Survey: Patient Matching Issues Common Among HIM Professionals

More than half of health IT management (HIM) professionals routinely work on mitigating possible patient record duplicates at their facility, while 72 percent of those work on mitigating duplicate records weekly, according to a survey from the American Health Information Management Association (AHIMA).

Further contributing to the issue, less than half (47 percent) of respondents state they have a quality assurance step in their registration or post registration process, and face a lack of resources to adequately correct duplicates. In order to learn more about AHIMA members’ experience with patient matching as it relates to linking patient records, the AHIMA membership survey was answered by 815 participants using 12 different electronic health record (EHR) systems and was conducted in the summer of 2015.

According to AHIMA, accurate patient matching “underpins and enables the success of all strategic initiatives in healthcare,” including:

• Patient-centric care: Identifiers serve to “link” all patient data. Compromising the “linking” ability compromises care delivery.
•  Health information exchange (HIE): Correlating patient data across enterprises, regions, or states requires accurate matching of patient data.
• Population health: While population health has many facets, the one common thread is the need to match consumer information at an individual level in order to address the goals.
• Analytics: Identifying best outcomes for patient study groups, identifying consumers across a continuum of care for engagement strategies, and effective research requires accurate patient matching.
•  Finance: Value-based purchasing, risk sharing reimbursement models, and accountable care organizations all rely on accurate patient matching across a care continuum.

Information governance encompassing patient matching is essential to successfully executing disruptive and transformational healthcare activities, according to AHIMA officials. Accordingly, here are five key findings from the AHIMA survey:

• A total of 43 percent of respondents are measuring data quality as it relates to patient matching. Routine quality check exercises are an important component of data quality for patient matching.
• A total of 47 percent of respondent’s state they have a quality assurance step in their registration or post registration process.
• A total of 55 percent of survey respondents were able to communicate the duplicate medical record rate within their organization, but additional questions relating to how the duplicate rate was calculated indicate a lack of a standard definition for duplicate rate calculation. For example, only 42 percent knew the numerator and 42 percent knew the denominator that factored into their organizations duplicate rate.
• A total of 57 percent of respondents work possible duplicates regularly. Of those respondents, 72 percent work duplicates at a minimum of weekly.

The top five challenges identified by survey respondents in managing the master patient index/enterprise master patient index are: Registration staff turnover; record matching/patient search terminology and/or algorithms; lack of resources to correct duplicates; inadequate information governance policy support and lack of executive support.

The authors of the survey said it shows the need to measure, monitor, and inform the marketplace of the need to better match patients to their specific health information. The survey responses illustrate the importance of information governance encompassing patient matching. Accurate patient matching is essential to patient-centric initiatives, and implementing quality assurance measures are critical steps to improving performance, the authors said. “We cannot sit around and wait for others to correct this problem,” the survey authors said. “As healthcare professionals, we need to embrace the challenge and collaborate to develop scalable solutions to assure patient information is available when and where it is needed.”

In February 2014, the Office of the National Coordinator for Health IT (ONC) released their full patient matching report before HIMSS14. That report called for data standardization of several patient demographic fields to increase patient matching accuracy and to enable EHRs to have the capability of creating patient matching reports to find duplicate records easily. ONC said at the time that it will not create a standardized algorithm for patient matching.

What’s more, later this month, the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) is launching its National Patient ID Challenge. “Matching the right patient with the right data at the right time is critical to ensuring patient safety and realizing the full benefits of health IT. As we continue to digitize the healthcare system, it has become clear that we need a private, accurate and safe system for patient identification. This is why CHIME teamed with HeroX to launch the National Patient ID Challenge: a $1 million global competition aimed at incentivizing innovators to develop a viable solution,” CHIME said.