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The House of Representatives has voted to lift the ban on the Department of Health and Human Services using federal funds to develop a national patient identifier system.
The Health Insurance Portability and Accountability Act (HIPAA) called for the development of a national patient identifier system. As the name suggests, a national patient identifier system would see each person in the United States issued with a permanent, unique identification number, similar to a Social Security number, that would allow each patient to be identified across the entire healthcare system in the United States. If a patient from California visited an emergency room in New York, the patient identifier could be used to instantly identify the patient, allowing the healthcare provider to access their medical history. Currently, the lack of such an identifier makes matching patients with their medical records complicated, which increases the potential for misidentification of a patient.
The extent to which records are mismatched has been shown in multiple studies. For instance, in 2012, a study conducted by the College of Healthcare Information Management Executives (CHIME) found that 20% of its members could trace an adverse medical event to the mismatching of patient records. In 2014, the Office of the National Coordinator for Health Information Technology (ONC) found that 7 out of every 100 patient records were mismatched. Between 50% and 60% of records are mismatched when shared between different healthcare providers. A study conducted by the Ponemon Institute suggested 35% of all denied claims are due to inaccurately matched records or incomplete patient information, which costs the healthcare industry around $1.2 million each year.
It has been 24 years since HIPAA was signed into law, yet there is still no national patient identifier system. A ban was implemented in 1999 preventing 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 ever since.
Attempts have been made to lift the ban, notably by Reps. Bill Foster (D-IL) and Mike Kelly (R-PA). Last year, their efforts were partially successful, as the House of Representatives voted to remove the ban, only for the Senate to reject the house provision by not including the language removing 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 free to evaluate a range of solutions and find one which is cost-effective, scalable and secure.
Proponents of lifting the ban 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 growing, not everyone believes such a system is wise. Opponents to the lifting of the ban believe a national patient identifier would create major privacy risks. The Citizens’ Council for Health Freedom said 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 concerns about 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 processing 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 lack of complete demographic data.
“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,” Russ Branzell, CHIME CEO.
“Removing this archaic ban is more important than ever as we face the COVID-19 pandemic,” said Rep. Bill Foster. “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.”