A couple of weeks ago, I moderated a panel on health IT for the Chicago chapter of the Association of Healthcare Journalists, an organization I am not a member of.
I was there with three actual experts, namely Dr. Arnold “Ned” Wagner Jr., CMIO of NorthShore University HealthSystem; Eric Yablonka, vice president and CIO of University of Chicago Medicine; and Dr. Diane Bradley, chief quality and outcomes officer of EHR vendor Allscripts, to explain the pressing issues in health IT to journalists who don’t normally cover this segment of the industry. The idea was to give a primer of sorts to reporters thinking of covering the annual Healthcare Information and Management Systems Society (HIMSS) conference next month, which is in Chicago for the first time since 2009.
During the Q&A portion of the event, we were asked a specific question about the notable lack of interoperability of health data in this country: Why isn’t there a national patient identifier?
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Without skipping a beat, I and at least one other panelist quickly responded, “Politics.”
The original 1996 Health Insurance Portability and Accountability Act (HIPAA) legislation called for HHS to develop a system of unique patient ID numbers as a complement to the privacy and security rules. But two years later, as critics raised concerns about identity theft and a Big Brother-like, government-controlled database, Congress voted to deny HHS funding to implement the ID system.
For the last 17 years, discussion of a national patient ID has popped up intermittently in the context of overcoming barriers to interoperability, but the talk produced no real action in the halls of Congress or even in the private sector.
That changed this week, spurred in part by the fallout from the February data hack of health insurer Anthem.
As MedCity News reported, the College of Healthcare Information Management Executives (CHIME) announced a $1 million challenge to create a national patient identifier that helps reduce medical errors caused by duplicate or incomplete records while also safeguarding patient privacy. CHIME put together a nice coalition of supporters, including the National Patient Safety Foundation, technology vendors and other health IT trade groups.
“Accurately matching patients with their health records, no matter where they have been collected or stored, remains a pressing challenge for our entire industry,” Howard Messing, president and CEO of Meditech, said in a CHIME press release. “We look forward to learning about any ideas that can meet this need, while still maintaining the highest levels of security and confidentiality possible.”
That’s a big deal that Meditech joined in, because the company is not a member of the CommonWell Health Alliance and rarely talks to the press in any capacity.
But don’t start popping the Champagne corks just yet, supporters of a national patient ID. For one thing, CHIME still needs to raise the prize money. This might be a formality, as I’m sure one or more of the vendors could easily write a check. I mean, Athenahealth CEO Jonathan Bush tweeted Wednesday that his company would pay the $1.4 million membership fee to get Epic Systems to join the CommonWell interoperability project, and Cerner boss Neal Patterson followed up with an offer to cover half.
The bigger issue is the privacy piece. We haven’t heard yet from the privacy camp, but there is sure to be opposition. “[A] universal health ID system would empower government and corporations to exploit the single biggest flaw in health-care technology today: Patients can’t control who sees, uses and sells their sensitive health data,” Dr. Deborah Peel, founder of the Patient Privacy Rights Foundation, wrote in a 2012 Wall Street Journal op-ed.
Expect similar opposition from data security experts, who will argue that a single ID makes it easier for hackers and identity thieves to know their targets. Given the nature of the challenge, it will be up to the entrants to address the privacy and security issues. Hopefully the judges heed the concerns and we get a truly useful patient ID. Otherwise, true interoperability will remain a pipe dream.
