That idea, however, soon ran afoul of privacy advocates, including the National Committee on Vital and Health Statistics, which recommended that HHS not adopt a standard for a unique patient identifier for individuals until after privacy legislation is enacted. It was a position adopted the following year by then-Vice President Al Gore and by Congress, which banned federal spending on a patient identifier until adequate privacy protections have been put in place. Multiple attempts to resurrect the unique patient identifier since then have died.
Lee Stevens, policy director for the state health information exchange program within HHS' Office of the National Coordinator for Health Information Technology, said in a blog post that his agency is launching a collaborative project to identify common denominators and best practices used by private sector healthcare delivery systems and federal agencies. “By identifying and recommending standardization of the basic attributes most commonly used for patient matching, we are looking to improve patient safety, care coordination and efficiency,” he said.
Today, patients and their records are most commonly linked via a technique known as probabilistic matching, applying computer algorithms to a limited set of data fields, such as first name, last name, date of birth, ZIP code and sex.
According to Stevens, the group will look at those commonly used fields and some others, including cellphone number, insurer or an emergency contact. In addition, Stevens said, the group will also define “the processes and best practices that are most effective to support high positive patient-matching rates utilizing these attributes.”
Helping the ONC will be members of the Federal Health Architecture, a coalition of about 20 federal agencies. Past FHA projects in health IT include Connect, which developed open-source software to link federal health agencies with health information exchanges as part of the proposed nationwide health information network.
Stevens also listed as partners in the patient matching initiative the Healthcare Information and Management Systems Society, the College of Healthcare Information Management Executives, the Bipartisan Policy Center, HealtheWay (formerly the ONC-led Nationwide Health Information Network), and the EHR/HIE Interoperability Work Group, a multistate effort to promote consensus around health information exchange standards and policies that is an offshoot of the New York eHealth Collaborative.
Audacious Inquiry, a Baltimore IT firm that has provided technical support for the Maryland Health Information Exchange and for the ONC, will support the matching initiative.
Follow Joseph Conn on Twitter: @MHJConn