Push for a national patient identification standard persists

Patient ID Now has written a letter urging House and Senate appropriators to remove the long-standing ban from the FY 2023 Labor-HHS Appropriations bill that prevents the use of federal dollars toward creating a national patient identification standard.  

“The lack of a national strategy on patient identification also causes financial burdens to patients, clinicians, and institutions. The expense of repeated medical care due to duplicate records costs an average of $1,950 per patient inpatient stay, and over $1,700 per emergency department visit. Thirty-five percent of all denied claims result from inaccurate patient identification, costing the average hospital $2.5 million and the US healthcare system over $6.7 billion annually,” says Patient ID Now in their letter signed by healthcare industry leaders. 

“In a recent survey by the Patient ID Now coalition, 72% of respondents agreed that there are delays in billing and reimbursement due to inaccurate patient information, and 70% indicated that patients undergo or receive duplicative or unnecessary testing or services due to difficulties in managing patient identities.” 

The need for a unique patient identification standard is far beyond financial and bureaucratic. Patient ID Now has collected healthcare mishaps related to patient identification problems ranging from inconvenient slip-ups to fatal mistakes.  

In one story, a woman had a routine mammogram and never received the results. She saw this as a good sign, figuring that she would only have been called if there was something to report. Months later, at her annual physical exam, she mentioned to her provider that she was relieved to hear that no abnormalities were detected.  

However, it turned out that her test results had been mistakenly filed in the medical chart of a deceased patient with the same name. When she finally received her results, they revealed that she did have cancer and, because of the one-year delay, it had become terminal.  

History of the patient identification ban  

For more than 20 years, the advancement of a national patient identification strategy has been impeded by a clause included in the federal budget, which bars the utilization of federal funds for the creation of a standard unique health identifier.  

A national patient identification standard was one of the original components of the Health Insurance Portability and Accountability Act (HIPAA). Having a unique patient identification number was thought to help advance the transition from paper to electronic health records in a thorough and effective manner. 

But Rep. Ron Paul (R-Tex.), a leading libertarian member in Congress at the time, perceived a unique identifier for health care as an intrusion by the government into private health matters. Consequently, he included phrasing in the federal budget to prevent the government from utilizing any financial resources to establish a unique identifier. This restriction has remained in effect ever since. 

Future of a national patient identification standard 

Bipartisan support to repeal the ban has grown so much that in 2022, for the first time, the Senate agreed to remove the language restricting federal dollars from being spent on a national patient identification standard from its Labor, Health and Human Services, Education, and Related Agencies appropriations bill, but in the final stages of negotiations, it was left as-is.  

The signatories on Patient ID Now’s past letter to Congress have included 119 healthcare institutions including medical associations, professional societies, and hospitals and healthcare systems across the country.  

The federal government has helped digital health advance and the more healthcare relies on digital health, the more important a patient identification standard will be.  

“While Congress prioritized interoperability and digital data exchange in the 21st Century Cures Act and other legislation, progress toward these national priorities is inhibited by patient matching and identification issues. Removing the ban that is currently preventing appropriate health information flow would assist in transitioning the US to a healthcare delivery system that focuses on high value, cost-effective, and patient-centered care.”