Unique health ID numbers could reduce medical errors, increase patient privacy

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Creating a unique patient identification number for every person in the United States would facilitate a reduction in medical errors, simplify the use of EMRs and help protect patient privacy, according to a new study from the RAND Corporation.

Although creating such a system could cost as much as $11 billion, the effort would likely return even more in benefits to the nation's healthcare system, according to researchers from RAND Health. In the absence of unique patient identifiers, most health systems use a technique, known as statistical matching, that retrieves a patient's medical record by searching for attributes such as name, birth date, address, gender, medical record numbers and all or part of a person's Social Security number.

"Establishing a system of unique patient identification numbers would help the nation to enjoy the full benefits of electronic medical records and improve the quality of medical care," said Richard Hillestad, the study's lead author and a senior principal researcher at RAND. "The alternative is to rely on a system that produces too many errors and puts patients' privacy at risk."

Federal legislation passed more than a decade ago supported the creation of a unique patient identifier system, but privacy and security concerns have stalled efforts to put the proposal into use, RAND said. As health IT adoption expands and more patient records are computerized, there have been increasing calls to create a system that would make it easier to retrieve records across varying systems.

RAND researchers examined the costs of creating a unique patient ID system, compared the error rates of such a system and its alternatives, and examined the operational advances and disadvantages of the technology.

Reviewing past research studies, researchers estimated that statistical matching returns incomplete medical records about 8 percent of the time and exposes patients to privacy risks because a large amount of personal information is exposed to computer systems during a search.

The study also concluded that many of the privacy concerns could be addressed through the creation and enforcement of laws that severely punish those who misuse information retrieved with a health ID number.

"Our research suggests that it's easier to safeguard patient privacy with a records system that makes use of a unique health ID rather than a system that uses statistical matching," Hillestad said.

A consortium of health IT companies, including Cerner, CPSI, Intel, IBM, Microsoft, MISYS, Oracle and Siemens, provided support for the study.