US Government Ban on National Patient Identifier Voted to Be Lifted by House

The big news coming out of Washington yesterday was the house’s vote to strike down the long time ban on federal funding for a national patient identifier. Here is a tweet that highlighted the vote.

Everyone would always ask why there wasn’t a national patient identifier in the US and the response was simple. The US government was legally not allowed to invest money in one. It’s hard to understand why someone would have put this in place in the first place. I’m sure it was done in the name of privacy, but those familiar with the issue know that it does little to protect people’s privacy.

Darius Tahir, who tweeted the vote above, offered this important note on the bill still needing to pass the Senate and the President.

What’s not clear to me is what else is in the bill. I hope that we’re to the point where the national patient identifier isn’t a reason for them to knock down the bill, but you have to wonder what else is in the bill that it’s been attached to that could get voted down.

While this is good news for healthcare, I think we should temper our expectations a bit. Just like we shouldn’t assume that a national patient identifier will be a problem for privacy, we also shouldn’t assume that having a national patient identifier will solve all of our patient identification and patient matching problems. That’s 100% not the case. It will help, but it won’t solve a lot of the patient matching problems.

We learned this first hand when CHIME ran their $1 million National Patient ID Challenge. They later chose to suspend the challenge which felt wrong and a slap in the face to everyone who participated, but that’s a different story. One good thing that came out of the challenge is that many of us came to realize the depth of complexity associated in patient identification. There are so many edge cases that create duplicate patients, mismatched patients, etc, that a national patient ID will only solve part of the problem.

If you want more information on this challenge, check out the video interview we did on patient identification and patient matching back in 2016 when the million dollar patient ID challenge was announced. Plus, you can learn about even more of the complexities of patient matching and overlays in this video roundtable we did.

The response from the industry has been similar to mine. For example, NextGate which is deep in the patient identification and EMPI space offered these comments:

NextGate applauds the House for their decision to overturn the ban on federal funding for a national patient identifier in a serious effort to improve interoperability and patient safety. While a universal patient identifier is not the silver bullet to solving the patient matching crisis in the U.S., it will help to move the needle forward toward building a safer, more interoperable healthcare system. Having worked extensively in other countries that currently have a mandated number—England and Scotland—it alone is not enough to achieve total integration across health and social care services. Because the U.S. healthcare system is much larger in scope and far more complex than that of the U.K., a national patient identifier should be perceived as another strong indicator of an individual’s identity, in conjunction with other demographics required for matching. Nevertheless, we commend the decision as a major step forward in enabling a longitudinal health record, and we are well-positioned to support the transition.

We’ll keep an eye on this legislation and update this post if it passes the Senate and the President signs it into law. My favorite response to this announcement came from Deputy CHIO at CMS, Alexandra Mugge:

Looks like CMS is as ready to do this as anyone else. Let’s hope it makes it through the rest of the legislative process.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Having been around during those discussions following the passage of HIPAA, there was a concern about personal privacy and there was a “papers, please” feel to it. A national patient identifier was considered akin to cradle-to-grave government control over our lives. This is well before Faceplant 🙂 Since that time, it seems that people do not have the same sense of privacy about themselves, the privacy of the content of their lives or control over their own destiny. Full disclosure is more or less expected today, so there is no sense that there is a problem being tagged with a national patient identifier that follows you around. After all, our phone gps knows where we are all the time. Society has changed and made the NPI possible. Of course, it doesn’t change the actual difficulty of matching records to patients and all the other “fun stuff” that needs to be done for a cradle-to-grave record of each of us. With Social Determinants of Health as part of our health record, it now includes where we live, what we eat and what we do with our time. Bottom line, I think it is a societal change that moved with advances in technology.

  • That’s some great perspective Peggy. Thanks for sharing your experience. I agree that the mentality of the nations has shifted in a big way. I think it’s a good change when it comes to a national patient identifier.

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