A new collaboration may help a universal patient identifier (UPI) become a reality in the US. The National Council for Prescription Drug Programs (NCPDP) is the newest client to sign up for the free service, which can help to increase patient safety and decrease record duplication. In this project, clients send their master patient index database to Experian Health, a global health information service group. Experian compares demographic information in the database to its own extensive consumer demographics database to identify when one person has been mistakenly filed as two or more different patients. Each patient is assigned a unique 16-character UPI, and then the database is sent back to the client. Duplicate files are noted but not combined, so clients can decide how to best handle them. Experian does not manipulate or change the file in any way other than assigning the UPI number.
As more clients use the system, a more complete picture of each patient can be obtained, even if they move from one healthcare provider to another. This can be very helpful for clients seeking to eliminate duplicate profiles. The Office of the National Coordinator for Health Information Technology estimated in a 2014 report that up to 8% of records in master patient index files are duplicates. The real problem comes when healthcare organizations merge. When they combine their databases, different demographic information, such as addresses, can produce very high duplication rates.
High duplication rates among databases can result in worrying outcomes, such as giving the wrong treatment to the wrong patient. They can also enable serial pain medication abusers to receive pills from different pharmacists more easily. But since the Health Insurance Portability and Accountability Act of 1996 prevents the Department of Health and Human Services from funding the creation of a UPI, private sector entities must develop it.
The UPI project was announced in September 2016 and began operation in late December. More than 100 clients have used the service already, with many more expected. A public-private partnership called the Sequoia Project created in 2012 began paving the way for UPI by promoting electronic data sharing among healthcare providers. A serious effort to eliminate duplicate records on a national level began in 2015 with a project launched by the College of Health Information Management Executives and crowdsourcing organization HeroX. That project will award $1 million to the group that develops the best UPI system; results will be announced in June.
Patient matching may not stay a strictly private sector project, though. In December, the 21st Century Cures Act was signed into law, which included a provision requiring the Government Accountability Office to conduct a study of current efforts to cut down on duplicate files. The study must be completed by December 13 of this year, and a report is due to Congress by December 13, 2018.