For the second successive year, the U.S House of Representatives has voted to remove the ban on the Department of Health and Human Services using federal funds for the development of a national patient identifier. Last year, the House of Representatives voted in favor of the removal of the ban, but the change was rejected by the Senate.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 called for the HHS to adopt standards for a unique patient identifier for all Americans. The patient ID would be issued to each American and, like a Social Security number, and would be kept for life. That ID would allow an individual to be identified across the entire healthcare system and would allow the medical records of a patient to be identified by healthcare providers, health plans, and employers.
However, in 1998, a band on funding such a system was introduced by former Congressman Rep. Ron Paul, R-Texas out of privacy concerns. In every year since 1999, that ban has been included in congressional budgets and no system has been developed.
The lack of a patient ID creates problems identifying the medical records of patients and often sees healthcare data matched to incorrect individuals. This has always been a problem, but it has been exacerbated during the COVID-19 pandemic. Many testing facilities have struggled to match test results with the correct patients due to a lack of demographic information.
Support for a national patient identifier has been growing. Many healthcare organizations are advocating for a national patent identifier, arguing that such a system would greatly improve patient safety by ensuring that medical data is correctly matched with each patient. A unique ID for each American would also help improve interoperability.
In August 2019, 56 healthcare organizations declared their support for the removal of the ban on funding such a system and urged Congress to adopt a national patient identifier only for the ban to remain in place. While the 2020 congressional budget retained the wording banning the funding of a national patient identifier, Congress did direct the Office of the National Coordinator for Health IT to work with private sector stakeholders to develop a strategy for improving patient identification.
The latest effort has been spearheaded by Reps. Bill Foster, D-Illinois and Mike Kelly, R-Pennsylvania. “Removing this archaic ban is more important than ever as we face the COVID-19 pandemic,” said Rep. Foster. “Our ability to accurately identify patients across the care continuum is critical to addressing this public health emergency and removing this ban will alleviate difficult and avoidable operational issues, which will save money and, most importantly, save lives.”
In addition to improving patient identification across the healthcare system, reducing the potential for medical errors, and helping to loser costs, such a system could also help to prevent patients from visiting multiple doctors to obtain opioids. Foster also suggested that such a system is even more important during the COVID-19 pandemic and could help to prevent the spread of the disease.
While there is strong support for a national patient identifier, the same privacy concerns that saw the ban implemented are still an issue. There is concern that such a system will place patient privacy at risk and the system could potentially be abused.
The American Civil Liberties Union has expressed concern about such a system. “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. Historically, we have seen examples of inadequate health privacy regulations, underscoring the importance of requiring Congressional approval of health privacy standards in this arena.”
If the HHS was allowed to use federal funding, investigations into various options could be conducted to identify the best possible solution; one that includes privacy protections to prevent misuse of patient IDs to appease critics of the system.
The Senate is due to release its draft appropriations bill next month and will decide whether the ban will be lifted.