Why a national patient identifier may be closer to reality

Softening of congressional limitations seen as enabling federal research efforts, says Leslie Krigstein.


As healthcare is facing calls for improved interoperability, the long-time congressional stance opposing a unique patient identifier appears to be softening.

Congress is enabling the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services to work with the industry on patient ID and matching initiatives.

That stands in contrast to a long-time restriction by Congress, which, pushed by privacy advocates 18 years ago, forbid the Department of Health and Human Services from using any federal funds to develop, adopt or assign a unique health identifier for individuals.

The need for an identifier is great, says Leslie Krigstein, vice president of congressional affairs at the College of Healthcare Information Management Executives, which represents CIOs and other health IT professionals.

Also See: Patient ID errors rising, common in hospital settings

In a recently enacted spending bill, the original funding prohibitions on HHS continue, but lawmakers now say the limitations do not prohibit HHS from examining patient matching issues, and the agency further can provide technical assistance to initiatives identifying patients to their health information.

Also, tucked into funding for the Office of the National Coordinator for Health Information Technology, was money for that agency to examine patient matching issues to ease interoperability.

“The Secretary is directed to further this work by studying approaches to improve person-centered healthcare through patient access to health information,” according to the legislation. “That work should examine accurate and timely record matching so that all EHR systems are collecting the information necessary for a fully interoperable system that protects patients from identity mismatch errors, but also considers patient privacy and security.”

Consequently, while prohibitions on a national patient identifier are not completely null and void, acknowledgement from lawmakers of problems with identifying patients and a growing awareness of the need is a big win for identifier advocates, Krigstein says.

In favor of the newfound openness to patient identification initiatives, she credits the 21st Century Cures Act and its variety of healthcare improvement initiatives, such as the Cancer Moonshot, Brain Initiative and the Precision Medicine Initiative, among others, that pave the way for new scientific breakthroughs.

“We think there are private sector initiatives” that offer promise in the patient ID arena, Krigstein says.

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