Experian takes on patient ID

The idea of a unique patient identifier is not new. Experian says it's ready to take it beyond an idea.

The company wants to fix a yearslong patient-safety problem by leveraging its expertise from the financial sector.

But unless enough organizations adopt the technology, the idea will remain mostly that—just an idea.

“If the payer uses the same unique identifier to identify Dan Johnson, and a hospital is sending them a claim, it ensures the accurate linking of the correct patient across enterprises,” said the aforementioned Dan Johnson, executive vice president of strategy for Experian Health.

Johnson said Experian's wealth of credit bureau data makes it the perfect private-sector innovator for patient IDs. “The credit bureau is really good at matching identity,” he said.

The company's Universal Identity Manager, first released in 2016, relies on a combination of probabilistic and referential matching. Experian claims that combination makes the match more accurate than deterministic matching.

Experian doesn't charge healthcare systems for its matching solution, instead charging fees for premium add-on services. “We need to give this away,” Johnson said. “We realized that we almost have to seed the market with this and remove the financial barrier to adoption.”

It's trying to get its ID out there by working with both industry and government. The company is in talks with Epic Systems Corp., Cerner Corp. and other vendors to incorporate the ID into their systems. It also has worked with Congress on the Ensuring Patient Access to Healthcare Records Act, which removes the business associate status from clearinghouses, thereby allowing them to use protected health information under HIPAA.

If the bill passes, Johnson said, then Experian's patient ID could be used to connect the information in the clearinghouses that most of the claims filed in the U.S. go through.

Though Experian's solution looks promising, Johnson admitted there's some fear about adopting the wrong identifier. William Marella, executive director of the ECRI Institute's patient-safety organization operations and analytics, compared the problem to choosing between Betamax and VHS.

“People would be more likely to endorse one patient identifier over the others if the industry could coalesce around one,” he said.

For his part, Dr. Donald Rucker, head of the Office of the National Coordinator for Health Information Technology, thinks that a probabilistic patient ID will eventually be adopted. Experian, of course, thinks its combination probabilistic-referential matching method will be the one to take hold.

“The technology for doing this has existed for many years,” Marella said. “It's really a political problem.”

HIPAA mandated creating a unique identifier, but Congress later banned HHS from spending money on one. The Joint Commission revived the call for patient IDs at the turn of the millennium. The accreditor said patient identification accuracy was key to avoiding major mistakes such as wrong-site surgery and blood transfusion errors.

“If you're going to have really safe care, it's key,” said Lorraine Possanza, a program director at ECRI.

Some still hold out hope that the government will step in and give patients numbers—other than the Social Security numbers people already have—so they can be easily connected to their health data. HHS is still prohibited from using federal funds to help create a unique patient ID, but Congress has indicated its willingness to encourage the Office of the National Coordinator for Health Information Technology to “provide technical assistance to private-sector-led initiatives.”

Johnson said whether the Universal Identity Manager catches on depends in part on who the early adopters are. The National Council for Prescription Drug Programs works with Experian, and the implementation pipeline now includes more than 
100 health systems, some payers and pharmacies. “Some of the big pharmacy chains are looking to adopt it,” Johnson said, “and if that happens, and if Epic adopts it, then I think it will accelerate.”