The Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) has released a statement criticizing U.S. Senator Rand Paul’s (R-KY) recent introduction of the National Patient Identifier Repeal Act.
Earlier this week, Sen. Paul introduced the legislation, which aims “to overturn a dangerous provision of existing law requiring the creation of a ‘unique health identifier,’ also known as a National Patient ID,” he stated. Paul added, ““As a physician, I know firsthand how the doctor-patient relationship relies on trust and privacy, which will be thrown into jeopardy by a National Patient ID. Considering how unfortunately familiar our world has become with devastating security breaches and the dangers of the growing surveillance state, it is simply unacceptable for government to centralize some of Americans’ most personal information.”
But CHIME, which has long been a proponent of removing the federal prohibition on funding for a national patient identification strategy, noted in a statement this week that “The patient identification conversation is one about saving lives and unlocking the potential for technology to revolutionize healthcare while cutting costs.” CHIME President and CEO Russ Branzell added, “Sen. Paul’s arguments are tired and lack a grasp of current reality. They are, to put it mildly, antiquated and from some bygone era. He tried a similar effort during a recent HELP Committee markup, but his ill-fated amendment was met with a resounding defeat by members of even his own party.”
In June, the U.S. House of Representatives passed an amendment that would end the current federal ban on the funding of a national patient identification strategy. That action was applauded by senior advocacy leaders CHIME. So, while it appeared that changes could be in the offering, Senate appropriators declined to include the language in its draft fiscal year 2020 funding legislation. Indeed, since 1999, the federal government has been prohibited from spending public funds on the development of a national patient identifier. As it stands now, that two-decade-long ban would remain intact.
Nevertheless, the private sector has tried their hand on certain initiatives; perhaps most notably and recently when CHIME launched a National Patient ID Challenge in 2016, a $1 million crowdsourcing competition to incentivize the private sector to develop a fail-safe patient identifying solution that links patients to their medical records. However, that project was eventually suspended; CHIME’s president and CEO Russ Branzell noted that the work was much more complex than ever imagined.
Some ground had been gained by the public sector as well. The 21st Century Cures Act, passed by Congress and signed into law by President Obama in late 2016, required the Government Accountability Office (GAO) to study the issue of matching all patient data obtained from various sources to the correct individual to help ensure appropriate treatment decisions are made.
But as Sen. Paul stated, “Enacting the [House’s] bill into law with this amendment or a similar provision would open the floodgates for a government-issued ID to be linked with the private medical history of every man, woman, and child in America.”
Interestingly, Sen. Paul’s father, former Congressman Ron Paul (R-TX), was one of the people who introduced language to the Labor-HHS appropriations bill in 1998 to restrict the use of federal funds to develop the identifier.
But according to CHIME, “Even in the paper era, Congress recognized the criticality of identifying patients with the passage of HIPAA. They acknowledged that maintaining the privacy and security of health data is of the utmost importance, but that the data needs to be portable to aid in the provision of care.”
Stakeholders in favor of removing the national ban point out that there is currently no universal standard to 100 percent accurately identify patients and match them to their medical records. CHIME, and a slew of other organizations, wrote in a recent letter to members of Congress, “Without the ability of clinicians to correctly connect a patient with their medical record, lives have been lost and medical errors have needlessly occurred. These are situations that could have been avoidable had patients been able to have been accurately identified and matched with their records. This problem is so dire that one of the nation’s leading patient safety organizations, the ECRI Institute, named patient misidentification among the top ten threats to patient safety.”
They added that at the time of the 1999 ban, electronic health records were “rudimentary at best.” But today, with their increased maturation, “Removing the antiquated ban that is currently preventing appropriate health information flow would assist in transitioning the U.S. to a healthcare delivery system that focuses on high value, cost-effective, and patient-centered care,” the groups wrote.
The letter continued, “Removing the prohibition on the use of federal funds to promulgate or adopt a national UPI will provide HHS the ability to evaluate a range of patient identification solutions and enable it to work with the private sector to explore potential challenges and identify a solution that protects patient privacy and is cost-effective, scalable, and secure.”
