The Senate is considering lifting a two-decades old ban on establishing unique patient identifiers in US healthcare settings after the House voted to repeal the ban in June 2019.

The proposed national patient identifier program would assign a unique number or code to every American, much like a Social Security number. Ideally, it would make it easier to match patients with their medical records and improve ease of interoperability among electronic health records at different facilities.

The move for a unique patient identifier program has been supported by leading medical groups including the AHIMA, CHIME, members of the American Medical Informatics Association and the American College of Surgeons.

Why now?

When HIPAA was passed 21 years ago, it originally required the adoption of a unique health identifier program, but that portion of the act was overturned by Congress because of patient privacy concerns. Advocates say that even though the United States has invested more than $30 billion in electronic health records, these systems aren’t as high-functioning as they could be.

Demographic data including name and birthdate are not always unique to individuals. That can result in duplicate or split records, according to an article in NEJM Catalyst. That also means that abnormal test results or medication allergies might not populate to all of a patient’s records, which could lead to redundant testing or worse — medical errors.

The Pew Charitable Trust has reported that trying to match patient records among facilities has high variability. In some instances, the match rates can be very high, but in other cases, they can be “as low as 50 percent even between organizations that share the same EHR vendor because of the variability in technology and processes.”

Plus, the Mayo Clinic estimates that each case of patient misidentification costs at least $1,200 and in some cases thousands of dollars and months to fix.

Advantages of a unique patient identifier:

• Data access is timelier
• Fewer chances of inappropriate care, redundant tests and medical errors
• Easier exchange of health information internally and among organizations
• Simplified sharing of information among providers
• Easier means of getting referrals to specialists and prescriptions to pharmacists
• Records can follow patients as they move more easily
• Increased patient engagement

Ireland, several Nordic countries and England already use these identifiers, and although results are generally positive, there are some stumbling blocks, too. Identifiers can accidentally be assigned twice, patients lose their cards and just like they do Social Security cards and there is a risk of theft.

Fortunately, because of the advances in technology during the past 20 years, combining a unique patient identifier with algorithms that use names and other demographic data can help mitigate these issues. In recent years, many advocates have started recommending the incorporation of biometric data as well. These technology advances also can address some of the privacy concerns related to unique patient identifier use.