Unique Patient Identifiers: What Are They and Why Were They Banned by Congress?

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A health information manager holding a patient record is standing in front of a hospital reception desk.According to the 2016 National Patient Misidentification Report conducted by Ponemon Institute, 86% of healthcare professionals have witnessed or know of medical errors caused by the misidentification of patients. Advocates of unique patient identifiers argue that shifting to a new system will help resolve this major problem. However, out of privacy and information security concerns, Congress has banned funding for implementing this alternative patient identification system in every federal budget since 1999.

Those hoping to eliminate the safety risks caused by patient misidentification and improve information sharing between relevant parties should consider the potential benefits of unique patient identifiers and why some resist their adoption. Pursuing a Master of Science in Health Information Management can help professionals in the field cultivate a deeper understanding of how to manage patient data so it is both accessible and protected.

What Are Unique Patient Identifiers?

Healthcare organizations need to correctly identify patients and keep track of their information. Doing so allows providers to access important medical histories and appropriately treat patients. In an emergency, knowing a patient’s identity and their medical history makes it possible for doctors to quickly act and make the best treatment decisions. Conversely, the misidentification of a patient can lead to serious mistakes such as prescribing the wrong medication or administering an inappropriate treatment.

Creating a nationwide patient identification system using unique patient identifiers would enable healthcare providers and insurance companies to more accurately identify patients. Such a system would assign alphanumeric codes, made up of personal information such as birthdate and Social Security number, to each patient. These singular identification numbers would match patients to their medical records across multiple provider systems. Hospitals, outpatient clinics, doctors’ offices, and other medical facilities would use the same unique patient identifier to reference a patient or store an individual’s medical data.

The Benefits of Unique Patient Identifiers

Unique patient identifiers offer valuable benefits. For one, they help avoid identification mix-ups. Providers can easily mismatch patients who share the same names and birthdates. Even patients with similar names have been confused.

For example, a case reported in the Department of Health and Human Services’ Patient Safety Network describes a 68-year-old woman getting a CT scan with contrast on her upper body when her doctor had actually ordered a noncontrast CT scan for her abdomen. As it turned out, the scan she received was actually meant for another patient who shared her first but not last name.

Unique patient identifiers offer a more reliable way to manage patients and their information. A system using unique patient identifiers can increase patient safety and prevent the harm and expense of mistakes caused by misidentification. They can also make information sharing between healthcare facilities more seamless, ensuring important data remains intact in patient records.

People receive their healthcare from multiple provider entities, and patients benefit when these different providers work in coordination. Unique patient identifiers facilitate a high level of care coordination by giving each separate provider access to the same information. For example, using unique patient identifiers would allow healthcare professionals to see all the tests administered, prescriptions written, and treatments delivered to their patients by themselves and others. This communication improves the continuum of care, ensuring interventions are reliably given to the intended recipients.

Unique patient identifiers can also eliminate duplicate patient reports. Duplicate patient records occur when healthcare organizations do not accurately locate a patient’s file and consequently start a new one. This can happen because some healthcare organizations house millions of patient records in which patients share similar or the same information including their birthdates, addresses, and names.

When one patient has two records, important information gets fragmented. This can result in incomplete or inaccurate histories that may lead to significant medical errors: Doctors can order the wrong tests or overlook patient allergies, dangerous drug interactions, medical implants, and so on.

Finally, unique patient identifiers can reduce security breaches. Cybercriminals often target healthcare organizations to steal patient information. However, the use of unique patient identifiers can make those records less valuable because it’s harder to use a patient’s stolen identity without their Social Security number.

The Unique Patient Identifier Debate

Given such clear advantages, why hasn’t the American healthcare industry adopted a system using unique patient identifiers? The present system lacks uniformity from one healthcare organization to the next. Some organizations identify patients using a combination of names and birthdates, while others use the patient’s personal information and take a photograph.

The U.S. government currently bans funding for unique patient identifiers. Opponents of unique patient identifiers cite privacy issues as a grave concern. They question how the identifiers will be used and regulated. Questions raised include:

  • Will use of unique patient identifiers be voluntary? (Can patients choose to allow an entity to use their identifier in the same way they choose to allow an entity to check their credit histories?)
  • Will patients receive notifications when their identifiers are used and by whom?
  • Will usage logs and statements be kept and made accessible?

These questions and others have raised concerns about lifting the funding ban. Nevertheless, advocates of unique patient identifiers recently progressed in their efforts to get federal dollars for the adoption of unique patient identifiers. In June 2020, Congress passed an amendment to eliminate the unique patient identifier funding ban. Now it’s up to the Senate to also nullify the unique patient identifier funding ban when they vote on the next appropriations bill.

Unique Patient Identifiers and Health Information Management

Unique patient identifiers can significantly impact health information technology by improving the efficiency of health information technology infrastructure, which strengthens patient care coordination.

Impact on Health IT Infrastructure

Unique patient identifiers increase accurate patient identification on a national level. Accurate patient identification plays a key role in having a robust and streamlined health IT infrastructure. However, implementing unique patient identifiers also requires a substantial investment in health IT infrastructure to manage records and to ensure their security and privacy.

Improved Care Coordination

Streamlining health IT infrastructure will improve care coordination between departments and between healthcare facilities. With improved patient identification and reduced numbers of duplicate records, healthcare professionals will have accurate information at their fingertips.

Learn More About Bolstering Health Information Management

Advocates of unique patient identifiers continue to push for a reversal of the funding ban. In the meantime, professionals in health information management seek innovative ways to bolster health information technology infrastructure and leverage effective health information management strategies to ensure patients receive the highest quality care.

To cultivate the expertise and skills needed to tackle the many challenges in healthcare delivery, consider the advantages of earning an advanced degree in health information management. Learn more about the University of Illinois at Chicago’s Master of Science in Health Information Management program, and how it can help you achieve your professional goals.

Recommended Readings

How to Become a Health Information Manager

What Is Care Coordination? Exploring a Dynamic Concept in Health IT

What Is Healthcare Compliance? Exploring a Core Concept in Care Delivery

Sources:

American Society of Clinical Oncology, Unique Patient Identifiers Could Help Streamline Nation’s Health Information Technology Infrastructure

Bill of Health, “A National Patient Identifier: Should You Care?”

EHR Intelligence, “The Pros and Cons of a National Patient Identifier (NPI) System”

Health IT Security, “House Votes to Lift HHS Funding Ban on National Patient Identifier”

Healthcare Finance, “House Votes to Overturn Unique Patient Identifier Ban”

HealthLeaders, “6 Best Practices for Patient Identification”

The Hill, “The Senate Can Save Lives by Removing Ban on Unique Patient Identifier”

Imprivata, The Real Cost of Patient Misidentification: 2016 National Patient Misidentification Report”

Optiv, “A National Patient Identifier’s Impact on Healthcare Security”

MedicineNet, Medical Definition of Unique Identifier Reporting

Patient Safety Network, “Patient Identification Errors: A Systems Challenge”

RightPatient, “Impact of Duplicate Medical Records in Healthcare Can Be Mitigated

STAT, “The House Has OK’d a Unique Patient Identifier. Here’s What Should Happen Next”