Health Identifiers Act 2014 - a means of reducing errors at the point of care?

The Health Identifiers Act 2014 was signed into law on 08 July 2014. Once commenced, the Act will create a new ground of Inquiry for regulators. The Act provides for the assignment of a number, known as an identifier, to each recipient and each provider of public and private health services in Ireland. We examine how this will impact on health care provision in Ireland and what new obligations the Act places on regulators. Background to Introduction of the Act: The Health Identifiers Act 2014 was signed into law on 08 July 2014. Once commenced, the Act will create a new ground of Inquiry for Regulators. The Act provides for the assignment of a number, known as an identifier, to each recipient and each provider of public and private health services in Ireland. This development has been welcomed by HIQA, who have stated that identifier numbers will help to ensure that the right information is associated with the right individual at the right time and thereby reduce the risk of identification errors occurring at the point of care. International Best Practice: A number of other jurisdictions such as Australia, England and New Zealand have already introduced health identifier systems. A report published by HIQA in 2011 noted that benefits achieved in these jurisdictions include a reduction in administrative inefficiencies. HIQA cited the potential benefits of the system as including:

• Clearer accountability of the practitioners responsible for patient care at each stage of the care pathway;
• Improved shared care initiatives; and
• Improved security of health information in situations where patients are under the care of multiple practitioners.

International research has shown that the absence of health identifiers increases the risk of adverse events such as medication errors and mismatching of healthcare records and test samples, leading to administration of the incorrect treatment to a patient. The cost to the State of dealing with the aftermath of adverse events is extensive and constitutes a major drain on the HSE budget. Costs involved include internal and external investigations, together with compensation and legal costs associated with medical negligence claims. National Register of Individual Health Identifiers: The Act provides for the establishment of a National Register of Individual Health Identifiers. This will comprise a Register of all recipients of health services. The HSE will be responsible for assigning Individual Health Identifiers to each recipient. This Register will not be publically available and will only be accessible to certain people, including the Minister for Health and other specified persons, which includes the State Claims Agency, Irish Medicines Board and the Chief Inspector of Social Services. Currently there is no national system of identifying recipients of health services. Each hospital and GP practice uses a different method of identifying patients, whether by name, date of birth or other means. The purpose of identifier numbers is to facilitate everyone involved in the care of a patient to communicate using a common method of patient identification. To function effectively, it is suggested that the new Individual Health Identifier number must replace local identifiers assigned to patients by individual healthcare providers. National Register of Health Service Provider Identifiers: The Act also provides for the establishment and maintenance of a National Register of Health Services Provider Identifiers, which will be publicly available. This will comprise a list of all health practitioners and providers, to include employees and agents of health practitioners and providers. The HSE will be responsible for assigning a Health Services Provider Identifier to each practitioner and organisation. Health practitioners will be obliged to place their identifier number on all medical records completed by them, unless they are already required to use a registration number assigned to them by their regulator. For example, medical practitioners are already required to place their Medical Council Registration Number (MCRN) on all medical records and so will be exempt from the requirement to use their identifier number on medical records. Ideally, the new identifier numbers assigned by the HSE would be used by all health practitioners. What does the Act mean for Regulators?

• The Act introduces a new ground of complaint for healthcare regulators. This new ground is a failure to use the appropriate identifier number on records completed by practitioners. This ground cannot be relied upon by members of the public to ground a complaint. Only the Minister for Health may make a complaint on this ground.
• Within 3 months of the commencement of the Act, regulators will be required to provide the Minister for Health with all relevant particulars in respect of each health practitioner. If the particulars provided become inaccurate, regulators will have 30 days to report the inaccuracy and provide the correct information.
• Regulators will be required to co-operate with investigations carried out by the Minister for Health. The Minister may carry out any investigations that he considers reasonable and necessary for proper monitoring of the use of identifier numbers. It is unclear from the Act what level of co-operation this will entail from regulators and in what form.

The Minister for Health has stated that the Act will be commenced “as soon as possible” in 2015. Remember that this article is for information purposes only and does not constitute legal advice. Specific advice should always be taken in given situations.