Many in the U.S. healthcare industry agree that a universal patient identifying solution is long overdue—and critical to reducing preventable medical errors. And, there is growing consensus that this is the year for positive patient identification.
The national patient identification movement gained significant momentum this past January when the College of Healthcare Information Management Executives (CHIME) launched the National Patient ID (NPID) Challenge, a $1 million crowdsourcing competition to incentivize the private sector to develop a universal patient identifying solution that privately, accurately and safely confirms a patient’s identity 100 percent of the time. CHIME will announce the $1 million winner in February 2017.
Costly patient matching inaccuracies are far-reaching; impacting clinical, financial and operational hospital performance, a fact that most healthcare leaders, like Marc Probst, vice president and CIO at Intermountain Healthcare, know only too well. Intermountain Healthcare, a 23-hospital health system based in Salt Lake City, Utah, spends about $5 million annually on technologies and processes to try to ensure proper patient identification. For Probst, the financial costs are not nearly alarming as the patient safety issues.
“The safety issues are by far the biggest issues associated with patient matching. And while problems are few and far between, but if you don’t have the right person you can make some pretty catastrophic mistakes. So, it’s key that we understand who we are dealing with and positively identify the patient,” he says.
Probst continues, “Imagine that a guy is going out for a jog in Salt Lake City, Utah and while he’s jogging, has a heart attack. He’s taken to the emergency room, and while there, we have to begin to revive him and take care of him. And imagine that his name is Joe Smith, and in Utah there are a lot of Joseph Smith and J. Smiths. He’s not able to talk, but we have to provide care. Now imagine that this same individual has an allergy to antibiotics, but we can’t figure that out because we can’t readily identify him.”
In a 2014 report about the issue, the Office of the National Coordinator for Health Information Technology (ONC) found the best error rate among healthcare providers is around 7 percent and the error rate is typically closer to 10 to 20 percent within healthcare entities. And, in fact, as healthcare providers vary in how they identify patients, the error rate rises to 50 to 60 percent when entities exchange information with each other.
While on the surface it would appear that accurate patient identification could be achieved by using simple demographic data, as most health systems and hospitals know too well, the issue of accurate patient identification is much more complex. Probst notes, “We’ve put together pretty advanced algorithms that look at various data around the patients, so we’re looking at names and addresses, birthdates, and phone numbers, and you’re trying to get as many points as you can to accurately identify that patient. But, even these algorithms are not 100 percent.”
In a recent article for Healthcare Informatics, David Muntz, former Principal Deputy National Coordinator for ONC, used an example from the Houston-based Harris County Health District (HCHD) to illustrate the challenge of the patient matching process without a unique identifier. According to HCHD patient statistics, there are 231 Marcia Garcia’s sharing the same date of birth.
In the article, Muntz argues that the healthcare industry needs to develop a consumer-managed national health safety identifier based on an email address combined with biometric-based validation, such as palm prints and retina scans. And, he says a private sector or public/private organization should create and manage a registry for these national health safety identifiers that can be accessed by authenticated emails.
There were efforts at the federal level to create a national patient identifier in the late 1990s in order to facilitate data sharing, yet criticism about identity theft and privacy stalled the idea. In fact, in 1999 Congress passed legislation prohibiting the U.S. Department of Health and Human Services (HHS) from spending public funds on the development of a national patient identifier.
Many healthcare leaders have voiced confidence that a crowdsourcing innovation platform could be an effective catalyst for a new, innovative solution. “I think we’re going to find some exciting solutions come out of this CHIME challenge and it’s going to make a difference, in dollars, and in the health and wellbeing of the people we serve,” Probst says.
HeroX, a crowdsourcing innovation platform, has been tapped to run the year-long CHIME competition, which, as of press time, has received more than 170 submissions. Russell Branzell, CHIME president and CEO, recalls that the idea to turn to a crowdsourcing innovation platform to address this issue evolved after meeting Peter Diamandis, M.D., the founder of X Prize, the parent company of HeroX, at a CHIME conference.
“He really challenged us and asked, ‘What is the problem in healthcare that is holding everybody back?’ And, every single person whether they were CIO members on our board, foundation members and those previously in the field, like myself, all said the same thing, ‘patient identification.’ And, I think it was the biggest epiphany when we looked at each other and he looked at us and said, “Then solve it’,” Branzell says. “We think the private sector is best positioned to solve these kinds of problems. This is a way to do it in a rapid way, a revolutionary way, different from the traditional private sector models.”
CHIME worked with a group of subject matter experts to develop the criteria and guidelines for the NPID Challenge, Branzell says. Essentially, the goal of the NPID Challenge is to find the best plan, strategies and methodologies that will accomplish the following: easily and quickly identify patients; achieve 100 percent accuracy in patient identification; protect patient privacy and identity; achieve adoption by the vast majority of patients, providers, insurers, and other stakeholders and scale to handle all patients in the U.S.
Many healthcare organizations, patient advocacy groups and vendors are putting their support behind this effort. During a press event announcing the NPID Challenge, Karen DeSalvo, M.D., National Coordinator for Health IT, praised CHIME’s leadership on this issue and noted that “there are opportunities for the private sector to advance in this space and to think of ‘out of the box’ opportunities for us to do a better job of making sure that the right information is wrapped around the right person and community.”
Beyond the very critical patient safety issues, a universal, accurate patient identification solution has far-reaching implications, touching on population health and even interoperability.
“The eco system of healthcare IT is going to get increasingly more open, with smaller solutions being delivered into our environment to allow things like population health, patient self-management, patient coordination of care and family coordination of care. And the only way that is going to be successful is if we can have a good, positive patient ID so that these applications can share the appropriate data with the appropriate people,” Probst says.