In theory, a nationwide patient health identifier number makes sense. Just like a Social Security number is used for government and financial purposes, a health identifier number is used for patient’s health information. The thought is that these numbers can help achieve interoperability goals, while reducing patient identification mistakes. The COVID-19 pandemic highlighted the need for a cohesive identification system, as national health administrators struggled to keep up with rapidly-changing patient data.
In fact, both the government and medical industry are in favor of instituting a National Patient Identifier (NPI). There is currently a federal ban on appropriating the funds necessary to implement NPI. Privacy advocates, and those concerned about the costs, have argued to uphold the ban, but medical industry groups are urging Congress to overturn the ban.
What is a Unique Patient Identifier?
Unique Patient Identifiers, or UPIs, are codes or data that are used to differentiate patients and provide access to their individual health records. This is regardless of health insurer, medical providers or medical history. Healthcare Industry Dive cited a Johns Hopkins University report that “more than 250,000 people in the U.S. die each year from medical mistakes, some of which are due to physicians operating on incorrect data.”
In 2019, the U.S. Government Accounting Office confirmed there was no national system in place to accurately match patient records to a specific patient. While states are trying to address this need, it is not guaranteed that a patient visiting two different doctors, two different hospitals or medical facilities in different states will always have correct medical record information for the providers.
Overview of the Health Identifier Legislation
This issue of a national system in under discussion over 25 years by Congress and medical industry representatives. Significant legislation in this debate includes:
- 1996: The Health Insurance Portability and Accountability Act (HIPAA) mandated the development of a standard national patient identifier.
- 1998: Section 510 of the Department of Labor/HHS appropriations bill prohibited using federal funds to develop a patient identifier.
- 2016: The 21st Century Cures Act required the Government to take steps to reduce mismatches, and supports the nationwide exchange of patient information.
- 2019: Removal of the ban saw support from both sides of the Congressional aisle.
- May 2022: Almost 120 constituent groups urged Congress to overturn the ban on unique patient identifiers as part of the 2023 appropriations bill.
How is a Unique Patient Identifier Used in Healthcare?
There are many issues that can lead to patient misidentification, including data entry errors, patient name or address changes, and name similarities. When patients enter a hospital, for example, it can be difficult to confirm their identification due to similar names or health situations. Assigning a patient wrong identification during the intake process, the results could be disastrous.
A patient identifier number would remove the need to tediously update records, as the UPI would be used to access patient information. Eliminating patient identification mistakes is a cornerstone of improving patient care. Identification errors can lead to:
- Errors in medication prescriptions and administration
- Incompatible blood transfusions
- Inability to provide care across medical providers
- Failure to recognize or treat a serious illness
- Compromise of private data and possible medical identity theft
Medical Industry Efforts to Lift the Ban
Industry experts cite many advantages to lifting the appropriations ban and beginning implementation of a national identification system. Scenarios where a UPI would be important include:
- Similar names (e.g. Jane Smith and Joan Smith): With UPI, the correct patient would be identifiable for prescriptions, medical procedures, and medical devices.
- Test results: UPI would assure that a positive test result is assigned to the patient needing care and not to a healthy patient.
- Hospital treatments: Patients with similar medical histories would be more likely to receive the indicated care and medications for their specific medical problem.
- Portability: Experiencing a medical incident in another state would not cause a delay while responding personnel seek to obtain accurate health records.
- Infant care: Patient misidentification can lead to serious medication errors in neonatal intensive care units.