ONC to Partner on Address Standard to Improve Patient Matching

Dec. 1, 2020
One-year project with standards development organizations to launch in January

To improve patient-matching efforts, the Office of the National Coordinator for Health Information Technology (ONC) has announced that in 2021 it will launch an effort in partnership with standards development organizations to develop a unified specification for patient address in healthcare.

Speaking Dec. 1 at ONC’s Year in Review session about progress with the FHIR standard and application programming interfaces (APIs), Steven Posnak, deputy national coordinator for health IT, said ONC will work in collaboration with HL7,  the National Council for Prescription Drug Programs (NCPDP), and X12, along with the other standards development organizations and members of the Health Standards Collaborative (HSC).  The goal of the new initiative, called Project US@, is to issue a unified, healthcare industry-wide specification for representing address within the year.

Posnak wrote in a blog post on the ONC website that “as mundane as address may seem, it is often one of the key elements used for the purposes of patient matching and linking records, though other data like email and cell phone number are gaining in their use.”

He explained that among the many standards stewarded by HL7, NCPDP, and X12 there are fields for address, but the approach to represent it are typically left to the implementer to decide. Without specific constraints to rely on, implementers use a variety of free and commercial third-party tools, resources, and methods to help normalize address representations. The United States Postal Service (USPS) Publication 28 is often a starting point for this kind of normalization, but as ONC discussed in its Cures Act Final Rule, it has its limits.

As stakeholders have pushed for additional constraints and consistency around patient address formatting, Posnak noted that Project US@ is reflective of how subtle improvements in health IT can have a big impact when implemented at a national scale. “By doing this together, we will be able to establish a lasting," he wrote, "industry-wide approach to representing patient address that is consistent across a spectrum of clinical and administrative transactions.”

In a statement released after the announcement, Ben Moscovitch, project director for health information technology at The Pew Charitable Trusts, said, “This initiative from ONC represents a significant step towards better patient matching, one that builds on research that shows that standardizing addresses could help link thousands of records a day that otherwise wouldn’t be. Targeted, bipartisan changes like these are some of the most effective near-term opportunities to improve matching and help get patients the care that’s right for them. ONC deserves credit for bringing these standards organizations together to take this concrete, actionable step forward on one of the most vexing problems in health IT.”

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