Unique patient identifier ban lifted in House vote, still faces Senate
Wednesday, June 26, 2019
The 20-year ban on the ability of the U.S. Department of Health and Human Services to establish a unique patient identifier has finally been struck down — in part. A unique patient identifier (or the lack of one) has long been a primary issue for health IT insiders and leaders.
The U.S. House of Representatives voted in favor of ending the ban June 12. If it becomes law, it would allow federal funds to create the long-sought-after patient identifiers.
The House voted 246 to 178 in favor of the Foster-Kelly amendment to H.R. 2740, the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act of 2020. The bill now moves to the Senate to be taken up for debate.
The patient identifiers debate began with Health Insurance Portability and Accountability Act (HIPAA), which originally required the creation of a health identifier in 1998. However, Congress overruled the legislation, barring federal agencies from investigating or creating patient identifiers out of privacy concerns.
Health IT leaders see the investigation and creation of unique patient identifiers as critical to solving issues with patient matching and potentially minimizing misidentification and medical errors.
The American Health Information Management Association (AHIMA) said it supports the move by Congress, and says it should repeal the "archaic ban that has stifled innovation and industry progress for nearly two decades."
"Accurately identifying patients and matching them to their data is essential to patient safety and care coordination, and it’s a requirement for health system transformation and the continuation of our progress toward enhancing nationwide interoperability," AHIMA CEO Wylecia Wiggs Harris, Ph.D., said in a statement. "Removal of this ban will empower HHS to explore a full range of patient matching solutions and enable it to work with the private sector to identify solutions that protect patient privacy and are cost-effective, scalable and secure."
AHIMA also sent a letter to members of Congress signed by 27 healthcare and health IT organizations voicing support for the Foster-Kelly amendment. That letter was signed by America's Health Insurance Plans, the American Medical Informatics Association, the College of Health Information Management Executives (CHIME) and the Federation of American Hospitals.
Organizations like CHIME and HIMSS have long urged Congress to lift the ban so that HHS could assist in funding a national patient identifier. The thinking is that such a move would help improve patient matching and reduce instances of mismatched or duplicative patient EHRs. The development of a national patient identifier may help to improve patient safety by reducing the likelihood patients will be matched incorrectly with critical health information, too.
This current bill would ensure HHS can contribute to standards development to prevent doctor shopping for prescription opioids, cut healthcare costs, and reduce preventable medical errors. The patient matching amendment was introduced by Reps. Bill Foster, D-Ill., and Mike Kelly, R-Penn.
"I’m proud to have these amendments adopted by the House," Foster said in a statement. "These amendments would strengthen our health care system, help fight the opioid epidemic, enhance America’s biosecurity readiness, and better equip policymakers to prepare for the workforce of the future. I thank my colleagues on both sides of the aisle for working and voting with me on these important measures."
Not everyone is for the development of a national patient identifier. Conservative group Freedom Works urged its supporters to reject the patient identifier portion of the bill citing "individual liberty" as one of the reasons for its opposition.
Anita Samarth, CEO and co-founder of Clinovations Government + Health, a consulting firm offering strategic, clinical, and health IT advisory, advocates for "referential matching," in which solutions compare customer records to a reference database that contains commercially available demographic data about each person in the U.S. — data that include the full name, name changes and variations because of things like marriage, old addresses, etc.
"This allows the referential matching solution to determine if two records belong to the same person, even if those records contain discrepancies in their demographic data. Two records with very different data can still yield a match," she wrote in an op-ed.
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