms are more crucial than ever.
Furthermore, the inclusion of "Mother’s Maiden Name" aligns with best practices in data management and patient safety initiatives. It supports compliance with regulatory requirements for accurate patient identification and enhances the overall quality of care by ensuring that healthcare providers have access to reliable patient information.
In addition to improving patient matching processes, this data element can facilitate better communication and coordination among healthcare providers, particularly in complex cases involving maternal and child health. It can also play a role in public health initiatives by aiding in the tracking of maternal and infant health outcomes.
We strongly advocate for the integration of "Mother’s Maiden Name" into USCDI v7 to strengthen patient identification efforts. Its adoption will substantially enhance the accuracy and security of patient matching processes, thereby fortifying the overall quality and safety of healthcare services.

CDC's Comment for draft USCDI v6

The inclusion of "Mother’s Maiden Name" as a data element in USCDI v6 is essential for reinforcing patient matching protocols, particularly in neonatal care where infants may not yet have an assigned name. The significance of “Mother’s Maiden Name” in patient matching and deduplication is highlighted in the publication titled "Consolidating Demographic Records and Vaccination Event Records," authored by the Modeling of Immunization Registry Operations Workgroup (MIROW) under the American Immunization Registry Association (AIRA). This identifier serves as a critical piece of information that enhances the precision and reliability of patient identification across healthcare systems, especially when standard identifiers fall short.

In scenarios where common names or birthdates are shared among patients, the mother's maiden name offers an invaluable additional reference point to mitigate misidentification risks and ensure patient safety. Incorporating "Mother’s Maiden Name" into patient records significantly reduces the incidence of duplicate records, addressing a prevalent challenge that compromises administrative efficiency, data integrity, and clinical outcomes.

As healthcare delivery becomes increasingly integrated and reliant on seamless information exchange, robust patient identification mechanisms become more crucial than ever. The integration of "Mother’s Maiden Name" into USCDI v6 will bolster these identification efforts. Its adoption will substantially elevate the accuracy and security of patient matching processes, thereby fortifying the overall quality and safety of healthcare services. Urgent consideration for this inclusion is recommended to enhance patient safety initiatives across healthcare systems.

Mother’s Maiden Name

The inclusion of "Mother’s Maiden Name" as a data element in the USCDI v6 is essential for reinforcing patient matching protocols, particularly in neonatal care where infants may not yet have an assigned name. The significance of “Mother’s Maiden Name” in patient matching and deduplication is highlighted in the publication titled "Consolidating Demographic Records and Vaccination Event Records " authored by the Modeling of Immunization Registry Operations Workgroup (MIROW) under the American Immunization Registry Association (AIRA). This identifier serves as a critical piece of information that enhances the precision and reliability of patient identification across healthcare systems, especially when standard identifiers fall short. In scenarios where common names or birthdates are shared among patients, the mother's maiden name offers an invaluable additional reference point to mitigate misidentification risks and ensure patient safety.

Incorporating "Mother’s Maiden Name" into patient records significantly curtails the incidence of duplicate records, addressing a prevalent challenge that compromises administrative efficiency, data integrity, and clinical outcomes. As healthcare delivery becomes increasingly integrated and reliant on seamless information exchange, robust patient identification mechanisms become more crucial than ever.

CDC strongly support the integration of "Mother’s Maiden Name" into USCDI v6 to bolster these identification efforts. Its adoption will substantially elevate the accuracy and security of patient matching processes, thereby fortifying the overall quality and safety of healthcare services.

CSTE Comment - v6

CSTE supports inclusion of this data element in USCDI V6. Please see previously submitted CSTE comments for additional recommendations.

CDC's Consolidated Comment for USCDI v5

• The "Mother’s Maiden Name" is a proposed vital data element for inclusion in the v5 USCDI, designed to bolster patient identification procedures, particularly for newborns who may not have a name assigned immediately after birth. This data element can significantly enhance the accuracy and security within healthcare systems by serving as an additional, reliable matching criterion for patient records. When standard identifiers such as name and date of birth are insufficient to differentiate between patients, the mother's maiden name can provide an additional layer of certainty, reducing the risk of misidentification and enhancing patient safety. This becomes especially critical in neonatal care settings, where precise identification is paramount for appropriate and timely care delivery. Moreover, "Mother’s Maiden Name" can be a powerful tool to prevent the creation of duplicate patient records. This pervasive issue contributes to administrative inefficiencies, data integrity problems, and potential errors in patient care. As healthcare systems evolve towards more integrated and interconnected models, the importance of precise and secure patient identification continues to grow. The inclusion of the "Mother’s Maiden Name" in the USCDI v5 is a practical, actionable step towards addressing these identification challenges, providing healthcare practitioners with a consistent and reliable means of matching patients to their medical records. We strongly advocate for incorporating the "Mother’s Maiden Name" data element into the USCDI v5, as it promises to markedly improve the reliability, security, and integrity of patient information across the healthcare spectrum.
• CSTE Comment: CSTE strongly agrees with CDC recommendation for this data element. 
• NACCHO Comment: Support - While LHDs will rely on the vital records systems for match verification, having this extra component will help ensure LHDs can verify any identification mismatch that occurs.

CDC's Consolidated Comment for USCDI v4

CDC continues to recommend inclusion of this high priority data element in USCDI v4

CDC's comment on behalf of CSTE

CSTE strongly recommends that mothers maiden name be moved into USCDI v3. This element is critical to include in eCR and ELR and is used heavily for person matching and deduplication as well as when requesting additional clinical information on a case of reportable disease. This element is in routine use in HIEs and for EHR to IIS data exchange.

Unified Comment from CDC

• Mother’s maiden name is a CDC immunization endorsed data element which is an important component of the medical records of infants and minors especially for those that may not yet have a name. The IIS uses this information to identify, prevent, and resolve duplicated and fragmented patient records using an automated process. This deduplication process, in turn, will help to ensure that the most accurate and up to date information is always available thereby improving data quality, clinical decision making and reporting quality measures (e.g, health disparities).
   
•  CSTE supports inclusion of this measure into USCDI v3: Inclusion of this element would be useful for patient matching/de-duplication