For the last few years, a major initiative in healthcare has been keeping patient records organized with a National Patient Identifier (NPI). The NPI was proposed as a solution to improve the organization of patient data in EHR systems. Doctors rely on names and birth dates to identify patients, and simple errors like a middle initial or identical name can result in confusion about a patient’s identity.
It requires significant administrative time and effort to result in these kinds of issues. Between January 2013 and July 25, 7,613 patient errors were reported across 181 healthcare organizations, according to the ECRI’s Patient Safety Organization. Healthcare organizations have urged lawmakers to approve the implementation of the NPI as a solution to the growing issues around patient identity. Yet Congress has barred funding to the Department of Health and Human Services (HHS) to create the NPI. What remains to be done to establish the NPI?
Are There Legitimate Security Concerns with the NPI?
A major reason the HHS has not received its funding to implement the NPI has been a concern about privacy. These arose largely from the idea that the social security number could be used as the standard identifier. Privacy advocates cautioned that using the social security number could trigger widespread invasions of privacy, which cast doubt on the use of NPI itself. In addition, there were concerns about fraud, specifically, “manipulation of the system for illegal purposes such as drug seekers, drug diversion or medical identity theft.”
Progress Being Made to Provide a Safe NPI
In a recent spending bill enacted by Congress, HHS funding for NPI is still prohibited, but the opinion of lawmakers about NPI has changed. They now say that the HHS can continue to investigate patient matching issues, and even offers technical support to initiatives for patient identification. Likewise, in the funding for the Office of the National Coordinator for Health Information Technology, there was additional money allotted for the examination of patient matching issues in order to “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.”
National Patient Identifier and EHR Interoperability
Since the Health Insurance Portability and Accountability (HIPAA) Act of 1996, interoperability remains the primary goal in healthcare. Interoperability among different Electronic Health Records (EHR) software systems contributes to an efficient and all-encompassing health care system that works for everyone. This interoperability is well within reach, and having patients indexed on a national scale through NPIs is a decisive step towards that goal. With the current progress being made in researching NPIs, that goal is now well within our reach.
For further reading, read this thought leadership piece about how NPI facilitates EHR system interoperability, published last year by the CEO of Bizmatics, Vinay Deshpande.