- In a bipartisan vote Wednesday night the U.S. House of Representatives passed a $99.4 billion HHS appropriations bill with multiple amendments, including one overturning a decades-old ban on federal funding for developing a national patient identifier. Forty-one Republicans joined 205 Democrats voting for the amendment.
- The amendment still has to pass the Republican-led Senate and be signed into law by President Trump: a rocky path given the longstanding concerns over establishing a national patient identification system with a permanent, unique ID for patients to create a method to link together medical records, regardless of health insurer, provider or medical history.
- Industry responded positively, with the American Health Information Management Association cheering the repeal of an "archaic ban," and patient matching firm NextGate CTO Dan Cidon saying it will "move the needle" on interoperability. The two organizations along with 24 other health IT, payer and provider organizations sent a letter to Congress before the vote urging them to vote yes.
Debate around establishing a country-wide method to link patients to their records has been going on for some time now, pitting the medical community, IT vendors and payers against some lawmakers and third-party groups concerned about privacy.
The House nod on the measure by Rep. Bill Foster, D-Illinois, to reverse the 23-year-old ban drew further warnings about the risk to privacy.
"Make no mistake. The [patient identifier] would be the end of privacy and the foundation of a national health data system and a socialized health care system," Twila Brase, president of the right-leaning Citizens' Council for Health Freedom, said in a statement.
Opponents argue that, unless HHS creates and maintains rigorous safeguards, patient identifiers could be stolen or misplaced, leading to fraud, black market ID sales and long-term damaging effects on a victim's personal, professional and financial lives.
But correctly matching patients to their medical records is a growing challenge for the healthcare sector, especially in light of HHS efforts to spur free, unfettered data sharing across the industry.
"True interoperability requires federation and identity management, which we can only achieve with a trusted foundation," IT security firm Imprivata CEO Gus Malezis said in a statement. "That trusted foundation starts with identity proofing."
Other potential solutions to match patients to their records include using biometric data, referential matching records to a central third-party database, roping in smartphones and other digital tools and standardizing how stakeholders input patient data into their records.
A UPI won't necessarily be a number, but could incorporate one or more data elements, according to Leslie Krigstein, the College of Healthcare Information Management Executives VP of congressional affairs.
"There's a recognition among all parties that we're far beyond assigning just another number," Krigstein told Healthcare Dive. "There should probably be a conversation about all the options."
Legislators have been trying to enact a national patient identifier since 1993. The mandate to create such a system was actually enacted in 1996 with the passage of the HIPAA. However, an annual prohibition on funding it passed in a 1999 appropriations bill over privacy concerns and funding it has been illegal ever since.
In 2017, lawmakers took another look at the issue in the face of maintained advocacy from health IT groups like HIMSS and CHIME. That year's appropriation bill included language allowing HHS to aid private sector development of a patient identifier.