How a National Patient ID Standard Could Boost Population Health

A national patient health identifier standard is integral to supporting direct patient care, value-based care, and population health initiatives through enhanced patient matching, according to members of the Patient ID Now coalition.

Earlier this month, over 100 members of Patient ID Now sent a letter to leaders of the House and Senate Appropriations committees calling to remove a funding ban for a national patient health identifier standard.

Patient ID Now is a coalition of healthcare organizations committed to advancing a national strategy to address patient identification. Founding members of the coalition are the American College of Surgeons, AHIMA, CHIME, HMMS, Intermountain Healthcare, and Premier Healthcare Alliance.

The letter noted that outdated rider language in Section 510 of the Fiscal Year 2023 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations bill prohibits HHS from spending federal dollars to adopt a national unique patient identifier standard.

"For more than two decades, innovation and industry progress has been stifled due to a narrow interpretation of this language, included in Labor-HHS bills since FY1999," the healthcare organizations wrote in the letter. "Without the ability of clinicians to correctly connect a patient with their medical record, lives have been lost and medical errors have needlessly occurred."

At a recent Patient ID Now Coalition press briefing, members of the coalition highlighted how the current lack of a national patient health identifier standard is hampering care delivery across the country.

"I think the direct impact on patient care falls into three main categories," John Lee, MD, CMIO of Allegheny Health Network, said at the briefing. "First, there's the direct transactional aspect."

Lee, a practicing emergency physician, noted that he gave a patient the inappropriate antibiotic because the allergy information attributed to the patient was actually from a patient with a similar name.

"I also know of a patient who couldn't get their COVID vaccine because, according to records, that patient had already received a COVID vaccine because their record had been overlaid with another patient's record," he said. "That sort of thing happens at scale on a repeated basis throughout our healthcare system."

Additionally, Lee pointed to the need for a national patient identifier standard to support value-based care delivery.

"Beyond the individual transactional healthcare episodes, if we want to get off of fee-for-service and actually get to true population health, we need to be able to identify our patients across patient or provider organizations," he said. "We can't do that without a much more developed and much more accurate patient identifying system."

Lee emphasized that a national patient identifier standard would make the healthcare ecosystem more efficient and help move away from fee-for-service and the "economic pain that is inflicting on our country."

"One of the biggest things impairing our ability to try to move off of fee-for-service is the patient matching issue," he noted. "It becomes such an arduous effort to try to get those patients matched across multiple organizations to do population health that we could spend that effort doing population health, rather than just trying to match up all the patients together in a population health strategy."

Lee also pointed out that a national patient identifier standard would aid in knowledge generation to support innovative healthcare delivery. 

"If we have large amounts of data at scale, then we can do things like identify different types of situations where certain drugs or therapies may be particularly worthwhile and be able to focus on some of the precision medicine efforts that we want to develop with big data and genomics,” he said.

He also asserted it is false that a national patient ID would compromise patient privacy.

"I do not believe there is any privacy gain in having this ban in place," Lee noted. "In fact, I think it probably contributes to reduced privacy. Patients have to enter and submit multiple pieces of various identifying information in various provider organizations, which makes privacy less secure."

Lee noted that as healthcare providers share more and more data, creating a national patient identifier is becoming even more critical.

"We are drinking out of an open fire hydrant, and that fire hydrant is getting larger and larger exponentially every single day," he explained.

"I think it's a fallacy to think that if you just know the patient in front of you, you can take care of the patient," he continued. "This is not Marcus Welby medicine anymore. We are not limited by our ability to know whether a treatment for a specific heart attack is appropriate in a particular clinical situation."

"What we are limited by now is we have too much information," Lee said. "The only way to parse and organize all that information is by having a better patient identification system. That is really where it starts."