Why a National Unique Patient Identifier Is Good for Small Practices

By: Michael Kurko on May 24, 2017

The debate about healthcare coverage in the U.S. continues to rage and shows no signs of settling down anytime soon. Within healthcare, another equally contentious debate is quietly stirring once again—whether or not to adopt a unique patient identifier, also known as an NPID.

If you don’t fully understand what an NPID is—don’t worry! You’re not alone. The term often gets wrapped up in debates about patient privacy and interoperability without really being explored or defined.

In this article, we’ll explain what an NPID is and how it can benefit individual medical providers and small practices.

Here’s what we’ll cover:

What Is a Unique Patient Identifier?

Resistance and Concerns

Benefits of a Unique Patient Identifier

Getting Ready for an NPID


What Is a Unique Patient Identifier?

The 1996 Health Insurance Portability and Accountability Act (HIPAA) called for a the creation of “a standard unique health identifier for each individual.” Since its proposal, the term national patient identifier (NPID) has also been used to describe a unique patient or health identifier.

NPID: Essentially a social security number (SSN) for medical records, a unique NPID would be assigned to every person in the U.S. and tied to their entire medical history, from birth to death.

Unique medical IDs are not a new idea. Over 30 countries, including Singapore and Australia, use similar health ID programs.

In Britain, for instance, every citizen gets a National Health Service Number they use when checking into medical facilities anywhere in the country. Instead of registering at each new practice, patients just use their number to ensure their medical history and information gets transferred to the new provider.

In 1998, Congress removed the provision of the unique patient identifier from HIPPA and even prohibited using federal funds to establish an NPID. Although Congress has maintained its position over the last two decades, initiatives in the private sector are putting pressure on legislators and may make the creation of an NPID a reality soon.

Resistance and Concerns

The main resistance to adopting a unique patient identifier in the U.S. concerns privacy and security. Here are some of the issues opponents have raised against using an NPID:

  • Identity theft: Hackers could potentially access an individual’s entire medical history with an NPID the same way they could access an individual’s identity using an SSN.

  • Lack of privacy: An NPID could give individuals less control of their medical information since their records could be freely moved from practice to practice.

  • Limited access to healthcare: Healthcare could be restricted only to individuals who have an NPID, making it even harder for people to get the medical care they need.

Benefits of a Unique Patient Identifier

While some of these concerns are valid, many of the risks outlined above can be easily overcome and are far outweighed by the potential benefits of an NPID. Here are some ways individual providers and small practices would benefit from a unique patient identifier:

  • Privacy protection: Many medical practices currently use an SSN as a patient identifier, creating an even greater risk to patient privacy than an NPID would. Hackers could only access someone’s health records with an NPID instead of their entire identity.

  • Individual control of information: Newer cyber security technology would give patients more control of their medical history. A two-key system proposed by the Department of Health and Human Services (HHS) would encode patient data with one key and decode it with a second key, one of which would remain in the control of the patient at all times.

  • Voluntary opt-in: A unique patient identifier could be created as a voluntary rather than mandatory system, allowing individuals to opt out while still being able to seek care at any medical facility.

  • Fewer HIPPA errors and fines: A small radiation oncology practice in Indiana was recently forced to pay a $750,000 HIPAA settlement after a laptop was stolen from an employee’s car. An NPID would eliminate the need to keep a patient’s SSN on file, making smaller practices less vulnerable to HIPPA violations.

  • Improved patient safety: A unique patient identifier would eliminate patient mismatches. Smaller practices would improve patient safety by making sure no patients are assigned the wrong procedures or medications. Accurate patient matching would also eliminate privacy errors, such as accidentally sending results to the wrong patient.

  • Cost savings: A 2016 AHIMA survey revealed that 50 percent of health information managers routinely work on managing duplicate patient records. Smaller practices would reduce time, money and even staff dedicated to managing and maintaining patient records.

  • New patients: An NPID would give patients an easy way to transfer their medical records to a new provider, reducing their resistance to seeking new providers and bringing them to smaller practices.

  • Improved patient care: Smaller practices would have all of a patient’s information at their fingertips, allowing them to focus on immediate care rather than catching up on medical histories.

  • Better patient experiences: Because an NPID would eliminate patient mismatches and allow patients to get better care with improved access to their medical records, small practices could focus more on the quality of care they deliver and improve their reputation, referrals and revenue.

Getting Ready for an NPID

While there are no immediate plans to implement a unique patient identifier system nationwide, the momentum seems to be building.

According to research firm Gartner’s report, Prepare for the National Patient Identifier Debate (available to Gartner clients), lack of action at the federal level is inspiring innovators in the private sector to create a national patient identifier as soon as 2020.

Recently, CHIME announced the finalists who will be competing for a $1 million prize in the National Patient ID Challenge. Announced in March 2015, the competition invites “new, early-stage, and experienced innovators to accelerate the creation and adoption of a solution for ensuring 100 percent accuracy in identifying patients in the U.S.”

Here are three easy steps you can take to make sure your practice is ready if and when a unique patient identifier system is implemented nationwide.

1. Evaluate Your EHR

Talk to your EHR vendor and ask about their plans for supporting connections between different EHRs and preparing for unique patient identifiers. You can also browse our guide to buying and implementing EHR software and see how yours measures up to other systems on the market.

2. Use a Patient Portal

Patients who want control of and access to their medical information will appreciate having a patient portal where they can access their records and results whenever they want. A patient portal connected to an EHR will make it easier to implement NPIDs in your patient records.

3. Reach Out to Your Patients

Patients have new expectations of how they want practices to communicate with them. Make sure you have systems that allow you to contact your patients through email or secure messaging and not just by phone. Your patients will appreciate that you’re staying current with new technologies, policies and procedures.


Initiatives in the private sector are bringing a unique patient identifier system closer to becoming a reality. While an NPID will certainly help the healthcare industry at large, it will also benefit smaller practices who are prepared for the change.

In summary, an NPID system—combined with a solid EHR integrated with a patient portal and good channels of communication with your patients—will reduce errors in your practice, improve patient safety and care and increase the number of patients your practice can serve. It’s a clear win-win for patients and practices alike.