National Patient ID System: Debate Stoked

6 HIE Vendors: How They Measure Up

A well-known health IT advocate and consultant has started a petition on WhiteHouse.gov asking Congress to lift its prohibition on the U.S. Department of Health and Human Services (HHS) setting up a national patient identification system.

The petition, posted this week on the official White House website, calls on a rollback of restrictions that have been in place for nearly a decade and a half. "Congress should permit HHS to develop standards, especially if this could increase efficiencies and prevent medical errors," the petition states.

The original Health Insurance Portability and Accountability Act (HIPAA) legislation from 1996 called on HHS to develop a system of unique patient identifiers to help promote privacy and security of personally identifiable health information. But federal appropriations legislation for fiscal year 1999, passed in 1998, denied funding for HHS to implement a patient ID program.

[ Data analytics could be a game-changer for healthcare, but establishing a framework first is key. Read more at Big Data Use In Healthcare Needs Governance, Education. ]

Though the Obama administration officially remains opposed to a national patient ID, some in the health IT industry believe the vision of a nationwide network of interoperable electronic health records (EHRs) is unrealistic without a standard means of locating and authenticating records.

"We're trying to apply a 1990s policy framework to a 21st Century technology problem," said the petition's creator, Brian Ahier, a part-time health IT "evangelist" at Mid-Columbia Medical Center in The Dalles, Ore., who also consults on health IT issues. "Right now, over three-quarters of Congress was not a member in 1998 when that law was passed," he added.

EHR vendor Cerner is among those now advocating for unique patient IDs. The Healthcare Information Management and Systems Society (HIMSS) also is calling for at least a national patient ID matching strategy. HIMSS said such an approach, which does not necessarily include a unique ID number for each person, would better facilitate health information exchange (HIE) and improve patient safety.

Ahier is a board member of the Oregon chapter of HIMSS and serves as president of Gorge Health Connect, an HIE in north-central Oregon.

By Thursday afternoon, the petition had fewer than 100 signatures, but Ahier said he does not expect to meet the listed goal of 100,000. The White House promises an official response to any petition that receives at least 100,000 signatures within 30 days -- though the threshold was 5,000 and later 25,000 during Barack Obama's first term as president.

"Direct contact [with the Obama administration] is more effective anyway," Ahier said. He and his allies have had plenty of contact with the HHS Office of the National Coordinator for Health Information Technology and other Washington insiders. He also said social media is helping to spread the idea of re-opening the dialogue about patient identification.

Ahier described the petition as more of a "firestarter" to urge Congress to reevaluate its 1998 decision. "We've hamstrung our policy development at HHS with this imposition," Ahier said of the funding ban. "Not everyone agrees, but at least we're having the conversation."

A 2008 report from Rand Corp. said that the prohibition against unique patient IDs would hinder development of a nationwide system of interoperable health records. While that report garnered headlines at the time, it did not spark much momentum toward changing the law.

As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital Big Data Analytics issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.)