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Universal patient identifiers: Get them done, now

My name is Don Fluckinger. My pals and work colleagues will likely confirm that I am, er, a unique individual.

Last I checked, I’m the only Don Fluckinger on Facebook, which makes me a popular guy, a conduit for all the John Smiths I went to school with looking to friend our mutual pal Jim Johnson, but who can’t figure out which one of the thousands Jim Johnsons on Facebook is the right one (or is he James? Or does he still go by his high school nickname, “Flock of Seagulls?”) — until they friend me and access my friend list. Ditto for LinkedIn, Twitter and other social media sites.

My name, it turns out, is a unique patient identifier. Once national health information exchange goes live, if I get in a car accident in Guam, the emergency room physicians will not likely have to wonder which Don Fluckinger I am en route to determining my antibiotic allergies.

The John Smiths, Jim Johnsons and Janet Jacksons of the world aren’t so fortunate. When minutes count in emergency situations, identity knowledge and access to data can literally be of life-or-death importance. Many health IT thinkers agree that, barring widespread adoption of biometric technology such as palm scanners for patient identification, giving every patient a number called a universal patient identifier could solve the issues that Social Security numbers can’t.

A couple contrasting articles tackle the topic this week: EHR vendor PracticeFusion’s chief medical officer Dr. Robert Rowley argues against universal patient identifiers, saying in a blog post that “fuzzy matching” technology is enough to get us through. Another, posted by Becker’s Hospital Review, covered a session at AHIMA’s Legal EHR Summit in Chicago. Speaker Indranil Ganguly, vice president and chief information officer at Centra State Healthcare System in Freeport, N.J. showed how a county hospital in Texas with a database of 3.4 million patients included 231 Maria Garcias with the same date of birth.

Patient identification clearly is a problem that needs addressing through some form of technology, be it biometric, fuzzy matching or with ID numbers assigned to each of us. The latter, so far, is dead in the water. Political forces in this toxic era of Washington gridlock and potential costs of maintaining a universal patient ID system have so far prevented it from happening, even though the federal government already published proposed guidelines for setting it up — 28 digits and a period for every patient, a character string comprising a 16-digit ID number, a period, six digits of checksum, and six digits of encryption.

What is so threatening about that? Maybe if you’re a guy like Newt Gingrich who has a unique name and enjoys being a blue-in-the-face contrarian, you don’t need to bother. But in looking over the names of sitting elected officials, perhaps the universal patient ID system could be a bipartisan cause led by the likes of Nebraska senator Ben Nelson, Florida senator Bill Nelson, South Dakota senator Tim Johnson, Alabama representative Mike Rogers, New York representative Peter King and New Jersey representative Chris Smith.

Those guys? If they don’t set up some way to differentiate themselves from the other citizens with whom they share names, it could get sticky. For instance: if one of them gets in a car accident in Guam and he’s lying unconscious on a hospital bed, good luck to the ER doc who has to guess if he’s allergic to antibiotics or not.

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Universal patient identifiers: Get them done, now - Health IT Pulse: My name is Don Fluckinger. My pals and work...
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