In the era of increasing digitization of healthcare data and a greater call for interoperability of said data, have we reached a tipping point to finally begin implementing a unique identifier for everyone in the United States? Say, something similar to what was implemented several years ago for providers–NPI or National Provider Identifier. This one would also be an NPI but for National Patient Identifier.
Is this even possible?
Did you know that the idea for a ‘national patient identifier’ was a part of the original 1996 HIPAA legislation. However, this piece stalled and was later removed due to concerns voiced by privacy stalwarts. We have been dealing for years–even decades–with stolen identities and hijacked sensitive personal data having everyone on edge. (Remember the days when our social security number was floating around EVERYWHERE? At one time, I even had my SSN printed on my personal checks!) However, this key piece of identifying information does throw a (pretty large) monkey wrench in trying to match up health IT data coming from within and outside an organization. This hampers overall interoperability efforts especially w/HIEs.
Most provider entities (especially hospitals and health systems) have quite a time w/their MPI (Master Patient Index) as it is. Before I worked at a large health system implementing their EMR solution, I was clueless as to how hard this can be. For example, take a common name such as John Smith. What if John is admitted to the hospital and tells the registration clerk his nickname, Johnny, and doesn’t have his insurance card on him but knows he has Blue Cross. The registration person enters Johnny Smith into the system. What about if this same patient uses another derivation of the name, Jonathan, his full name but it differs than what is on his insurance record. If this same person comes in for a follow-up visit in two weeks and has moved and gives his name as Jonathan but the registration clerk miskeys his name and enters Johnathan (w/an h)? This is all the same person but he has three different first names and at least two different addresses. All for the same patient. How is an organization to know that this is one person? Here’s an interesting article that delves a bit further into this issue.