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.
By voice vote, House amends appropriations bill to strike down longtime ban on federal funding for national patient identifier. Not official yet, the votes will be recorded, but a big moment — feel like I’ve been hearing pleas to strike this down for years.
— Darius Tahir (@dariustahir) June 12, 2019
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.
Of course, it’ll need to survive the Senate and President. Nevertheless a big precedent.
(should note that the logistical challenges for identifiers will be big, not least — as someone once pointed out to me — bc you’ve got to conjure IDs for dead people.)
— Darius Tahir (@dariustahir) June 13, 2019
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:
I volunteer to implement! pic.twitter.com/Rx3eya4zA4
— Alexandra Mugge (@AMugge) June 13, 2019
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.