Will HHS Have the Assurance of a Patient Identifier?

HHS has been banned from using a patient identifier but several organizations, including national payers, providers, and prescription drug networks, want this reversed.

Probabilistic matching or a patient identifier—which would be a safer bargain when merging patient health records to allow health information exchange? HHS has been banned from using a patient identifier and now several organizations, including national payers, providers, and prescription drug networks want this reversed.

A letter sent to the House Appropriations Committee and its Labor, Health and Human Services, Education and Related Agencies Subcommittee earlier this week, urges committee members to clear the way for developing a national strategy that will identify patients to any health system across the country that uses an electronic health record system. The letter claims that allowing HHS and CMS to offer technical assistance by accurately identifying patients and matching them to their health information will ensure patient safety and also prove a significant cost saving to hospitals, health systems, physician practices, and long-term post-acute care facilities.

This is very important as CMS and other private payers develop care delivery and reimbursement models in which health information technology plays a prime role. Wrongly identifying a patient right at the time of registration can lead to a cascade of unwanted events including wrong procedures or patient orders, the letter stated. With accountable care organizations and increased emphasis on coordinated care as a means to save healthcare costs, precise patient identification and matching their healthcare information is the only way forward for the success of interoperability.

The letter has been signed by 23 organizations including America’s Health Insurance Plan, Blue Cross Blue Shield Association, EHR Association, IMS Health, Superscripts, and Intermountain Healthcare.

According to Modern Healthcare, the Health Insurance Portability and Accountability Act, or HIPAA, passed by Congress in 1996, had called for developing a nationwide unique patient identifier (UPI). However, the National Committee on Vital and Health Statistics advised HHS to not adopt UPI or a patient identifier until a federal privacy legislation was enacted. In 2006, however, a report released by the not-for-profit Markle Foundation determined that the benefit of a patient identifier system would not be worth it.

The College of Healthcare Information Management Executives (CHIME), however, believes it is worth a million dollars. The organization is expected to declare the winner of its National Patient ID Challenge—announced on January 19, 2016—early next year.

“Patient mismatching and our inability to accurately identify patients across the continuum of care has been an ongoing problem for the industry,” CHIME president and chief executive officer, Russell Branzell, had said when he opened up the challenge in collaboration with HeroX, a crowdsourcing innovation platform. "Now is the time to fix this problem. We have an ethical responsibility to fix the problem in front us and we’ve done this in a unique way."