Will Unique Health Identifiers Become a Reality in the United States?

October 31, 2002

Washington, DC—On October 30, the United Kingdom assigned its first unique "lifelong" ID number to baby Beth Atkinson (see article below titled "Day-Old Baby Makes History Books Count").

Will the United States be next? Will all U.S. citizens be assigned a number for tracking their medical records from cradle to grave?

That depends on whether or not Congress continues its moratorium on federal funding for unique health identifiers in the United States. It has upheld the moratorium for the past four years. However, if Congress FAILS to continue the moratorium on unique health identifiers (when it returns for a brief work period after the elections to work on a Labor/HHS appropriations bill), then every citizen in the U.S. will be assigned a unique health identifier for tracking their medical records from cradle to grave. In fact, it is mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)—better known as the Kennedy-Kassebaum health insurance bill. (For an overview of how and when unique health identifiers were established by law, see "The Peril to Our Privacy.")

It's ironic that Congress has refrained from working on a Labor/HHS appropriations bill and voting on whether or not to continue a moratorium on federal funding for unique health identifiers, until after the elections.

Don't let policymakers get away with sneaking unique health identifiers into policy without an informed citizenry sharing their own opinions. A Gallup survey found most Americans have not heard about plans to assign citizens a medical identification number, yet the majority of Americans oppose such tracking numbers.

It's time to become informed about the plan to create unique health identifiers for all U.S. citizens and to share your own views with your policymakers.

Little Beth Atkinson's birth - at three minutes past midnight yesterday - made medical history.

Beth, who came into the world at Newcastle's Royal Victoria Infirmary, became the first baby in the country to be given an NHS "lifelong" identification number.

The unique nine-digit reference number will stay with Beth for the rest of her life - the key to her clinical history and a complete record of every visit she makes to her doctor, every vaccination she's given and every illness she contracts.

Proud parents, Caroline and Robert are both nurses and know their 7lb 15oz youngster marks the start of a major new initiative that will change the face of the NHS and the way that people's health records are compiled.

Launched at maternity and child health units across England and Wales, the scheme - called NHS Numbers for Babies - is to reduce the risk of mistakes and lost records during the first few months of a baby's life.

Until yesterday, babies have had to wait several weeks for their registration number to come through from the registrar of births and deaths.

During that time the child may have undergone tests and treatment in different locations, had their name changed or changed address.

The new system gives the baby a unique ID number, helping to ensure that personal records are consistent and universally available to NHS staff from day one.

For Caroline, a cancer nurse with the Northern Centre for Cancer Treatment, and Robert, a psychiatric nurse at the RVI, Beth's number was the last thing on their mind as they cradled their new daughter, a sister for 20-month-old Megan, at their home in Kingston Park, Newcastle.

Caroline says she fully supports the new scheme.

She said: "I think it's a really good thing they are doing, ensuring every baby has a number from birth. I know how important it is to have a patient's full medical details in front of you and to start collecting that information together from the moment a child is born is vital."

Prior to the introduction of the new scheme, the information gathered about babies from different organisations could not be linked.

This is because the information collected was specific to particular Trusts, different centres assigning different numbers so there was no "common currency" between them.

Liz Gaffing, operational services manager for women's services for the Newcastle Hospitals Trust, said: "The numbers are given out in numerical order.

"The system basically prevents any mistakes and is an extra reassurance for parents that their baby will be given the best and most appropriate care."

A child's details often change in their first few weeks. Data collected by the Department of Health showed that in one hospital, 80pc of the babies born there changed their surname within the first six weeks. Typically the figure is 30pc.

Other information collected in the first few months of a baby's life include:

• details about labour and delivery
• the child's health immediately after birth
• prescriptions
• neonatal screening
• visits by the midwife and health visitors

Martin Weller, a spokesman for the Information Authority, said: "The new system provides additional safeguards in the key early stages of a child's life and ensures that a comprehensive health record is available wherever and whenever it is needed."

Facts about the new Numbers for Babies

What is the NHS number?

The "common currency" of NHS information - a reliable, unique identifier that provides a link between a patient's records, both manual and electronic.

The number allows the NHS to keep track of people when they change their name, address or other information.

Why is the system changing?

At present babies have to wait until civil registration before their NHS number is issued. Often this is not until the child is at least six weeks old.

A lot of tests and medical treatment can be administered in the first six weeks of life and it is also a period when name and address changes are very common, and so the need for a definitive identifier from day one is crucial.

How will the number be issued?

Under the new system, NHS numbers will be allocated to babies as close to birth as possible as part of the Birth Notification process carried out by midwives.

A new computer system called the Central Issue System will allocate newborn babies with NHS numbers, which will be given out in order as babies are born.

An NHS number is unique.

The first nine digits are the identifier and the tenth is a check digit used to confirm the number's validity.

To find out more about the new system access the NHS website on www.nhsia.nhs.uk.

Secret Scheme

Until The Journal contacted the Department of Health and informed them of Beth's birth a spokesman said the earliest baby it had so far been informed of was in Stoke on Trent, born at 12.18am.

Copyright ©Trinity Mirror Plc 2010. Posted for educational purposes.