[Med-privacy] unique patient identification numbers

[peter marshall]

Study favors use of national health ID numbers for patients
The report says unique identifiers would reduce errors and protect 
privacy, but privacy watchdogs are not convinced.

By Brian Hedger, AMNews staff. Dec. 1, 2008.

A new study says using unique patient identification numbers for U.S. 
citizens would reduce medical errors, make electronic health records 
simpler and protect privacy.

The October study says that despite a potential cost of $11 billion to 
create unique patient ID numbers, the effort "would likely return even 
more in benefits to the nation's health care system."


Most health care systems use statistical matching to find EHRs, 
according to the study by RAND Health, a research division of the RAND 
Corp. Statistical matching looks for demographic information, including 
names, birth dates and all or part of Social Security numbers.

RAND researchers, who reviewed past studies, said that method causes 
errors or incomplete results about 8% of the time and leaves patients 
more exposed to privacy breaches.

"Assuming every health care system would have these [ID] numbers, then 
you'd be more likely to pick up all of the person's information," said 
Richard Hillestad, PhD, the study's lead author. "It would certainly 
make a lot of things easier."
Using demographic information to locate EHRs causes errors or 
incomplete results about 8% of the time.

But critics expressed concerns.

"It's an absolutely terrible idea," said Deborah Peel, MD, a 
psychiatrist and chair of the Patient Privacy Rights Foundation, a 
watchdog group based in Austin, Texas. "Any database that has these 
numbers is bound to be a treasure trove for identity thieves."

The study was funded by a group of health information technology and IT 
companies, but Hillestad said that didn't influence the outcome. Dr. 
Peel is skeptical. "The combination [of data] is really deadly," she 
said. "That's why I say this is a data miner's dream."

The American Medical Association advocates prohibiting the sale and 
exchange of personally identifiable health information for commercial 
purposes without a patient's consent. The AMA also advocated in 1999 in 
favor of legislative action to repeal the portion of the Health 
Insurance Portability and Accountability Act of 1996 that mandated use 
of a unique patient identifier.

Hillestad said privacy is a big issue, but touted the ID numbers as a 
security boost.

"You're not sending all of the name and demographic information through 
the line to get connected," he said. "[Privacy] would depend on how 
much you protect the numbers."



  ADDITIONAL INFORMATION:
Weblink

"Identity Crisis: An Examination of the Costs and Benefits of a Unique 
Patient Identifier for the U.S. Health Care System," RAND Health, 
October, in pdf (www.rand.org/pubs/monographs/2008/RAND_MG753.pdf)