I walk into too many clinics where the phones keep ringing, the portal queue grows, and a telehealth patient is on hold while staff scramble to confirm who is who. That is the moment identity proofing rises from an abstract standard to the guardrail that keeps access safe, throughput steady, and staff workload sane.
Identity problems slow care, frustrate patients, and trigger rework. When intake is uncertain, staff spend time chasing documents instead of moving the visit forward. When messaging lives in silos, teams miss callbacks or duplicate work. A practical way to shrink that chaos is to adopt a standard that raises confidence in who is at the other end of the line, whether that is a patient or a provider. IAL2 does exactly that, it requires verified evidence and proof of control before higher risk actions proceed.
You already know the downstream ties. A verified identity supports cleaner scheduling and authorization tasks, smoother referrals, and safer notes access. This is where a unified communications and intake approach pays off. If your operation is moving toward a unified inbox and AI intake automation, both integrated with the record of truth, you can bind IAL2 outcomes to everyday workflows. That is the design behind Solum Health, one platform for outpatient facilities, specialty ready, with measurable time savings. To see how data moves, browse EHR PM system integration and EHR inbox integration. For governance and privacy language, see patient communications governance, secure email for patient communications, and practical intake articles like referral intake and front office automation.
NIST Identity Assurance Level 2, often shortened to IAL2, is a formal level defined in the NIST Digital Identity Guidelines. At IAL2, an organization collects reliable identity evidence, validates that evidence, and confirms that the applicant controls the identity. This can happen remotely or in person, with or without a representative in attendance, as long as the verification steps meet the standard. For authoritative language, see NIST SP 800 63A.
IAL2 is not a single tool, it is a set of requirements you can implement in different ways. The pattern is consistent, select acceptable evidence, validate it, confirm the person controls it, then bind that proof to the account or credential you will use later.
Create a written policy that lists which identity evidence you accept, for example a passport or a driver license, and which corroborating checks you will run, for example authoritative database lookups. NIST classifies evidence by quality, so align your choices with that taxonomy. If the action carries higher risk, such as access to sensitive notes, require stronger evidence. Parsimony is useful in storage, not in the initial proofing bar.
IAL2 supports remote proofing when you include robust ownership checks. Typical controls include image capture of the document, biometric comparison of a selfie to the document photo, liveness detection, and corroboration against authoritative sources. Some clinics prefer attended remote sessions, a live agent supervises the proofing, when policy or risk appetite calls for extra friction. If your setting allows in person verification for specific steps, write that option into policy and keep the experience consistent across locations.
After you validate the evidence, confirm the applicant controls the identity. Techniques include one time verification to a known point of contact, biometric match to the captured document, or cryptographic verification if you accept mobile credentials. Then bind the verified identity to a persistent account or a token that your systems can consume. Store only what you need to satisfy audits and local retention rules.
Proofing without integration is busywork. Map IAL2 results to access policies in your EHR, PM, and portal. Ensure the session knows the assurance level and that sensitive actions require it. Log every proofing event, document exceptions, and give staff simple language on what to do when a proofing step fails. If you want a quick primer on connecting identity to message flow, scan AI driven patient communications.
Do not store more data than you need, write a data minimization rule and live by it. Do not let each location write its own exceptions, give them a single playbook with clear escalation paths. Do not assume a vendor workflow equals IAL2, validate the specific controls against the standard. Finally, do not bolt identity proofing onto a silo, connect it to the systems that schedule, authorize, and message, or staff will feel like they are double documenting.
Q1, What is the key difference between IAL1 and IAL2? IAL1 involves minimal or no identity proofing. IAL2 requires verified evidence and proof of control, which raises confidence and reduces impersonation and matching errors.
Q2, Can a clinic meet IAL2 through a fully online process? Yes, when the remote workflow uses approved evidence, validation, and ownership checks. Examples include biometric comparison, liveness detection, and authoritative data corroboration. The standard allows remote, on site, and attended or unattended variations, see NIST SP 800 63A.
Q3, Do we need special hardware to meet IAL2? Not necessarily. Many implementations rely on consumer mobile devices for capture and comparison. Some organizations use dedicated readers when policy requires it, but it is not a universal prerequisite.
Q4, How does IAL2 support HIPAA related goals? IAL2 strengthens identity assurance, which helps ensure only authorized people access protected information. While IAL2 is not a HIPAA mandate, the controls align with common administrative and technical safeguards.
Q5, Are mobile driver licenses or verifiable credentials acceptable for IAL2? They can be, if your process can validate their authenticity and provenance to the level NIST specifies. Follow the evidence quality and cryptographic verification guidance in the standard.
First, name the actions that require higher assurance, for example portal enrollment, telehealth session access, sensitive note retrieval, and prescription requests. Second, publish your evidence policy and select a workflow, remote, attended remote, or in person, that matches your risk map. Third, connect the outcome to your systems, if you are already moving toward a unified inbox and AI intake automation, bind the IAL2 flag to role based access in the EHR and the portal. Fourth, train staff with a simple script for exceptions, and document data retention. Fifth, monitor results, measure response time and rework, compare pre and post. If you want a quick benchmark on breach economics to frame the investment discussion, the Cost of a Data Breach Report summarizes trends that continue to put healthcare at the top of the risk ledger.
You do not need to do everything at once. You do need to pick a starting point that matters for your patients and your staff, then make sure proofing and messaging live in the same workflow. That is how IAL2 turns from a compliance box into time saved and trust earned.
