National patient identifier critical to ensuring patient safety

With all the renewed talk lately about the need for a national patient identifier in healthcare, Andrew Gettinger, MD, chief medical information officer in the Office of the National Coordinator for Health IT, prefers the term “individual safety identifier” instead.

Regardless of what he calls it, the driving force behind such an identifier is patient safety, according to Gettinger, given that identifying patients and accurately matching their electronic health records as they move across healthcare organizations continues to be a daunting challenge.

“Until we can consistently identify who our patients are, aggregate their information regardless of where it’s stored and allow clinicians to use that information in their patient care, we’re going to continue to struggle,” said Gettinger at this week’s AHIMA 2016 conference in Baltimore, adding that, “right now, folks at Google know more about our medical information than the doctors and nurses caring for you.”

For nearly two decades, the federal government’s ability to authorize a national patient identifier—first authorized by HIPAA in 1996—has been consistently blocked by every budget passed by Congress since 1999, effectively preventing the Department of Health and Human Services from spending funds on NPI as a solution for the problem of patient misidentification.

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Gettinger, who is also executive director of ONC’s Office of Clinical Quality and Safety, said that NPI as a concept in HIPAA’s original form was “very thoughtfully constructed by folks who designed the law who recognized that without it, aggregating information around a patient would be very difficult.” He commented that the “prohibition that says HHS shall not implement a patient identifier” has been in each congressional appropriations bill ever since then because of concerns over privacy.

However, Gettinger said he is encouraged by legislative language included in the fiscal year 2017 Labor-HHS appropriations bill that draws attention to the growing problem in healthcare of patient data mismatches and the need to develop a coordinated national strategy to promote patient safety by matching patients to their electronic health information.

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“The current committee suggested that HHS should actually now study this problem, which is a huge step forward,” he concluded. “I think we will have a solution in the near term.”

Gettinger is particularly excited about a $1 million National Patient ID Challenge launched earlier this year by the College of Healthcare Information Management Executives, which aims to create a solution that ensures 100 percent accuracy of every patient’s health information to reduce preventable medical errors.

“It is a very exciting private sector initiative,” he said, adding that he serves on a panel of judges for the competition. “I am so excited by some of the proposals that have come forward in the first round, and now they’re in the second round and they’re being looked at much more carefully.”

According to Gettinger, CHIME has teamed with crowdsourcing platform HeroX to run the competition—which is open to developers from around the world—with the grand prize winner slated to be announced in April 2017.

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