On June 12, the U.S. House of Representatives passed a bill that would end the current federal ban on the funding of a national patient identification strategy. That action was applauded by senior advocacy leaders at the Ann Arbor, Michigan-based College of Healthcare Information Management Executives (CHIME). CHIME’s vice president of congressional affairs, Leslie Kriegstein, wrote in a blog on the association’s website, “Great news! Yesterday evening the House passed an amendment that would remove a prohibition on funding for a national patient identification strategy. Our members have seen that 20-year prohibition as a barrier to interoperability and a risk to patient safety. Thank you to everyone who helped us reach this milestone.”
Kriegstein added that “We commend U.S. Reps. Bill Foster (D-IL-11) and Mike Kelly (R-PA-16), the sponsors of the amendment, for their leadership on this critical patient safety issue. Reps. Foster and Kelly took to the House floor, with the Chairwoman of the House Appropriations Subcommittee on Labor-Health and Human Services (Labor-H), Rosa DeLauro (D-CT-3), to highlight the patient care implications of addressing patient identification in a meaningful way with the passage of this amendment. The House will now need to vote on the full Appropriations package, which is expected next week; it will then be sent over to the Senate for consideration.”
As Marianne Kolbasuk McGee wrote in an article in HealthcareInfoSecurity entitled “House Approves Lifting HHS Ban On Unique Patient IDs,” “Many healthcare and health IT industry groups have long been urging Congress to lift the ban so that an identifier could be used to help match patients with the correct electronic health information from multiple sources to improve care quality and patient safety. But privacy advocates worry that an identifier could lead to inappropriate exposure of sensitive information. The bipartisan passage of the amendment by a 246 to 178 vote is the first time either chamber of Congress has approved an initiative to lift the ban,” she wrote.
Kolbasuk McGee added that “[T]he House still needs to approve its appropriations bill. Plus, a similar provision lifting the ban would need to be approved by the Senate in its funding bill. Then a final funding bill containing a provision lifting the ban would need to be signed by President Trump.”
Indeed, there is currently no universal standard to 100 percent accurately identify patients and match them to their medical records. And, since 1999, the federal government has been prohibited from spending public funds on the development of a national patient identifier.
Nevertheless, the private sector has tried their hand on certain initiatives; perhaps most notably and recently when CHIME launched a National Patient ID Challenge in 2016, a $1 million crowdsourcing competition to incentivize the private sector to develop a fail-safe patient identifying solution that links patients to their medical records. However, that project was eventually suspended; CHIME’s president and CEO Russ Branzell noted that the work was much more complex than ever imagined.
Some ground has been gained by the public sector as well. The 21st Century Cures Act, passed by Congress and signed into law by President Obama in late 2016, required the Government Accountability Office (GAO) to study the issue of matching all patient data obtained from various sources to the correct individual to help ensure appropriate treatment decisions are made.
In a brief video statement given by Foster explaining the amendment, the congressman said, “This bipartisan amendment would strike Section 510, which bans HHS from adopting a standard for a unique patient identifier that would allow patients to be uniquely identified across electronic health record systems. For the last 21 years, this misguided policy has been in place and thousands of Americans have died due to getting the wrong drug to the wrong patient, or due to incorrect or incomplete electronic medical records, all arising from the inability to simply and correctly merge health records from different systems.”
Foster continued, “Countless man hours have been lost trying to figure out if one patient’s information is the same as another whose name might be spelled differently, or is recently move from a new city or state, or might be under their maiden name. Matching records properly requires a unique identifier for each patient. A federal ban on doing this properly makes our healthcare system more expensive and less safe for patients.”
Industry stakeholders have already begun to react to the House’s vote. A letter signed by numerous organizations, including the American Health Information Management Association (AHIMA), the American Medical Informatics Association (AMIA), CHIME and others, stated, “Today, identifiers are widely-used in federal programs, including identification for soldiers within the US Department of Defense’s Military Health System and veterans within the Veterans Administration. Moreover, in 2015, Congress overwhelmingly passed the Medicare Access and CHIP Reauthorization Act, which included a new, Medicare non-social security identifier to ensure our seniors’ healthcare records are kept safe and secure. If such identifiers are good enough to be used for our soldiers, veterans and America’s seniors, why not the rest of us?”
However, the American Civil Liberties Union (ACLU) took the opposing stance of the healthcare groups, stating that the amendment could be interpreted as allowing the development of a national unique health identifier without legislative approval. The ACLU’s letter wrote, “The dangers of having a system like this compromised or inappropriately used or accessed to track individuals are profound. For this reason, the ACLU has historically opposed national I.D. systems, like a national unique health identifier, because of the threat they pose to privacy rights.” The group also attested that “Absent strong privacy protections, use of unique health identifiers could empower HHS and potentially other federal agencies (including law enforcement) to gain unprecedented access to sensitive medical information.”
