- Members of the healthcare industry are once again pressuring Congress to remove what they say is a major pain point in their operations and in the delivery of patient care: the ban on a nationwide unique patient identifier.
- Almost 120 health IT groups, EHR vendors, hospitals, physicians and health insurers sent letters on Wednesday to House and Senate appropriators urging them to remove decades-old rider language in a 2023 appropriations bill that prevents the HHS from spending federal dollars to create or adopt a UPI standard.
- Signees, including payer lobby AHIP, software companies Cerner and Epic, and health systems Banner Health and Intermountain, called the ban "archaic" in the letters. However, regulators have noted a UPI is unlikely to be a silver bullet against the nation's patient matching problem.
Identifying patients and matching them correctly to their records is a perennial issue in healthcare, and one that's resulted in a patchwork of strategies across the industry in absence of one overarching federal standard. Like many other gaps in the U.S. medical system, the absence of a cohesive patient matching infrastructure has been highlighted by the coronavirus pandemic, as public health agencies struggled to collect and track longitudinal data on metrics like testing and vaccinations.
UPIs, which are numbers, codes or data used to differentiate one person from another, are a popular solution, with proponents saying enacting one linked to patients' record — regardless of their health insurer, provider or medical history — would cut waste, duplicates and avoidable medical errors.
More than 250,000 people in the U.S. die each year from medical mistakes, some of which are due to physicians operating on incorrect data, according to Johns Hopkins University.
The debate has pitted the medical community against some lawmakers and privacy watchdogs concerned that, like Social Security Numbers, UPIs could foment fraud, black market ID sales and damage victims' personal, financial and professional lives. Additionally, creating one would be pricey: One estimate from the RAND Corporation puts the total costs of a UPI between $3.9 billion and $9.2 billion.
Despite the HIPAA privacy law mandating the HHS create a UPI, Congress barred the agency from appropriating funds for a standard in 1998, citing privacy concerns. Language continuing the ban has been included in every appropriations bill for the past 23 years, despite some movement in the House, where legislators have removed the ban from the HHS' appropriations bill for the past three fiscal years.
Now, industry groups are once again ratcheting up the pressure as congressional subcommittees continue hearings for 2023 appropriations bills.
"For more than two decades, innovation and industry progress has been stifled due to a narrow interpretation of this language," the letters signed by 119 organizations read. "Without the ability of clinicians to correctly connect a patient with their medical record, lives have been lost and medical errors have needlessly occurred."
But health IT regulators have noted, in light of the numerous technologies and strategies for patient matching that are already in place, throwing a UPI into the mix is unlikely to seriously move the needle on patient identification.
"It's unclear to me actually, that even if you could wave the magic wand for a national patient identifier, that that would significantly solve a whole bunch of the problems that are out there," Micky Tripathi, head of the Office of the National Coordinator for Health IT, told Healthcare Dive in a March interview.