The issue of interoperability has become a stark reality. So has the fact that additional standards and policies are needed to support improvements in accuracy and execution of the methods used to match patients to their health records. The level of interoperability and meaningful electronic information sharing remains fairly low. Republican Louisiana Senator Bill Cassidy addressed the lack of a patient identification strategy during an event at the Bipartisan Policy Center earlier this month. The event occurred as part of a focused effort to improve health through interoperability and information sharing, led by a group of influential representatives. Cassidy, a physician and member of the Senate Health, Education, Labor & Pensions (HELP) and Senate Appropriations Committees, as well as the Senate Appropriations Committees, recognizes the issue of interoperability and the need to develop a solution that will support patient privacy to the highest degree.
Thus far, health information sharing had caused much unease amongst the privacy community, who is concerned not only with fraud and cyber breaches, but also with errors like incorrectly matching patients to health records, wrongful disclosure and wrong treatment.
Nonetheless, Cassidy’s sentiments are that a patient identifier is a critical component of data sharing and central to coordinated, patient-centered models of care. This 2012 CHIME study outlines the adverse effects of patient mismatches. Senate has expressed their commitment to developing a standard on how to best match patients with their records and they are working with organizations like the National Institute of Standards and Technology (NIST), who focuses on improving cybersecurity of the nation’s critical infrastructures. A proliferation of new privacy and security concerns only continues to grow as more health information is collected and shared.
Cassidy has been steadfast in working to improve electronic health records for physicians. Both he and Sheldon Whitehouse introduced bipartisan legislation to strengthen accountability and improve transparency in health information technology systems. The Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015/2016 would help ensure that certified health IT systems are performing as promised in the field.
Bottom line: There is no evidence that a universal patient identifier will infringe on personal privacy BUT there is evidence that patient mismatches have increased medical error rates.
Why you should care: Every provider wants greater interoperability and medical record portability. A unique patient identifier will simplify interoperability and portability.
One more thing: CMS has to get serious on national Health Plan Identifiers. They keep giving payers a free pass on this issue. Their adoption has been serially postponed. The Health Plan Identifier is a standard, unique health plan identifier required by the Health Insurance Portability & Accountability Act of 1996 (HIPAA), mandated in 1996 but postponed again in October 2014 when the Centers for Medicare & Medicaid Services (CMS) announced the latest delay. Presently there is no firm date for enforcement of this rule.