Privacy guru knocks patient ID as ploy

'You don't need [a unique] ID, you need information transparency'
By Neil Versel
09:55 AM
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In calling for a national patient identification system, Bill Spooner, senior vice president and CIO of Sharp HealthCare in San Diego, said at the CHIME Fall CIO Forum earlier this month, "The real opponents [to a unique patient ID] are the privacy advocates." He was right.

Adrian Gropper, MD, Watertown, Mass.-based CTO of the Patient Privacy Rights Foundation in Austin, Texas, called the renewed push for a national patient ID an intentional ploy by healthcare providers, insurance companies and health IT vendors to protect revenue streams and avoid investing in patient-matching technology.

"If you wanted to exchange medical information, let the patient specify how they want to be identified," Gropper said. "You don't need [a unique] ID, you need information transparency."

Last week, Gropper wrote a commentary on The Health Care Blog, arguing that payers and providers are using government databases to learn all kinds of things about consumers, but are "keeping price transparency or access to our own records via Blue Button Plus always just out of reach" of individuals.

[See also: CIOs push for patient ID progress.]

"Powerful hospitals and insurers have decades of experience in how to keep US prices 30 percent higher than the rest of the developed world," Gropper wrote. "What tool do consumers have?"

Gropper, a longtime entrepreneur and engineer who founded imaging IT vendor Amicas, suggested that healthcare companies hide behind IT to fix prices. "The insurance company could identify me properly if they wanted to. They give me an ID card that I have to show my doctor. Everyone knows know how to ID me to send me a bill," he wrote.

"My doctor and my insurance company even know how to ID me online so they can give me delayed and fragmented information through their patient portals. But when it comes to giving consumers the power to actually compare prices, health insurers and healthcare providers make sure it’s too hard."

In an interview with Healthcare IT News, Gropper said hospital CIOs are trying to keep information away from independent physicians as much as they are from patients. "This is not accidental. This is done intentionally," he said.

[See also: CIOs push for patient ID progress.]

He noted that the Obama administration's National Strategy for Trusted Identities in Cyberspace called for the private sector to create an "identity ecosystem" that gives people a secure means of validating their identities with minimal disclosure of personal information whenever they conduct online transactions. "People in the healthcare industry are trying to undermine it," Gropper said.

Gropper further argued that so many interoperability projects, from state health information exchanges to the Office of the National Coordinator for Health Information Technology's Patient Matching Initiative to the health IT vendor-driven CommonWell Health Alliance, largely have excluded consumer and privacy advocates. "This is a concerted effort," Gropper said.

Nearly a decade ago, Gropper was a member of the Integrating the Healthcare Enterprise Committee that developed technical specifications for the Cross-Enterprise Document Sharing standard, a building block for what was then called the Nationwide Health Information Network and is now known as the eHealth Exchange. He said he proposed letting patients specify how their personal information would be identified for the purpose of data exchange, but was outvoted by vendor interests on the committee.

Today, his position -- and that of Patient Privacy Rights founder Deborah Peel, MD -- is that the Direct Project and Blue Button Plus are far superior and feasible options to a national patient ID. "Right now, Direct is the best mechanism," Gropper said.
 
Farzad Mostashari, MD, who recently stepped down as national health IT coordinator, has said that Direct is a better option than a national patient ID, including at the same CHIME event in 2012. Mostashari oversaw the launch of the Patient Matching Initiative in September.

However, Washington seems to be sending mixed messages. A Government Accountability Office report issued last month recommended that the Centers for Medicare and Medicaid Services remove full Social Security numbers from Medicare ID cards, either by hiding digits or by creating a new identifier for Medicare beneficiaries.