September 14, 2017
By An-Chan Phung
Original Article in HIT Leaders&News
Take a look through the contacts in your cell phone. Do you have more than one entry for the same person? Or, do you have one listing for your cousin Maggie’s old cell phone, one for her new cell phone, and one for her work line at the job she lost three years ago? When you bought that new iPhone, you expected that all of Maggie’s different entries would be appropriately matched and the right data would appear in the right fields. However, now, when it comes time to reach her, it‘s time-consuming and frustrating to get to Maggie’s magical record. You spend more time sifting through the information and trying to make sense of it than you do connecting with the people who matter in your life. Even technology as simple and integral as your personal smart phone can be made complex and time-consuming if the data inside isn’t managed properly.
Now, picture facing this problem on a larger life or death scale—trying to find accurate patient contact information in a hospital or health system EMR. Over time, your hospital acquires new technology solutions, a wide variety of employees from across your entire health system begin to enter personal health information, the hospital acquires additional hospitals and/or practices, and the duplicate records just keep adding up. Unfortunately, however, now the stakes and the potential negative impacts are much higher, and your new “duplicate record problem” begins to prevent your overall hospital from achieving healthcare’s Triple Aim.
Unfortunately, as the volume and complexity of data has proliferated, duplicate and inconsistent patient records have been growing like a hidden virus, and the problem is now approaching epidemic proportions. This problem is now affecting every part of most hospitals’ operations today, from the quality of care delivered to the ability to coordinate care among facilities, to patient and provider satisfaction. In fact, according to a study published in the Spring 2016 issueof Perspectives in Health Information Management:
- Duplicate patient records are costing health systems an average of $96 per record
- The cost of repeated tests or delayed treatments caused by duplicate records can add another $1,100 per patient
- More than 100,000 people die annually due to mistaken identity or “wrong patient” errors; and
- Four of every 100 cases involving duplicate records has a negative care impact
Take, for example, an average 300-bed hospital with approximately 800,000 patient records, with a duplicate percentage of 12. That equates to 96,000 duplicate patient records at a cost of $96 per record, costing the health system over $9M to “steward” those patient duplicates. These are costs that neither an organization or its patients should be forced to bear, in terms of financial impact or the resulting health outcomes.
Turning to Technology
As with most problems, the solution to the patient identification and matching challenge lies with people, process, and technology. It’s important to establish standardized policies and procedures surrounding patient data management; however, the ultimate solution must come from some type of scalable and seamless technology solution that puts data stewardship back in the hands of your own HIT managers.
Multiple data systems, each limited in functionality and walled off in siloed departments, can’t solve the problem. Neither will system constraints that make patient engagement complex and difficult. IT groups will not be able to solve the problem without the proper tools. The only way to effectively integrate the multitude of systems that have become repositories of data from clinical, financial, research, and specialty services is through use of a next-generation Enterprise Master Patient Index (EMPI). An advanced EMPI provides sophisticated tools and matching algorithms that enable healthcare organizations to address the difficulties of trying to gain a single, complete, accurate picture of their patients, and finally identify “the golden patient record.”
Here are four ways a next-gen EMPI can meet the challenges of patient identification and matching.
1. Breaks Down Silos
Overall, the growing adoption of technology in the healthcare industry has been positive, but it has one significant downside. As organizations increase the use of technology, they tend to add new systems and applications, many of which can’t communicate with one another. As a result, most organizations employ multiple systems to collect data for clinical, financial, research, and specialty purposes. This makes it increasingly difficult to maintain the quality, accuracy, and consistency of their data. EMR/EHR systems and other solutions may be the central technology anchor in an organization, but core provider functionality is limited to that system alone, so information silos are always going to exist. In addition to the EMR, a hospital may have separate systems for advanced surgery, cardiology, and wound care that aren’t easy to replace. These solutions are often working effectively within their own respective silos; however, they’re all contributing to the increasingly pervasive and costly issue of unclean and inconsistent data.
Advanced EMPI—also referred to as Master Data Management (MDM) in non-healthcare settings–is the key enabling technology for hospitals and healthcare organizations to take control of their data. An advanced EMPI system integrates the data from these disparate systems and forms an overarching technology umbrella, resolving and synchronizing data issues and providing a single patient view that can be accessed across the enterprise. It resolves data quality issues and synchronizes back to enable accurate patient identification and matching and minimizes duplicate records. No matter what the silo, data type, or data model, an advanced EMPI offers a truly agnostic solution.
2. Provides Advanced Technology
Many EMPI and EHR solutions claim to be able to resolve data issues, but if they could, data quality, patient identification and matching, and duplicate records would not be the problem they are today. Most vendor solutions are systems developed one or even two decades ago, and they simply don’t have the wherewithal to manage today’s ever-increasing data issues.
What hospitals need is a solution that offers truly modern capability and high-speed processing and has the computing horsepower necessary to synchronize patient data. By providing advanced matching algorithms, relationships, and hierarchies, an advanced EMPI provides true interoperability among an organization’s various systems. Synchronizing large volumes of patient data that need to be loaded, matched, and merged in real-time requires an enormous amount of computing power. Legacy systems will bog down under the weight of such an operation. An advanced EMPI can easily handle the processing job required, significantly improving performance. It allows an organization to verify, standardize, and enrich patient information across your various internal systems and external reference sources to ensure consistent high-quality, real-time patient data management.
3. Enhances Both Patient Engagement and Collections
Effective patient engagement requires an organization to reach the right patient, at the right time, with the right message. Mismatched patient records not only make population health more difficult –it could pose a danger to your patients.
To meet the goals of Triple Aim – enhanced patient care experience, improved population health, and reduced costs – clinicians need an all-inclusive and singular view of each and every patient. An advanced EMPI eliminates the problem of multiple patient instances resulting from numerous system databases.
Consolidating patient records into a single view is not only instrumental to patient safety, but also reduces the cost of outreach and helps improve reimbursement–which is becoming increasingly important as patient payments become a growing component of hospitals’ overall revenue mix.
4. Reduces Use of IT Resources
Organizations can address patient identification and matching issues with a legacy EMPI, but doing so requires reliance on vendor services that can cost hundreds of thousands of dollars. An advanced EMPI is built on a modern framework that enables quick implementation and empowers self-service management that eliminates high vendor service costs.
A next-generation EMPI offers several advantages that make life easier for an organization’s IT staff. It simplifies implementation and maintenance and makes data management easier. Adding new data sources is easier than with a legacy EMPI and helps ensure that databases stay current.
An advanced EMPI automatically matches and merges duplicate records into a “golden record,” and distributes clean data back into source systems. This is an area where the mega-vendor systems consistently fall short. They can clean data within their own siloed databases, but struggle to break through and synchronize with other systems in the organization. An advanced EMPI minimizes those costs by empowering in-house staff to handle management tasks historically handled exclusively by external IT vendors.
Embracing the Future
Imagine the entire population of Springfield, Illinois (116, 500) or Ann Arbor, Michigan (120,782) dying every single year. That’s equivalent to the number of people who die annually as a result of identity or “wrong patient” errors.
This devastating outcome is caused in large part by the difficulty healthcare providers have in accurately identifying and matching patient records. Sixty percent of preventable deaths are attributed to patient misidentification–much of that the result of duplicate records. According to a RAND Corporation report, on average, eight to 12 percent of the records of U.S. healthcare organizations are duplicates. For large systems, that soars to 16 percent.
That means that up to one out of every seven patients at large healthcare providers have multiple records. Duplicate records can cause a host of patient and provider problems, from inaccurate billing and claims denials, to redundant testing, incorrect diagnosis and treatment, and even, as the numbers show, to death. The challenges of patient record identification and matching grow exponentially as EHR adoption becomes more prevalent. According to some estimates, EHR implementation has reached nearly 95 percent, and not only are healthcare IT systems nearly universal, but the challenge of maintaining clean patient data is a constantly moving target. And, much like the smartphones in our pockets, the only way for organizations to stay ahead of the curve is to embrace the most advanced technology solutions—today.
An-Chan Phung is the chief technology officer at VisionWare.