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Cracking the Patient Identity Code: Precise Patient Matching with an EMPI

nurse reviews and confirms patient identity information on a laptop, both wear medical masks

One of my early jobs with a healthcare provider was running a daily report off the Radiology Information System (RIS) to look for potential duplicate records – i.e. patient records that had similar demographic information, yet were assigned two different Medical Record numbers. Ensuring that the information in a health record is correct and actually belongs to the patient being treated is an issue that has plagued the healthcare industry for many decades. When I was doing manual reviews, the problem was often related to human error, e.g., typing in the wrong information, or not finding an existing patient record during a search. Today, the problem has been exacerbated by sourcing and exchanging data between provider organizations, payers, labs, pharmacies and others in the healthcare ecosystem.

While the simple solution would be to assign everyone a national patient identifier, US law doesn’t permit that. The industry has invested considerable effort over the years on solving the problem through better patient matching.

ONC (The Office of the National Coordinator for Health IT) defines patient matching as “the identification and linking of one patient’s data within and across health systems in order to obtain a comprehensive view of that patient’s health care record.” It’s been going on for decades with some recent initiatives outlined on the ONC Website.

For example, 2021’s initiatives included:

  • Project US@ Unified Specification for Address in Health Care
  • FHIR at Scale Task Force, Identity Tiger Team
  • USCDI (Patient Demographics)
  • ONC ISA, Patient Demographic Record Matching

Organizations do succeed, despite the challenges

Fortunately, many organizations succeed using technology called an EMPI (Enterprise Master Patient Index) or MPI. One of our customers, Hunterdon Healthcare, has served as a lifeline to patients in western New Jersey for decades. But as interoperability became more critical to insights and outcomes, the full-service health system needed to ensure that clinicians could receive accurate, complete patient health data on demand — a challenge that has vexed some of the world’s largest organizations.

When Hunterdon set out to achieve healthcare data interoperability among its 35 facilities, including a 178-bed teaching hospital, the small data team had to reckon with six electronic health record (EHR) systems and more than 100 applications. Furthermore, Hunterdon had invested in best-of-breed applications, which further complicated the effort.

The team homed in on a strategy that fit its budget, worked with existing technologies, and didn’t overwhelm staff: an EMPI to correctly identify patients and a unified care record to corral data across departments. Since then, the initiative has created a system that delivers key data to clinicians when and where they need it, fueled by notifications, from a single logon. All the while, Hunterdon’s data experts have retained the resources and flexibility required to keep the health system running at full power.

Internal HIE Drives Data Sharing

It’s not easy to derive insights from large volumes of data, all while navigating evolving technological and regulatory landscapes. The task becomes even taller when budgetary and personnel constraints come in, as is common among community hospitals. Just 13 percent of small, independent hospitals have leveraged interoperability to find, send, receive, and integrate data. Hunterdon was able to do this by leveraging our technology, HealthShare’s Unified Care Record and Patient Index to create a longitudinal record which allowed records to move smoothly across all clinical environments.

When Hunterdon recently partnered with a larger nearby health system to launch a radiology and surgical center, the MPI integrated with the unique identifiers of the partner system’s EHR. Hunterdon used the Unified Care Record to aggregate and share patient data between the two organizations. Across Hunterdon, quick, convenient access to accurate data has laid the groundwork for more personalized care.

The challenge of accurate patient matching and identification isn’t going away anytime soon in healthcare. Fortunately, as Hunterdon’s story illustrates, health systems of every size can address it without waiting for some far-off day when we have a national patient identifier, or counting on an entry-level analyst like that younger me!

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