In Washington, the House of Representatives has voted to remove the ban on the Department of Health and Human Services using federal funds to create a national patient identifier system.
The Health Insurance Portability and Accountability Act (HIPAA) called for the creation of a national patient identifier system. As the name suggests, a national patient identifier system would see every individual in the United States assigned a permanent, unique identification number, similar to a Social Security number, that would allow each patient to be identified across the federal healthcare system in the United States. If a patient from California attended an emergency room in New York, the patient identifier could be implemented to instantly identify the patient, allowing the healthcare provider to access their medical history. At present, the absence of such an identifier means that matching patients with their medical is difficult, which increases the potential for misidentification of a patient.
The extent to which records are mismatched has been revealed in multiple studies. For instance, in 2012, a study completed by the College of Healthcare Information Management Executives (CHIME) found that 20% of its members could track an adverse medical event to the mismatching of patient records. In 2014, the Office of the National Coordinator for Health Information Technology (ONC) discovered that 7 out of every 100 patient records were mismatched. Between 50% and 60% of records are mismatched when shared between different healthcare suppliers.
It has been 24 years since HIPAA was enacted by the Clinton administration, yet there is still no national patient identifier system. A ban was put in place in 1999 stopping the Department of Health and Human Services from funding the development of such as system out of privacy concerns. The ban has remained in place to ths day.
Efforts have been made to end the ban, notably by Reps. Bill Foster (D-IL) and Mike Kelly (R-PA). In 2019, their efforts were partially successful, as the House of Representatives voted to remove the ban, only for the Senate to deny the house provision by not including the language deleting the ban in the fiscal year 2020 funding bill for the HHS.
On July 30, 2020, the House approved the Foster-Kelly amendment for the House fiscal 2021 appropriations bill covering the departments of labor, health and human services and education. If the Foster-Kelly amendment is included in the Senate fiscal year 2021 funding bill, the HHS will be able to consider a range of solutions and find one which is cost-effective, scalable and secure.
Supporter of a ban removal claim a national patient identifier would increase patient safety and would help with the secure exchange of healthcare information. While support for a national patient identifier is increasing, not everyone believes such a system is wise. Opponents to the removing the ban believe a national patient identifier would create major privacy risks. The Citizens’ Council for Health Freedom stated that a national patient identifier “would combine all of your private information, creating a master key that would open the door to every American’s medical, financial and other private data.”
While there are some worries regarding privacy, the benefits of introducing such a system have been highlighted during the COVID-19 pandemic. Temporary healthcare facilities and testing sites have been set up and laboratories are now completing huge numbers of COVID-19 tests. There have been many reports of healthcare facilities struggling to correctly identify patients and laboratories have found it difficult to match test results with the right patients due to the absence of complete demographic data.
Russ Branzell, CHIME CEO, said: “The coronavirus pandemic continues to demonstrate the importance of accurately identifying patients and matching them to their medical records. Today marks another milestone in keeping patients safe with the passage of the Foster-Kelly Amendment in the House, bringing us closer to a national patient identification solution.”
Rep. Bill Foster said: “Removing this archaic ban is more important than ever as we face the COVID-19 pandemic. Our ability to accurately identify patients across the care continuum is critical to addressing this public health emergency, and removing this ban will alleviate difficult and avoidable operational issues, which will save money and, most importantly, save lives.”