Experts react to National Patient ID concept as $1 million prize looms

The idea of a national patient identification system (NPID) is nothing new, but thanks to a recently launched $1 million challenge, it could be closer than ever to becoming reality.

The NPID system would allow health care organizations around the country to quickly and accurately identify patients, reducing the preventable medical errors that lead to thousands of deaths each year, while improving health information exchange and interoperability.

“A national patient ID would be very helpful,” says Judi Bindermann, vice president and chief medical informatics officer at California, San Joaquin-based Community Medical Centers. Such a system could aid in a health care organization’s ability to differentiate between patients with identical or similar names, reducing cases of mistaken identity that can lead to serious complications.

Cases of mistaken identity are not as rare as one might think, occurring in 7% of all cases, according to a 2014 study.

“How many Juan Garcia Gonzalez Ramirezes are there in every city in the country? Some might even have the same birthday, which is a real problem,” says Bindermann. Such cases of mistaken identity are not as rare as one might think, occurring in 7% of all cases, according to a 2014 study from the Office of the National Coordinator for Health Information Technology.

CHIME National Patient ID Challenge

Originally proposed as part of the 1996 Health Insurance Portability and Accountability Act (HIPPA), the NPID was eventually scrapped when Congress raised concerns about security risks and identity theft, going so far as to implement a ban on the use of federal funds to develop such a system.

While there has not been much movement on developing a NPID system over the last two decades, the 2016 data hack of major health insurer Anthem, along with a new crowdsourced $1 million prize from the College of Health Information Management Executives (CHIME) has brought the idea to the forefront.

The CHIME National Patient ID Challenge calls on private sector participants to develop a NPID solution that will, according to its website, “Ensure 100% accuracy of every patient’s health info to reduce preventable medical errors and eliminate unnecessary hospital costs.” Launched in early 2016, CHIME will announce a $1 million winner in late spring 2017.

In addition to its ambitious goal of 100% accuracy, the CHIME challenge includes five additional goals from developing a system that easily and quickly identifies patients, to protecting patient privacy and identity, achieving adoption by the vast majority of patients, providers and insurers and scaling up to handle all patients in the U.S.

The renewed discussion of a NPID system comes at a time when medical errors stand as the third greatest cause of death in the U.S. While the typical error rate for a single health care entity stands between 10 and 20%, that figure rises to as much as 50 to 60% when it comes to sharing information between distinct health care organizations, according to a 2015 report from analytics-sciences software vendor, ARGO.

“It would eliminate so many obstacles in terms of data matching challenges and safety issues,” says Christopher Manakas, chief medical information officer at Fort Healthcare and Beaver Dam Community Hospital. Manakas says that such a system would not only improve the exchange of information between disparate health care organizations, but lead to greater buy-in from patients themselves.

“The patient is the one who is entitled to their record and comprehensive record and by creating an identifier that can help a patient have ready access, you enable them to be more engaged with their care,” Manakas says.

Motivation for change

The CHIME Challenge is seen by many as a great motivator for companies looking to revolutionize the way patient information is stored and shared, but experts agree that any such system will ultimately require cooperation from governmental organizations.

“I applaud CHIME for getting out there and initiating the challenge, but it has to be a combination of government mandate and vendor cooperation,” says Joan McFaul, senior vice president and chief information officer for Southcoast Health System.

Matt Sakalosky, chief information officer at Fremont Health, echoes McFaul’s concerns, positing that such a system is unlikely to gain traction without a larger buy in. “We’re still a long way away from something like that. I think it would be difficult to do on a local level, and to do it on a national level demand would have to come not so much from the market, but from a central source that would demand a NPID,” Sakalosky says.

There has also been discussion around developing a full scale universal health record system which would effectively require all health care organizations to use an identical format, but industry experts say any such system is still a long way off. While many currently use myriad health record systems to catalogue a patient’s medical history, such proprietary systems often have difficulty communicating with one another due to a lack of universal standards.

“There have been proposals to get to a universal standard that would allow us to define, for example, ‘this is the allergy field and this is how we code it,’ but those aren’t set yet. If you think everyone’s software is proprietary, trying to get them all to agree to a format with universal nomenclature and coding is really tough,” Bindermann says.

As of late 2016, CHIME had extended the deadline for the competition by a month, and had garnered submissions from almost 370 participants in 40 countries.