The US RAND Corporation has called for the introduction of a unique patient identification number for every person in the United States as a key step in developing e-health.

The influential policy think tank says the creation of a national system of unique health ID numbers would improve patient safety, simplify the use of electronic medical records, increase overall efficiency and help protect privacy.

Although creating such a national ID system could cost as much as €8.7 billion ($11 billion), the effort would likely return even more in benefits to the nation’s health care system, according to researchers from RAND Health.

The study argues that a national health ID system offers significant benefits to the development of integrated electronic health information systems. The creation of such a system would make it easier to retrieve records across varying systems such as those used by doctors and hospitals.

"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.

He added: "The alternative is to rely on a system that produces too many errors and puts patients’ privacy at risk."

The Rand study notes that Federal legislation passed over a decade ago supported the creation of a unique patient identifier system, but efforts stalled due to privacy and security concerns.

The researchers reject the idea of using the US Social Security Numbers because they are so widely used and they pose risks of identity theft.

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

The RAND study concluded that one of the primary benefits created by broad adoption of unique patient identifiers would be to eliminate record errors, and help reduce repetitive and unneeded care.

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. Based on past research studies the RAND researchers estimate that statistical matching returns incomplete medical records about 8 percent of the time. Each mismatch exposes patients to privacy risks because a large amount of personal information is exposed to computer systems during a search.

Addressing privacy concerns the study says most issues 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.

One suggested way to deal with privacy concerns is to allow to people to voluntarily enroll in a unique patient ID system, researchers say. Such an approach would allow a unique health identifier system to demonstrate that it can be used without compromising patient privacy and can be more accurate than current statistical matching systems.

Support for the study was provided by a consortium of health information technology companies. They include Cerner Corporation, CPSI, Intel, IBM, Microsoft, MISYS, Oracle and Siemens.


Identity Crisis: An Examination of the Costs and Benefits of a Unique Patient Identifier for the U.S. Health Care System