5 Senators ask GAO to study dangers of patient mismatching

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Five Senators are asking the Government Accountability Office to study problems associated with patient misidentification.

The request comes from Senators Elizabeth Warren (D-Mass.), Orrin Hatch (R-Utah), Sheldon Whitehouse (D-R.I.), Tammy Baldwin (D-Wis.) and Bill Cassidy (R-La.), in a letter to GAO Comptroller General Gene Dodaro.

That request could be added to the GAO’s planned initiative to research patient matching challenges faced by the nation’s healthcare organizations; the research was a requirement included in the 21st Century Cures Act, which was passed late last year.

Both research efforts would be welcomed by the nation’s healthcare industry, which has long sought a way to improve identification of patients and better link them to their patient records.

When the Health Insurance Portability and Accountability Act of 1996 was signed into law, provisions in the bill required creation of patient identifiers along with data transmission standards to improve the reliability of health information. However, Congress later banned funding to develop a unique patient identifier system. Consequently, there is no single identifier that links to a specific patient, and patients often have disparate identifiers across multiple provider organizations.

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The senators’ letter to the GAO noted a 2012 survey that found one in five physicians encountered mismatched patient information that led to harm at least once in the previous year. Further, a 2016 report estimated the value of denied claims from misidentification at an average hospital was $1.2 million annually.

The senators also note that the National Coordinator for Health Information Technology has taken steps to address patient matching, which will be among the issues covered in the GAO report, but the lawmakers want GAO to broaden its report boundaries.

“In addition to the study parameters required by the 21st Century Cures Act to evaluate ongoing efforts related to patient matching, we ask that GAO provide data on the prevalence of patient data mismatches as well as the costs and risks associated with these mismatches,” the senators tell Dodaro.

The lawmakers also ask that GAO produce recommendations for federal agencies to improve patient matching, which could include development of a national strategy.

“In evaluating the impact of patient matching efforts on factors like privacy and security of patient information, we hope you will at the same time consider impacts on medical fraud, medical identity thefts and medical reimbursement,” they conclude. GAO’s report is due to Congress in December 2018.

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