Posts

solving the patient ID crisis in healthcare

Does Renewed Call for National Patient ID Signal…Anything?

solving the patient ID crisis in healthcare

Will the latest letter to Congress asking for the 18 year HHS moratorium on a national patient identifier encourage them to act? (Photo courtesy of pexels.com).

Early last week, a group of 25 healthcare organizations representing providers, payers, and health IT companies submitted a letter to members of the House and Senate Committees on Appropriations asking for the removal of a nearly twenty-year-old provision preventing HHS from adopting or implementing a national patient identifier. (source: http://bit.ly/2oQ9PEJ). The goal is to prod Congress to include specific language in the FY18 Labor-HHS spending bill that allows HHS to assist private sector organizations in promoting patient matching initiatives. It’s an unprecedented move to bring yet more attention to the growing and complex problem of accurate patient identification and data matching that continues to plague the healthcare industry from top to bottom, affecting just about every element of care delivery as patients move in and out of the care continuum.

As we have written about before on this blog, we have been saying for years that healthcare simply has to solve the patient ID dilemma and adopt a more holistic approach to patient matching that effectively addresses authentication at the host of new touchpoints borne from the digital health revolution. In fact, hospitals and healthcare systems who invest in patient ID solutions that only cover identification in physical, brick and mortar environments are doing themselves a disservice and severely limiting their ability to ensure patients are kept safe no matter where or in what context they seek care. If any of these institutions plan to participate in local, regional, or national health information exchanges (HIEs) or adopt interoperability standards in the spirit of open and fluid data exchange, they will quickly realize they made the wrong investment choice.

To frame the urgency of the situation, the letter stated:

 “According to a recent study of healthcare executives, misidentification costs the average healthcare facility $17.4 million per year in denied claims and potential lost revenue,” the letter stated. “More importantly, there are patient safety implications when data is matched to the wrong patient and when essential data is lacking from a patient’s record due to identity issues.” (Source: http://bit.ly/2oQ9PEJ

The letter even went on to point out that important initiatives like precision medicine and disease research could continue to suffer and lose significance in the absence of solving the patient ID issue not to underscore the potential negative impact on the aforementioned HIE and interoperability efforts. What’s clear is that millions and millions of research and development capital and manpower has been invested in advancing personalized medicine, data exchange, and interoperability in the absence of solving the problem of inaccurate patient identification and to be honest, we feel that many are starting to get a little nervous.

The question becomes – will this letter actually move the needle and capture lawmaker’s attention? Considering the new administration’s failed efforts to repeal and replace Obamacare and their healthcare agenda moving forward, our guess is probably not. While we applaud the effort, past attempts to bring this issue to the forefront in the spirit of including language and funding in the HHS appropriations bill that lifts the 18 year moratorium on patient identification have generally stalled. In our opinion, there are too many more high profile healthcare issues at play that diminish the urgency of solving patient ID in healthcare. Unfortunately, achieving accurate patient ID in healthcare doesn’t carry enough political clout to be considered something worth immediately pursuing and it’s simply not enough of a concern of lawmaker constituents for them to kick up a fuss at the fact that it remains unsolved. At least not yet, anyway.

We wonder….would this group of 25 healthcare organizations be better served to build a larger and more widespread groundswell of support among us, the patients, about achieving accurate patient ID in healthcare instead of going after the big fish (Congress)? Could an argument be made that it’s a more effective strategy to build consensus among patients who, indirectly, can then place pressure on their respective lawmakers to take action? Is it more effective to attack and leverage the power of the voter vs. swaying the whims of Congress? Perhaps, however it should be noted that grass roots efforts take an enormous amount of time to organize and execute, and the issue of accurate patient ID in healthcare simply can’t afford to wait any longer. 

So, we wait. Cautiously optimistic that when framed in the larger context of tangential initiatives failing in the absence of accurate patient ID, 2017 could indeed be the year that Congress takes a step forward in solving the issue. Heaven only knows if they will act, but a step forward is surely more powerful than 18 steps in place.

 

 

patient identification in healthcare

Is Petitioning Congress the Answer to Achieving Accurate Patient ID?

patient identification in healthcare

AHIMA’s efforts to petition Congress to life the federal moratorium on funding research on developing a national patient identifier may not do much to adequately solve the problem.

Hat tip for the recent efforts by the American Health Information Management Association (AHIMA) to launch a petition drive that will move Congress to lift the federal legislative ban that has prohibited the U.S. Department of Health and Human Services (HHS) from participating in efforts to find a patient identification solution. It’s a noble effort and adds fuel to the hot fire burning in the industry to solve the persistent and dangerous problem of achieving accurate patient identification in healthcare. We understand that the effort to improve patient identification in healthcare has many downstream benefits to the entire industry including (but not limited to):

— Revenue cycle management
— Patient safety
— Health information exchange
— Population health

The fact that organizations with the clout of AHIMA and CHIME have contributed their powerful voices to the battle of improving patient ID in healthcare is advantageous to the end goal of finding a universal solution that can be adopted collectively throughout the industry. AHIMA and CHIME’s efforts are working to garner more attention to the persistent patient matching problem in healthcare and sparking more discussions about how to solve the problem. Often relegated as a back seat initiative in favor of other healthcare technology initiatives (e.g. – ICD-10, EHR implementation, interoperability), we have always believed that improving patient identification in healthcare should be higher on the priority list.   

AHIMA’s initiative has merit, but is advocating the use of a credential predicated on the concept of presenting something you have or know the answer to solving the patient identification problem in healthcare? One of the reasons that the healthcare industry has struggled with accurate patient identification is that legacy methods of identifying patients have proven to be easy targets to exploit. Human identification generally falls into three distinct categories:

  • “What you know” – address, phone number, date of birth
  • “What you have” – insurance card, driver’s license, passport, government issued identity
  • “Who you are” – biometrics

Traditional identification methods generally rely on asking a patient what they know or what they have but we already know that these are frequently abused and easy sources to commit fraud. Just look at the continued rise in cases of medical identity theft at the point of service – an estimated 2.3 million Americans or close family members had their identities stolen during or before 2014, and a large number of these cases involve family members stealing or sharing medical insurance credentials.

In geographic locations throughout the country where a large percentage of the patient demographic may share similar names, providing a false name or multiple variations of a name at the point of service in order to defraud the system is common. An example widely used throughout the industry to illustrate this is the Harris County Hospital District in Houston where among 3.5 million patients, there are nearly 70,000 instances where two or more patients shared the same last name, first name and date of birth. Among these were 2,488 different patients named Maria Garcia and 231 of those shared the same birth date.

In geographic locations throughout the country where a large percentage of the patient demographic may share similar names, providing a false name or multiple variations of a name at the point of service in order to defraud the system is common. An example widely used throughout the industry to illustrate this is the Harris County Hospital District in Houston where among 3.5 million patients, are were nearly 70,000 instances where two or more patients shared the same last name, first name and date of birth. Among these were 2,488 different patients named Maria Garcia and 231 of those shared the same birth date.

Pushing Congress to lift the federal moratorium on funding research on developing a national patient identifier may lead to a solution that requires patients who opt-in to bring this credential with them when seeking medical treatment. In the absence of incorporating an additional identification credential that relies on “who you are,” simply creating another individual authentication credential that relies on “what you know” or “what you have” leads us down the same path of abuse and fraud. After all, in theory the national patient identifier would be similar to a social security number or other credential that is subject to being stolen, shared, or swapped just like current methods of identification. Do we really want to allow this to happen? Seems as if this solution would be the equivalent or rearranging the deck chairs on the Titanic. 

Moving forward, the smarter way to solve the identification crisis in healthcare is to adopt technology that identifies patients by who they are, or some sort of a combination of what you have or what you know with who you are. For example, the use of biometrics for patient identification – already a proven technology that patients accept and significantly reduces duplicate medical records, overlays, medical identity theft, and fraud – would be a more sensible way to identify patients to alleviate the problems caused by misidentification. 

Lobbying Congress to lift the moratorium on funding research to develop a national patient identifier won’t solve the patient ID problem in healthcare unless the industry realizes that it must move away from antiquated identification methods that rely on what you have and/or what you know and instead shift to identifying patients by who they are. Unless this is part of the equation, healthcare will continue to spin it’s wheels in the effort to solve the vexing problem of how to achieve 100% accurate patient identification.

establishing accurate patient identification in healthcare is critical

CHIME Breathes New Life Into Patient Identity Crisis in Healthcare

establishing accurate patient identification in healthcare is critical

Did CHIME’s recent letter to Congress stressing the importance of establishing a national patient identifier light a fire under the government to act?

Last week, word came from Washington D.C. that the College of Healthcare Information Management Executives (CHIME) included language in a letter written to the Senate Committee on Health, Education, Labor & Pensions that accentuated the importance of accurate patient identification as a key component to ensure patient safety. In the letter, CHIME CEO Russell Branzell wrote:

“The accurate and effective matching of patients with their healthcare data is a significant threat to patient safety. We must first acknowledge that the lack of a consistent patient identity matching strategy is the most significant challenge inhibiting the safe and secure exchange of health information. As our healthcare system begins to realize the innately transformational capabilities of health IT, moving forward toward nationwide health information exchange, this essential core functionality consistency in patient identity matching must be addressed.”

Kudos to CHIME for resurrecting this issue and calling intention to its importance in the scope of the new healthcare industry paradigm of fluidly sharing patient data both in and outside of healthcare networks to advance to goal of improving both individual and population health. In their letter, CHIME and Branzell also recommended that Congress remove the prohibition levied on HHS every year since 1999 that prohibits the use of federal funds for the development of a unique patient identifier. 

CHIME’s actions are extremely significant in the overall scope of inching closer to the establishment of a national patient identification credential because they are arguably the most influential healthcare lobbyist on Capitol Hill representing the general views of over 1,400 members around the world, many of which are healthcare CIOs — a very powerful voice in health IT. The root of the patient identification problem at hand stems from multiple sources – lack of industry standards, a lack of consistency on how patient data is collected, and the public’s perception that they don’t have to show ID when accessing healthcare, just to name a few. Couple that with the aggressive push to establish concrete interoperability between healthcare systems for the seamless exchange of patient health data and you can see where the conundrum lies.

We have always thought that initiatives set in motion by the healthcare industry championing interoperability have always been sort of a “cart before the horse” scenario. Realistically, how can the healthcare industry expect to achieve meaningful interoperability when one of the core issues to reaching that goal (accurate patient identification) gets little to no attention as a key factor in its success? Furthermore, lack of a sustainable, federated patient identification credential inhibits progress towards the “triple aim” of healthcare — improving the patient experience, improving population health, and reducing the per capita cost of care.

Think the situation could get more complex? Don’t worry, it does. When you factor in the explosion of patient touchpoints permeating the healthcare market (e.g. mobile devices, patient portals, mhealth apps), the patient identification issue becomes much more stickier. As the multitude of channels patients can now submit and access health data to grows, any national patient identification solution must have the ability to address accurate patient identification at each and every touchpoint patients come in contact with. No longer interactions in strictly brick and mortar environments, administering care to patients has slowly evolved in lockstep with the rise of digital health capabilities, pushing the urgency to implement stricter patient ID protocols in an effort to ensure accuracy and safety.

Data accuracy in healthcare is unlike data accuracy in any other industry. Consumers can always rectify banking errors for example, but errors in interpreting inaccurate or missing health data can be matters of life and death adding even more urgency to solving the patient identification dilemma.

As we move closer towards opening the door even wider to advanced discussions on the issues surrounding patient identification within the U.S. healthcare system, you can bet that CHIME will continue to be a strong voice and influential entity to mold and shape future policies that address the need to establish more accuracy at each point along the care continuum. 

What are your thoughts on CHIME’s statements to Congress? Will their efforts help left the moratorium? Please let us know in the comments below.