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Why Optimism Is Building for National Patient Identifier

Congress appears to be softening in its opposition to potentially funding the development of a national patient identifier.

By Kyle Murphy, PhD

report from the House Committee on Appropriations contains language on the use of national patient identifiers indicating the possibility that future legislation could remove the prohibition against the federal government funding a means for improving patient identification and matching.

The language is question comes from the report's analysis of 2017 appropriations to be made to the Department of Health & Human Services (HHS) and related agencies if passed on the subject of a unique patient health identifier.

"Although the Committee continues to carry a prohibition against HHS using funds to promulgate or adopt any final standard providing for the assignment of a unique health identifier for an individual until such activity is authorized, the Committee notes that this limitation does not prohibit HHS from examining the issues around patient matching," the report states.

"Accordingly, the Committee encourages the Secretary, acting through the Office of the National Coordinator for Health Information Technology and CMS, to provide technical assistance to private-sector led initiatives to develop a coordinated national strategy that will promote patient safety by accurately identifying patients to their health information," it adds.

The appropriations bill, however, does not allow for federal funding of efforts "to promulgate or adopt any final standard providing for a unique health identifier until legislation is enacted specifically approving the standard" under Section 510.

According to the College of Healthcare Information Management Executives (CHIME), the bill and accompanying report could clear the way for the federal government to pursue a national patient identification strategy.

"Every year since 1999, Congress has passed appropriations bills prohibiting the Department of Health and Human Services from using funds to promulgate or adopt a rule that would establish a unique health identifier," CHIME's Vice President of Congressional Affairs Leslie Krigstein said in a public statement midweek.

"While we continue to believe that the ban should be lifted," she continued, "we applaud the House Appropriations Committee for clarifying the limitations this restriction places on HHS and for encouraging the department to work with the private sector on developing a national patient identification and patient matching strategy."

CHIME has long advocated for a national patient identifier as a vehicle for improving care coordination and patient safety by ensuring positive patient identification when information is shared among providers.

"Accurate patient identification is a linchpin to creating a safer and more efficient healthcare delivery system," Krigstein maintained. "Unfortunately, the lack of a national patient identification system results in some patients being misidentified. The safety implications of that are immense. According to a 2012 survey, 20 percent of CHIME members could attribute at least one adverse medical event to patient identification or matching mistakes."

Earlier this year, the organization launched the CHIME National Patient Challenge with the purpose of ensuring the complete accuracy of every patient’s health data to reduce preventable medical errors and eliminate unnecessary treatments and use of other provider resources. The total prize is set at $1 million and will be awarded February on next year.

Patient matching will only grow in importance as result of advances in health IT interoperability and the increased use of health information exchange, according to the authors of a position paper published in Perspectives in Health Information Management.

"As health IT innovation and system interoperability needs continue to grow, ensuring that patient data are accurate will be a key concern of many healthcare providers," wrote Lusk et al. "It is paramount that organizations seek to establish a real-time automated patient matching process. For HIE to be successful, standards for data capture, definitions, and formatting must be developed to allow an electronic system to accurately identify patients across disparate EHR systems."

Based on the report from the House Committee on Appropriations, the next move on the development of a national patient identifier belongs to HHS to assess the strategies and standards necessary for making positive patient identification across the United States a reality.




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