Congress may use funding bill to push study of patient matching

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A call to investigate patient matching approaches for Medicare beneficiaries is on the radar for a congressional committee, which is calling for it to be used by the nation’s providers.

A provision in the Fiscal Year 2018 funding bill put forth in the Labor, Health and Human Services and Education funding bill, now under consideration in the House Appropriations Committee, could jumpstart efforts to develop a patient matching strategy for Medicare beneficiaries to improve identification of patients, with the intent of ensuring the safety of their care.

The language, if enacted, is not extensive but far-reaching, as it would mandate that hospitals adopt patient matching technology as a condition for Medicare participation.

“The committee recognizes that a lack of a patient matching system for Medicare beneficiaries results in duplicate procedures and poses a significant patient safety risk,” according to a report of the Appropriations Committee.

“The Committee is aware that a number of patient matching systems are currently being used in the commercial sector, but one has yet to be adopted in Medicare. The Committee requests a report not less than 12 months after the date of enactment of this Act on the impact of care improvement, reduction in costs, estimated saved lives or reduction in errors, and improvements in patient safety if hospitals were required to use a patient matching system as a requirement for participation in the Medicare program.”

Reaction to the legislative language varies widely among industry experts.

Kate Borten, president of the Marblehead Group privacy and security consultancy, believes the patient matching provision in the funding bill is critically needed.

“Patient matching processes are complex and imperfect, but they are essential for maintaining comprehensive medical records with data integrity,” she says. “Moving the country toward patient-matching standardization will benefit patients and the healthcare industry.”

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Dean Sittig, a professor at the school of biomedical informatics at the University of Texas Health Science Center, says the congressional proposal is just a limited first step.

“Patient matching technology is, by definition, a flawed approach to accurately identifying patients, since only the date of birth is a guaranteed constant throughout one’s life,” he notes. Names change, especially for females, and many first names may evolve into nicknames.

“If the government were really interested in solving this problem, they would create a large nationwide database of multiple biometric data, such as fingerprints, iris scans, palm vein images and DNA, coupled with a unique person identifier that could be used to unambiguously identify every person,” Sittig adds. “For most people, just thinking about the socio-political problems with such a database makes it sound crazy,” he acknowledges. Solving this problem is critical, but beyond our current societal willpower.”

Elizabeth Westbrook, a government relations advisor at the Buchanan, Ingersoll & Rooney law firm, takes the middle ground on the congressional proposal. “It is encouraging that Congress is cognizant that patient matching is a key part of the future of healthcare and electronic health records. However, this is an area of health IT where private industry is likely to move much faster than the government. ONC and HHS should continue their research, but they should also stay out of the way of innovators as much as possible.”

Health IT Now, a coalition of patient, provider, employer and payer stakeholders, is supporting the patient matching language in the appropriations bill. Earlier this year, a group of associations and other advocacy groups called for inclusion of language that would support private sector-led patient-identifying initiatives, and the new congressional language honors the request, according to Heath IT Now.

“Providers must have a means of accurately identifying patients and matching them to their health information,” says Joel White, executive director at Health IT Now. The delay in adopting such technology “threatens patient safety and results in significant avoidable costs.”

While much work needs to be done to realize the full potential of patient data matching, “the Appropriations Committee’s report takes an important step forward by showing that Congress will not stand in the way of private sector innovations to curb patient identification errors,” White adds.

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