October 19, 2021, was an exciting day for the Healthcare industry as the Senate Appropriations Committee voted to lift a 20 plus year-old ban that has been restricting the funding necessary to create a unique patient health identifier. 

We are thrilled to hear that funding has become available to create a national Unique Patient Identifier (UPI) and look forward to collaborating with the government and other healthcare entities to develop a reliable identification program. To work around the historical lack of a UPI, our team created a unique national master patient index (MPI) using referential data sets and triangulation techniques. Our MPI allows us to accurately attribute clinical records to each patient and confidently exchange data with our network.

We believe that our MPI can act as a great example and foundation for the Department of Health and Human Services as they partner with others to establish the national UPI and begin mapping the historical patient data to the new national number.

Patient ID Now, a coalition that includes more than 40 healthcare organizations, has been rallying around the cause since the beginning of the year and deserves a round of applause for its efforts in lobbying Congress to fund a UPI. Their goal to create a national strategy that addresses patient identification is a critical component of our mission to empower patients and providers with complete access to health data. 

We adamantly believe that consistently and reliably identifying and matching patients to their health information is critical as their journey progresses across the healthcare ecosystem. We shared this need with the Office of the National Coordinator for Health Information Technology (ONC) and the Recognized Coordinating Entity (RCE), the Sequoia Project, in our QHIN Technical Framework feedback earlier this year. We recognized and advocated the need for standards to be set and adopted to truly create a Trusted Exchange Framework that decreases the healthcare industry's administrative burdens and improves organizational security. The ability to securely and confidently identify patients is foundational and necessary to improve healthcare information exchange.

Earlier this year, Patient ID Now released a strategic framework to create a national plan around patient identification. In this framework, the coalition called on the federal government to collaborate with the private sector and public health stakeholders to work toward the goal of accurate patient identification. Our team at Health Gorilla appreciates the coalition for recognizing the importance of the private sector and agrees that it will take a combination of all three to create a secure and trusted national patient identification method. 

The framework addresses many aspects of what a national strategy should entail and speaks well to the patient identification challenges faced in interoperability today. As a Health Information Network (HIN), the standardization aspect speaks heavily to the work we accomplish on a daily basis. The framework encourages the use and expansion of existing industry standards, such as HL7, and aligns well with the ongoing national efforts around interoperability. Adopting a set of agreed-upon standards and leveraging the current patient matching efforts will not only increase how quickly a UPI is developed but also ensure that it is compatible with principles and standards already in place. ‍

The History of National Patient Identifiers‍

In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) to establish national standards that protect patient clinical records and other personal health information. It also gave individuals the right to examine and access copies of their health records and called for creating a unique patient identifier that would give each person a permanent number to be used across the healthcare ecosystem. But, due to security and privacy concerns, Congress has restricted spending any federal budget on developing a UPI since 1999. ‍

What are the Benefits of Unique Patient Identifiers?‍

Once a reliable patient identification method is in place, healthcare organizations will be able to confidently share an individual's clinical information with one another, allowing them to create more accurate and timely treatment plans for their patients. 

Unique patient identifiers will also increase patient safety by mitigating the expense and harm attached to misidentification mistakes and will decrease duplicate patient reports. Duplicate reports are often created when a healthcare entity cannot locate a patient's file, forcing them to create a new one. Multiple reports for the same patient can lead to an inaccurate history of that patient and hinder a physician's ability to create an accurate treatment plan. 

It's also believed that a UPI will lead to a reduction in security breaches. Healthcare organizations have historically used social security numbers as a piece of their puzzle when identifying patients and sharing records. Gaining access to a person's social security number could give someone access to all aspects of their life, from health information to finances. Removing SSNs and replacing them with a unique and secure patient identifier will confine a compromise to strictly a person's health information, and will decrease the data's overall value to cybercriminals, and should reduce the number of attacks.‍

How Will Unique Patient Identification Impact Healthcare Infrastructure?‍

While this is a tremendous step forward for the healthcare community, plenty of efforts still need to be taken before the value will truly be seen. The main challenge will be uniting all of the currently disparate data across the country, which will require a substantial investment in health IT infrastructure and organizations updating each patient's record with the new UPI. 

The lift on the restriction also ties in nicely with the 21st Century Cures Act and Trusted Exchange Framework and Common Agreement (TEFCA), which will begin establishing national exchanges of electronic health information and universal interoperability standards between health information networks (HIN) next year. Including a unique patient identifier method will allow these HINs to confidently share their clinical data and ensure that critical information stays intact and attached to the correct person. ‍

‍What's Next‍

Access to this funding will allow the Department of Health and Human Services, healthcare organizations, and the private sector to begin developing a framework and strategy to improve patient identification. 

Many intricacies still need to be worked out, including the creation of a policy defining where and how numbers will be created, the process of issuing these new numbers, and ironing out how this new data will interact with each component of health IT software.

There is much work to be done, but overall this should be looked at as great news for the healthcare industry. The buy-in from the federal government and funding becoming available will allow the healthcare community to start down the road that has been blocked by regulations for far too long.