I welcome Mari Savickis, Vice President of Public Policy for the College of Healthcare Information Management Executives (CHIME) to discuss patient identification, and why it remains a thorny issue.
I kick off the podcast with an anecdote from my days working in a large, multi-specialty practice. Another, much larger, practice in the same town had an annoying habit of asking the patient for the clinic number, rather than the patient’s name, when they called the practice. My clinic took a more personal route and asked for the person’s name. They found that some patients actually left the other clinic because the “what clinic number” approach was too impersonal.
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I introduce Mari Savickis, vice president of Public Policy for CHIME, a long-time advocate for leveraging technology in healthcare. Savickis champions policies that improve the clinical experience for patients and providers alike and promote innovation and competition. She serves as the voice in Washington, D.C. for CIOs and chief security officers and other C-suite executives charged with the purchase and secure deployment of healthcare technology and oversees the advocacy and interaction with federal agencies at the White House and in Congress.
I asks Savickis to share how she got involved with her various initiatives and what drew her to the position she currently holds.
Savickis shares an amusing anecdote about the time her daughter asked her to come in for a third-grade career day and explain her role as a lobbyist. She admits that no kid ever got up in the morning and proclaimed, “I’m going to be a lobbyist.” And neither did she. Starting as an undergraduate Art major, she became disillusioned with the faculty and opted for a politics and government class, which she aced. She never turned back.
Fast-forward a few years, and she found herself working at CMS––just as HIPAA was being introduced. HIPAA was all about portability at the time, although she notes that it was really the precursor to health IT. She fielded more than a few calls from physicians who were disgruntled with the four patient identifiers required in HIPAA at the time.
Don’t Share Anything! Wait! Share Everything!
I comment on the demands of keeping abreast of new federal regulations, and note that the recent introduction of TEFCA could finally usher in real data interoperability. I ask Savickis about her experience on Capitol Hill and her observations on the process that resulted in TEFCA.
Savickis notes the dichotomy of the “old” HIPAA days, when physicians were wary of “over-sharing” patient information, versus today, when the mandate is “share everything.” She says that while the two concepts are not diametrically opposed, it’s hard for physicians to change their way of thinking on information sharing. Meanwhile, there’s a need to educate the frontline office staff regarding the new realities and sharing requirements.
We take a trip back in the “policy time machine” and discuss the evolution of HITECH, the American Reinvestment Recovery Act and, most recently the 21st Century Cures Act, and their respective roles in advancing HIT and interoperability.
Savickis notes that there are only a handful of staffers on Capitol Hill who even know what TEFCA is, which can make implementing such legislation even more complicated.
“Inter” Without “Operability”
I wonder about the future of patient identification numbers, saying that many smart people have tried all manner of permutations for identifiers, while the answer could be as simple as a unique number assigned to each person. But there’s been pushback on this concept, despite the fact that not having such a system is monstrous for U.S. healthcare.
Savickis points out that the stakes of mis-identifying a patient are potentially deadly, and providers have provider identifiers – so why not patient identifiers? Again, the conversation goes back to Capitol Hill, where some lawmakers have opposed such a bill for decades. As a result, organizations have to discover their own strategies for interoperability and patient identification.
She discusses the initiatives begun by Patient ID Now, a coalition of healthcare organizations representing a wide range of healthcare stakeholders committed to advancing through legislation and regulations a nationwide strategy to address patient identification, Other provisions, such as one included in the recent CHIPS act are attempting to address identity, but considerable challenges remain.
“So, how do you identify somebody in the ether so that you know that it’s you, Dr. Anders, the right Jay Anders, and that it’s not your colleague down the street who happens to have the same name and birthday as you?” Savickis asks.
Ultimately, changing minds in Washington will require real-world stories. In an attempt to elicit those patient stories regarding identity mix-ups, CHIME designated a Patient ID Awareness Week. “So if you want to help get the word out, or if you know of a patient who’s been harmed, please give them our email so we can talk to them in confidence… That’s how you win the hearts and minds of lawmakers.”
If there were one thing you could change…
I close the discussion with my signature question, “If there were one thing in healthcare or healthcare IT you could change, what would it be?”
“We don’t need a million pieces of paper in the garbage. It has to be efficient. It has to be meaningful. It needs to meet the patient where they are. It needs to meet the provider, the clinician where they are. So it has to be efficient, effective. It’s just having smart technology. Doctors aren’t opposed to technology, they just want good stuff that works.”
This article was originally published on the Medicomp blog and is republished here with permission.
About the Show
On Tell Me Where IT Hurts, join host Dr. Jay Anders as he sits down with experts from across healthcare and technology to discuss ways to improve EHR usability for end users. Dr. Anders and his guests explore opportunities to enhance clinical systems to make them work better for clinicians, reduce burnout, maximize revenue potential, and drive better patient care outcomes. Join the conversation on Twitter at #TellMeWhereITHurts.