Would National Patient Identifiers Work?

Posted on January 25, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Right now,  healthcare organizations have to go through some pretty tricky maneuvers to link patient data across varied systems and settings.  It’s possible to connect patient info electronically through database hacks, but more often than not, matching patients to clinical data gets done by hand.

Given the insane complexity of the existing system, would it make sense to create a national patient identification number for every U.S. patient?  The question is worth revisiting, given the immense level of error and wasted time generated by the existing system. After all, not only would putting an NPI in place make it easier to track patients within a hospital or health system, it would simplify the rollout of HIEs dramatically, wouldn’t it?

Dr. Robert Rowley of EMR vendor Practice Fusion notes that the biggest enemies of establishing a National Patient Identifier are privacy advocates who feel that an NPI would expose patients to greater risk of breaches or misuse of data.

But is that a realistic concern? Probably not. I agree with Dr. Rowley, who asserts that it’s hard to imagine that PHI would be at greater risk simply because of how it’s indexed.  As he notes, PHI breaches are nearly always often haphazard affairs in which a laptop is stolen than Big Government or corporate conspiracies. (If you’re afraid the government is covertly siphoning your health data off to study it, not having an NPI won’t protect you, anyway.)

No, the real barrier to this kind of administrative simplification measure is time, money and resources, the same barriers that hold back any other proposed HIT project.  It’s hard to imagine the resources that would be involved in instituting such a system — the idea makes my head hurt — and I have to assume it’d be several years before it was anything like mature.

Still, it’s good to bear in mind that at least some members of the public are afraid that creating an NPI would compromise their privacy. If the only barrier to improving patient matching in our EMRs is technical, that’s one thing — but if it’s patient fears, that’s another thing entirely. Sometimes, it’s good to remember that most of the world doesn’t think like a health IT exec.