Inside CHIME: Finally! Progress on Patient Identification in Washington, DC

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5.11.17 by Leslie Krigstein
VP of Congressional Affairs, CHIME

After nearly 18 years of inaction from Congress, last week alongside the federal spending bill, Congress gave the go-ahead for the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) to work with the private sector on patient identification and patient matching initiatives.

The longstanding prohibition on the Department of Health and Human Services (HHS) from using any federal funds to “…promulgate or adopt any final standard under section 1173(b) of the Social Security Act (42 U.S.C. 1320d–2(b)) providing for, or providing for the assignment of, a unique health identifier for an individual (except in an individual’s capacity as an employer or a health care provider), until legislation is enacted specifically approving the standard,” remained, but it was the additional clarification offered in the Committee Report that has opened some new doors with our federal partners on this critical patient safety issue.

Congress acknowledged the lack of a national approach to patient identification as a barrier to interoperability, saying:

Unique Patient Health Identifier.—The Committee is aware that one of the most significant challenges inhibiting the safe and secure electronic exchange of health information is the lack of a consistent patient data matching strategy. With the passage of the HITECH Act, a clear mandate was placed on the Nation’s healthcare community to adopt electronic health records and health exchange capability. Although the Committee continues to carry a prohibition against HHS using funds to promulgate or adopt any final standard providing for the assignment of a unique health identifier for an individual until such activity is authorized, the Committee notes that this limitation does not prohibit HHS from examining the issues around patient matching. Accordingly, the Committee encourages the Secretary, acting through the Office of the National Coordinator for Health Information Technology and CMS, to provide technical assistance to private-sector led initiatives to develop a coordinated national strategy that will promote patient safety by accurately identifying patients to their health information.[1]

Further, in explaining how Congress believes ONC should use its federal funding, they said:

Electronic Health Records.—The Committee believes HHS’ work to encourage the adoption of electronic health records has provided important new opportunities to improve the quality, safety, and cost-effectiveness of health care. The Secretary is directed to further this work by studying approaches to improve person-centered healthcare through patient access to health information. That work should examine accurate and timely record matching so that all EHR systems are collecting the information necessary for a fully interoperable system that protects patients from identity mismatch errors, but also considers patient privacy and security. [2]

For a further breakdown and comparison of recent updates, view our latest CIO legislative brief: Understanding the Congressional Funding Ban on a Unique Patient Identifier.

CHIME continues to be a leader on patient identification, earlier this year, we led more than 25 organizations in a letter delivered to appropriators asking for the Committee Report language that we saw accompany the funding bill last week. We’ve also submitted a request to the National Committee on Vital and Health Statistics (NCVHS), HHS’ advisory body on the Health Insurance Portability and Accountability Act (HIPAA), asking to hold a hearing on the issue of patient identification and matching.

Meanwhile, the CHIME Healthcare Innovation Trust National Patient Identification Challenge is underway to find a solution for 100 percent patient identification 100 percent of the time, seeking to leverage the innovation occurring in the private sector to solve an issue the government continues to be restricted from acting on.

If you had a patient identification error or near-miss that you would be willing to share with the CHIME public policy team, or if you would like to learn more about CHIME’s ongoing advocacy efforts, please contact Leslie Krigstein and Mari Savickis at [email protected].

[1] https://www.congress.gov/114/crpt/hrpt699/CRPT-114hrpt699.pdf
[2] https://www.congress.gov/114/crpt/srpt274/CRPT-114srpt274.pdf

More Inside CHIME Volume 2, No. 10: