Two health information exchange organizations have issued a white paper with a framework to improve patient matching without the use of a national patient identifier system.

That's because Congress passed appropriations legislation for fiscal year 1999 that prohibited the Department of Health and Human Services (HHS) from using federal funds to implement a national identifier system, citing privacy concerns. Language regarding the prohibition has been included in appropriation bills each year since. Several stakeholder organizations, such as CHIME, have urged lawmakers to lift the congressional ban on the use of federal funds to develop such a system.

The white paper was authored by the Care Connectivity Consortium and the Sequoia Project. The white paper includes the funding of a case study conducted by Intermountain Healthcare that increased successful match rates among exchange partners from 10 percent to greater than 95 percent, according to a release. Project participants identified a set of key patient data attributes and drove that increase by standardizing the way such attributes were recorded. The organizations developed their recommendations partly on that project, as well as other local HIE participants. 

In addition to standardizing data formats, the white paper includes a "number of specific rules" for patient matching such as having technical staff not rely on any one specific identifier and using exact character-by-character matching.