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Healthcare Organizations Still Lack National Patient Identifier

Despite a resurgence of interest in improving patient identification, a national patient identifier is still a distant dream.

National Patient Identifier

Source: Thinkstock

- For years, organizations including HIMSS and CHIME have vocalized the need for a national patient identifier.

As health IT and health data exchange continue to evolve, the need for a consistent, accurate way to identify patient health records is becoming more and more pressing.

The lack of a nationally uniform patient identification system has resulted in increased healthcare facility costs, health data exchange inefficiencies, and patient safety threats, among other pervasive problems.

Earlier this month, a group of over 25 healthcare organizations called upon HHS members to remove a decades-old provision barring HHS from implementing or adopting a national patient identifier.

The undersigned providers, payers, and health IT companies suggested language be included in the FY18 Labor-HHS spending bill to allow HHS to help private sector organizations make the national patient identifier a reality.

“Clarifying Congress’ commitment to ensuring patients are consistently matched to their healthcare data is a key barrier that needs to be addressed if we are to solve this problem,” authors stated.

Federal funds and technical assistance could boost efforts to implement a patient identifier spanning the industry. HHS involvement could also send the message that a consistent patient identification system is a national priority.

“Allowing ONC and CMS to offer this type of technical assistance will help accelerate and scale safe and effective patient matching solutions,” stated the authors. “The absence of a consistent approach to accurately identifying patients has resulted in significant costs to hospitals, health systems, physician practices, and long-term post-acute care (LTPAC) facilities as well as hindered efforts to facilitate health information exchange.”

Patient misidentification, duplicate patient records, and instances of missing data are just a few potential problems resulting from a lack of standardization in patient identification.

“According to a recent study of healthcare executives, misidentification costs the average healthcare facility $17.4 million per year in denied claims and potential lost revenue,” the letter stated. “More importantly, there are patient safety implications when data is matched to the wrong patient and when essential data is lacking from a patient’s record due to identity issues.”

This public plea is one of many calling for a national patient identification solution.

Beth Israel Deaconess Medical Center CIO John Halamka, MD, MS, has also publicly expressed earnest support for a national patient identifier to improve health data exchange and allow for true interoperability.  

In a blog post last month, Halamka listed establishing a national patient identifier as one of the top ten biggest industry priorities.

“HIPAA called for the creation of a national patient identifier to improve efficiency and safety,” Halamka wrote. “While patient-matching technology and processes have improved tremendously since HIPAA was enacted, a national patient identifier would still offer considerable efficiency and safety benefits and would remove a barrier to seamless interoperability.”

Despite such persistent advocacy across the industry, legal barriers still stagnate efforts to launch patient identification initiatives forward.

With legislative support from HHS still an uncertainty, researchers are looking to reduce patient matching errors in any way they can.

A recent ECRI Institute presentation based on an analysis of over 7,600 patient safety events from January 2013 to August 2015 addressed ways to reduce patient matching errors.

A lack of registration staff training, patient verification by photo IDs, and standardized processes for recording identifiers or reporting irregularities all contribute to harmful patient identification errors.

Using the acronym IDENTIFY, Senior Research Analyst Amy Tsou, MD, MSc, outlined ways to mitigate these problems:

Include—Electronic fields containing patient identification data should consistently use standard identifier conventions.

Detect—Use a confirmation process to help match the patient and the documentation.

Evaluate—Use standard attributes and attribute formats in all transactions to improve matching.

Normalize—Use a standard display of patient attributes across the various systems.

Tailor—Include distinguishing information enhancing identification on screens, printouts, and those areas that require interventions.

Innovate—Integrate new technologies to facilitate and enhance identification.

Follow up—Implement monitoring systems to readily detect notifications to facilitate proper identification.

Yield—Include high-specificity active alerts and notifications to facilitate proper identification. 

These recommendations should minimize patient harm while healthcare organizations continue to push for the necessary legislation.

In the meantime, inaccurate patient data matching will continue to muddle health data exchange and pose a threat to patient safety.

Before industry-wide interoperability can become a reality, federal agencies will need to prioritize standardizing all aspects of patient health record exchange. 

 

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