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Solving for Interoperability: Addressing the Patient ID Problem

  • May 03, 2016|
  • 2 years ago

by Tom Foley

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Director, Global Health Solution Strategy

Interoperability is a word full of syllables—and opportunity, especially when it comes to securing accurate patient information. Beyond transferring data, interoperability is about moving data from one hospital system to another, to a clinic, a private practice or wherever a patient’s journey may lead—and ensuring each receiving system can accurately integrate that data into an existing or new patient record.

To add to that mouthful, semantic interoperability is really what needs to be addressed. The Healthcare Information and Management Systems Society (HIMSS) emphasizes that this is “interoperability at the highest level, which is the ability of two or more systems or elements to exchange information and to use the information that has been exchanged.”1 Making the next step in this case merging data in ways that will positively impact record accuracy, quality of care, and the security of patient identity.

Suppose an individual—let’s call him Chris Jones—lives in a community that has two hospitals. One uses Epic for its EHR software; the other uses Cerner. Say Chris receives care at the Epic hospital, while a Chris Jones imposter gets treated at the Cerner hospital. If those two records were merged—because they both seem to relate to one Chris Jones—the data would become corrupted. The real Chris Jones’ doctor will now rely on inaccurate information to make treatment or diagnostic decisions. Decisions that could be harmful or even life-threatening for Chris.

Patient identity theft and fraud is an annual $84 billion problem. Add the cost of duplicate records to that given they account for 15% of all patient records, and the lack of semantic interoperability seems impossible to ignore. Indeed, today the average medicare patient sees nine different doctors in any given year. What if each of those nine doctors is using a different EHR?

Organizations industrywide are spending millions of dollars on the back end to manually reconcile duplicate records (but how do you know medical identity theft has occurred? Marc Probst, vice president and chief information officer at Intermountain Healthcare, is among many healthcare leaders who is experiencing the costly impact of record inaccuracies across clinical, operational, and financial performance. Intermountain, a Utah-based health system with 23 facilities, spends approximately $5 million a year on technology systems and training to improve patient identification

We also need to factor in the growing number of data sources. As patients and physicians gain access to digital health platforms—from web portals to wearable devices—patient identity, once again, is the crucial linchpin in securely identifying where data is coming from and who it belongs to. True interoperability cannot be achieved without establishing a single patient identity solution that is supported across all settings of care.

Such a solution leads to the transition of probabilistic matching algorithm (same used by yahoo and google when resolving a search) to a deterministic matching algorithm. By establishing this policy, using a deterministic matching algorithm (rather than probabilistic), we will create a more refined system for integration across different EHRs.3

Where do we start? Collaborative partnerships between health systems and technology companies.

“Clinicians and institutions are doing so not necessarily to be MU, but because health IT can make a difference in clinical care,” says Patricia Wise, RN, FHIMSS, vice president of healthcare information at HIMSS. “They’re just not doing it to the government requirements. They’re providing outstanding quality care, but they’ve moved away from providing the data the government requires on Meaningful Use. They’re moving forward with technologies they think are more applicable to their populations.”4

Other partnerships are forming to accelerate solution development, such as the collaboration between the College of Healthcare Information Management Executives (CHIME) and HeroX, a crowdsourcing innovation platform. Both are working to “encourage innovators to help solve the complex problem of patient misidentification.”5 Many more organizations such as WEDI, HIMSS, and the Office of the National Coordinator for Health Information Technology (ONC) continue to focus on patient identity issues.

Vendor giants, like Cerner Corporation and Epic Systems, have signed a pledge by the Department of Health and Human Services for industrywide interoperability. This unified push for greater integration will only continue to build throughout 2016 as more key industry leaders get involved.6

With rapidly advancing technology available to us, there is no excuse not to pursue a single form of patient identification. With accurate patient ID at the point of care—whether that is at a traditional clinic, through remote monitoring, or a personal device—we can safeguard patient records from inaccurate data and potential patient identity fraud.

1. “What is Interoperability?” HIMSS, April 5, 2013.
2. “Top Ten Tech Trends: National Patient ID Movement” Healthcare Informatics, March 24, 2016.
3. “Probabilistic or Deterministic?” Alchemy Viral, May 3, 2013.
4. “Evaluating the current state of meaningful use” Medical Economics eNews, March 22, 2016.
5. “CHIME Launches $1M National Patient ID Challenge” Healthcare Informatics, Jan. 19, 2016.
6. “Recapping Important HIMSS 2016 EHR Interoperability News” EHR Intelligence, March 7, 2016.