Healthcare Information Technology Research & Analysis : Coplan & Company : IT Procurement Management, Project Management, System Acquisition

It is obvious that correctly linking a patient to their medical record is critical to the quality of care. Most large providers identify a patient using a computerized statistical match on multiple personal attributes, e.g., name, address, and Social Security number (SSN) .  They then examine the results of the search to select the correct patient.  According to the RAND | Monographs | Identity Crisis: An Examination of the Costs and Benefits of a Unique Patient Identifier for the U.S. Health Care System, the average error rate is about 8 percent, increasing with larger systems.  Larger systems are already exchanging clinical information electronically with resulting higher error rates, e.g., Regional Health Information Organizations (RHIOS). Higher Healthcare Information Technology (HIT) adoption will increase incidences of serious medical errors instead of the promised increase in quality of care.

Rand's study states using a Unique Patient Identifier (UPI) that:

...enables disparate health care information systems across the United States to allow authorized users to easily and quickly share critical health information has the potential to enhance safety and dramatically improve the quality and efficiency of the national health care system.

Privacy advocates (e.g.,  Citizen"s Council on Health Care, Health Privacy Project, Patient Privacy Rights, World Privacy Forum) say that using UPI's will add to the already serious healthcare identity theft problem. Rand disagrees with these critics, stating:

Proponents of statistical matching suggest that a UPI scheme will reduce privacy by making all of a patient’s data recognizable and accessible via the single UPI. However, if a statistical matching scheme is made as accurate as a UPI, it provides an identical capability to identify and access patient data by using its matching keys. Furthermore, the matching keys for an algorithm reveal the identity of (and other information about) the patient whose data they identify, whereas a UPI (being just an alphanumeric value) reveals nothing about the patient. And, in contrast to using personal information, being able to retire a compromised UPI and issue a new replacement UPI should facilitate reestablishing security after a breach of a patient’s health information. 

I understand both parties' concerns.  Unfortunately, this issue comes down to how much privacy you are willing to give up to increase your quality of healthcare.  Do we have to have this trade-off?