Hospitals, CIOs call for increased patient identifier action in interoperability roadmap

Hospitals and health system CIOs both stressed the need for patient identifiers in comments sent late last week to the Office of the National Coordinator for Health IT on its draft roadmap.

The College of Healthcare Information Management Executives and the Association of Medical Directors of Information Systems, for instance, call patient identification "paramount" to the formation of an interoperable Learning Health System.

"Without a standard patient identifier, the creation of a longitudinal care record, composed of data and created through disparate systems, geographies and chronology is simply not feasible," the organizations said in a joint statement. "Without a standard patient identifier, the creation of a longitudinal care record, composed of data created through disparate systems, geographies and chronology is simply not feasible."

CHIME, last month, announced that it plans to launch a $1 million challenge this summer for the creation of a patient matching solution. "There is a growing consensus among payers and providers that a unique patient ID would radically reduce medical errors and save lives," CHIME President and CEO Russell Branzell said in a statement about the challenge.

The American Hospital Association, meanwhile, called such an effort urgent, saying it regrets that congressional law shackles the U.S. Department of Health and Human Services from creating a unique patient identifier.

"At a minimum, we believe that the federal government should fund a study of consumer attitudes about a patient identifier in the digital age," AHA said in its comments to the ONC.

AHA also is not convinced that the roadmap is sufficiently "grounded in an assessment of present realities," nor does it believe it will "enable public and private stakeholders to travel from" the present-day landscape to a more clinically and technologically appropriate future landscape.

The American Medical Association also was critical of ONC's roadmap, saying the agency must let punitive approaches to provider compliance with interoperability go by the wayside.

"This is simply a flawed and misguided means of removing the current barriers to interoperability," AMA said in its comments. "This approach will not work."

AMA also took the opportunity to speak out against the proposed rule for Stage 3 of Meaningful Use, saying it "retains a construct that is overly prescriptive" and a barrier to interoperability.

The Healthcare Information and Management Systems Society said it supports the timelines rolled out by ONC, and also wants to see the agency work within the current infrastructure and systems as it continues to develop new governance processes.

"HIMSS does not support a 'rip and replace' approach toward advancing widespread interoperability," the organization said in its comments. "There would be far too many patient safety risks if the community started over on interoperability with completely new processes."

To learn more:
- read the CHIME/AMDIS comments (.pdf)
- check out the AHA comments (.pdf)
- here are the AMA comments (.pdf)
- read through HIMSS' comments (.pdf)

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