Healthcare industry groups have been chewing on the challenge of accurate patient matching for years, with the prospect of patient misidentification presenting questions around safety and security, even as the importance of data sharing becomes more apparent.
And the COVID-19 crisis, said industry group representatives at a working session convened by the Office of the National Coordinator for Health IT on Monday, is clarifying the need to address that challenge.
“Having incorrect data has a negative impact on the timeliness of the public health response,” said HIMSS VP of Government Relations Tom Leary during the session.
Patient identification and matching challenges amid the novel coronavirus pandemic, said Leary, can lead to inaccuracies in the longitudinal care record, delays in sharing test results and data collection gaps, among other implications. Leary described how some public health nurses have even relied on Google searches to try and correctly identify some patients and get in contact about their COVID-19 test results.
As we prepare for a COVID-19 vaccine, too, large-scale immunization programs will depend on accurate patient information – including determining who has had the disease, who has been vaccinated and patient outcomes.
“Not having a true approach to patient identification” is exacerbating existing public health issues associated with the crisis, said Leary.
Leary, along with Premier Healthcare Alliance senior director of federal affairs Meryl Bloomrosen, spoke on behalf of Patient ID Now, a multi-organization coalition – of which Healthcare IT News parent company HIMSS is a part – committed to advancing a national strategy to address patient identification through legislation and regulations.
Although Leary and Bloomrosen emphasized that the coalition is solutions-agnostic, one major goal is the repeal of a ban on federal funding for the adoption of a unique patient ID. The U.S. House of Representatives voted to remove the ban this past month, but the Senate still must approve the policy change.
The U.S. Department of Health and Human Services should be “at the table with the healthcare community,” said Leary.
According to Patient ID Now, issues stemming from misidentification include mislabeled lab results, overlaid patient records or wrongful billing.
Leary also argued that patient matching is an important issue for underserved communities. At one nonprofit health IT services provider for 50 sites, he said, Black individuals make up 13% of the patient population, but 21% of duplicates; Latinx patients make up 21% of the population, yet 35% of duplicates; and homeless people make up 4.3% of the population, but 12% of its duplicates.
Patient privacy and security are vital factors to consider, said stakeholders during the session. The American Civil Liberties Union last year argued against overturning the patient ID ban, saying it could “permit inadequate unique health identifier regulations to move forward without Congressional approval.”
Other stakeholders cautioned that a nationwide personal identifying information database would present an “irresistible honeypot,” as Global Patient Identifiers Ffounder and Chief Scientist Barry Hieb put it.
“Any system that involves interaction with human beings, no matter how well it is designed, it will encounter errors,” said Hieb. “It must be possible to fully restore the integrity of a patient’s identity following any human data input error.”
“The [national health ID] system must be designed to prevent as much of this fraudulent activity as possible,” Hieb continued.
However, said Leary, the current system has created an “inverse privacy challenge,” with individuals repetitively disclosing identifiable information to every healthcare provider they see.
“The challenge is how you link patient records while taking into account the privacy and security interests, and how do we associate patient info accurately with patient records, yet protecting patient anonymity?” said Kathryn Marchesini, chief privacy officer at ONC.
Kat Jercich is senior editor of Healthcare IT News.
Healthcare IT News is a HIMSS Media publication.