Patient Identifiers: Which Items Should Be Used To Identify a Patient?

Patient identification is a critical aspect of healthcare delivery, as it directly impacts patient safety, care quality, and data integrity. Accurate patient identification is essential for ensuring the right care is provided to the right patient at the right time.

In this article, we will explore the essential patient identifiers that should be used in healthcare settings to ensure accurate identification and promote patient safety.

What Are Patient Identifiers?

Patient identifiers are unique data elements that help distinguish one patient from another, ensuring accurate identification and reducing the risk of medical errors. These identifiers help maintain patient safety and facilitate care coordination across healthcare settings.

Which Method Is Most Commonly Used To Identify Patients?

The most common method of patient identification involves using demographic information, such as name, date of birth, and medical record number. This method has its advantages, such as being relatively simple and easy to implement. However, it also has drawbacks, including the potential for errors due to similarities in patient information or data entry mistakes.

Two Patient Identifiers

To improve the accuracy of patient identification, healthcare providers should use at least two patient identifiers in combination. For example, a healthcare provider might verify a patient's name and date of birth before administering medication or performing a procedure. Using multiple identifiers helps minimize the risk of misidentification and ensures patient safety.

How Many Patient Identifiers Are Required?

The number of patient identifiers required may vary depending on the healthcare setting and the specific situation. In general, healthcare providers should use at least two patient identifiers for routine patient interactions. In more complex situations or when dealing with sensitive information, additional identifiers may be necessary to ensure accuracy and patient privacy.

What Are the 18 HIPAA Identifiers?

The 18 HIPAA identifiers are specific data elements that can be used to identify a patient and are considered protected health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA).

  1. Names
  2. Geographic subdivisions smaller than a state, and geocodes (e.g., zip, county or city codes, street addresses)
  3. Dates: all elements of dates (e.g., birth date, admission date) except year, unless an individual is 89 years old or older
  4. Telephone numbers
  5. Fax numbers
  6. Email addresses
  7. Social Security numbers
  8. Medical record numbers
  9. Health plan beneficiary numbers
  10. Account numbers
  11. Certificate/license numbers
  12. Vehicle identifiers and serial numbers, including license plate numbers
  13. Device identifiers and serial numbers
  14. Web Universal Resource Locators (URLs)
  15. Internet Protocol (IP) address numbers
  16. Biometric identifiers, including finger and voiceprints
  17. Full-face photographic images and any comparable images
  18. Any other unique identifying number, characteristic, or code

Ways To Improve the Accuracy of Patient Identification

Several strategies can help improve patient identification accuracy, including:

  • Implementing electronic health records (EHRs) with robust patient-matching algorithms.
  • Using unique patient identifiers, such as biometric data or radio frequency identification (RFID) systems.
  • Providing ongoing staff training on patient identification best practices.
  • Encouraging patients to actively participate in the identification process by verifying their information.

Consequences of Patient Misidentification

The lack of a standardized patient identifier system in the U.S. healthcare system leads to wrong patient identification, which has multiple negative consequences, including patient safety incidents, detrimental healthcare outcomes, medical identity theft, and patient data integrity failure.

Patient misidentification often occurs during patient registration and can result in the creation of duplicate medical records or medical record overlays, both of which can lead to inaccurate treatment plans and negative healthcare outcomes.

Patient safety is jeopardized, as they may receive incorrect medications, treatment plans, or even transplants, leading to irreversible damage or even death. Patient data integrity is compromised when records are used for the wrong patients, often tracing back to incorrect patient identification.

Medical identity theft can be facilitated by the lack of proper patient identification, as fraudsters can impersonate patients during the check-in process.

Challenges with Improper Identification

Researchers recently conducted a literature review of relevant articles published from January 2015 to October 2019, aiming to identify current patient identification techniques used worldwide and the challenges associated with improper patient identification.

Six common patient identification techniques were identified worldwide: unique patient identifiers, algorithmic approaches, referential matching software, biometrics, radio frequency identification device (RFID) systems, and hybrid models.

The authors found three themes associated with unresolved patient identification:

  1. Treatment, care delivery, and patient safety errors.
  2. Cost and resource considerations.
  3. Data sharing and interoperability challenges.

Errors in patient identification have implications for patient care and safety, payment, as well as data sharing and interoperability. The authors suggest that optimizing algorithmic matching through data standardization and referential matching software should be studied further to identify opportunities to enhance patient identification techniques and approaches.

Additional efforts to improve patient identity management include the adoption of patients' photos at registration, naming conventions, and standardized processes for recording patients' demographic data attributes.

How Do I Identify Confused or Comatose Patients?

Healthcare providers can face challenges when identifying confused or comatose patients. Here are some tips to help properly identify these patients:

  1. Utilize non-verbal approaches: Be aware of and use non-verbal methods for identifying comatose or confused patients. This can include checking for identification bracelets or medical alert tags and observing physical characteristics or belongings that might provide clues to the patient's identity.
  2. Collaborate with family members or caregivers: Family members or caregivers can provide valuable information about the patient's identity and medical history. They can also help verify existing patient identifiers, such as name, date of birth, or medical record number.
  3. Review available medical records: Examining existing medical records can provide additional information about the patient's identity, medical history, and any unique identifiers, such as medical record numbers or health plan beneficiary numbers.
  4. Use a systematic approach: When evaluating confused, obtunded, or comatose patients, take a systematic approach to gather information and search for physical signs that might point to causes and help identify the patient.
  5. Maintain clear communication: Ensure that all members of the healthcare team are aware of the patient's condition and the steps being taken to identify them. This can help prevent errors and ensure a coordinated approach to patient care.

To further enhance patient safety and protect patient privacy, healthcare professionals should undergo HIPAA training. By enrolling in our comprehensive HIPAA training program, healthcare providers can ensure they are well-versed in the latest regulations and best practices for safeguarding patient information.