Citing the potential to minimize misidentification and medical errors, health informatics leaders from England, Scotland and the United States are calling on Congress to lift a 20-year ban on using federal funds to establish a unique patient identifier.
John Halamka, M.D., CIO at Beth Israel Deaconess Medical Center and David Bates, M.D., senior vice president and chief innovation officer at Brigham and Women’s Hospital, were joined by health IT leaders at Britain’s National Health Service and the University of Edinburgh in advocating for the use of patient identifiers in the U.S. Although HIPAA initially required the creation of a health identifier in 1998, Congress overruled the legislation, barring federal agencies from investigating or creating patient identifiers out of privacy concerns.
In an op-ed published in NEJM Catalyst, the group said Congress responded to a “highly vocal minority” and called on the Office of the National Coordinator for Health IT to push lawmakers to lift the decades-old ban and begin piloting possible solutions.
“When accurate information is attached to the right patient, data access is timelier for clinical, administrative, quality improvement and research purposes; inappropriate care, redundant tests and medical errors are reduced; and health information exchange becomes easier—within organizations as well as between,” the authors wrote. “Identifiers are also beneficial for patient mobility, allowing information to be linked to patients and following them as they move.”
Health IT and provider groups have long supported the development of a unique patient identifier. Last year, 25 organizations—including the American Medical Association and HIMSS—called on lawmakers to allow ONC to provide “technical assistance” to efforts led by the private sector. Other organizations like the Center for Data Innovation have made similar pleas, arguing that patient identifiers would assist with interoperability.
However, private efforts to develop a patient identifier have faltered. Late last year, the College of Health Information Management Executives (CHIME) called off its National Patient ID Challenge that industry and government officials were watching closely. A spokesperson said the effort “ultimately did not achieve the results we sought to this complex problem.”
There are some signs that Congress is willing to relax its hardline stance. Last year, the House Committee on Appropriations included funding for patient matching research in its 2018 budget bill. Lawmakers also asked the Government Accountability Office to expand the scope of a planned review on patient matching to include consideration of a national strategy. ONC has also nibbled at the edges, launching a new patient demographic tool in December designed to assist organizations with data management.
But the NEJM authors advocate for more encompassing efforts at the federal level, pointing to the successful implementation of unique patient identifiers within the NHS system and efforts at the state level to legalize patient identifiers.
“With billions of dollars having been spent on EHR implementation, the healthcare system must vigorously investigate more efficient ways to connect fragmented patient data, an effort that is increasingly relevant as the U.S. moves from a fee-for-service to a value-based health care system focusing on outcomes and populations,” they wrote.