National Patient Identifiers: Why Healthcare Needs Them

In 1996, HIPAA legislation called for the development of a national patient identifier system that would give each person in the U.S. a permanently assigned, unique number to be used across the entire spectrum of the national healthcare system.

Citing privacy concerns, Congress prevented the Department of Health and Human Services from implementing national patient identifiers by refusing to provide funding.

In my opinion, this decision has prevented all the potential benefits that employing national patient identifiers would bring to fruition, including added security, costs savings, improved interoperability and more accurate data registries.

Added Security

Sharing Congress’ concern, many opponents of national patient identifiers raise security risks when attempting to argue against the need for them. However, NPIs would actually have a positive impact on the security of patient information.

Consider how doctors currently identify patients using common indicators like name, birthdate and Social Security Number. What would happen if a patient’s SSN were compromised? In theory, someone could gain access to all aspects of the patient’s life, from health information to finances.

Now, say a patient’s national patient identifier is compromised. Although their health information will be at risk, which is obviously problematic, the threat would be confined strictly to their health information.

National patient identifiers limit the damage incurred during a security breach, while not in any way increasing the risk of one actually occurring.

Healthcare Savings

Another common argument against the use of national patient identifiers is the estimated financial commitment it would take to implement a new system. Some put the costs of implementation at somewhere between $1 billion and $50 billion. Although a broad estimate, it’s costly nonetheless.

Across the country, though, billions are already lost due to the costs associated with the cumbersome process of identifying patients. According to a study by Rand Corporation, a policy and decision-making think tank, if 90% of the U.S. were to adopt national patient identifiers the country could save between $77 billion and $154 billion per year. Meaning it would take only one year to begin seeing a positive ROI.

Realizing Interoperability

Currently, the government is pushing programs like Meaningful Use to increase interoperability between healthcare providers. But without national patient identifiers, exchanging health information is extremely cumbrous, as providers have to use three or four indicators to ensure they’re correctly identifying patients.

This arduous process allows too much room for error. A mistake or lack of diligence during the identification process can lead to a disastrous misstep in patient treatment. Imagine giving two patients the wrong medication just because they share a common name.

With national patient identifiers, the verification process is streamlined and the risk of misidentifying patients is essentially eliminated.

Improve Patient Data Registries

The vast amounts of data made available by the digitization of health records holds the promise of improving regional health outcomes by equipping doctors with the knowledge of geographic health trends. Adopting national patient identifiers would help ensure the data held in these registries is accurate.

If physicians are to benefit from this data, it must be reliable. NPIs would link patient information across registries for different patient encounters.  At the moment, these registries rely on statistical matching logic based on aforementioned general identifiers (name, birthdate, etc.), which can bring about problems when patients share the same name or date of birth.

More accurate data wouldn’t just be good for individual providers looking to improve patient care, but for scientific research as well by leading to faster and more reliable breakthroughs in medicine.

I believe national patient identifiers should be brought back to the forefront of HHS’ initiatives. NPIs would help both physicians and patients, as well as provide a boost to the government’s current push toward a more connected healthcare industry.

My estimable colleague, Xavier Martinez, doesn’t share the same point of view on national patient identifiers. Check back on Friday to read his rebuttal. In the meantime, sign up for our email list below.

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