I have blogged extensively about the urgent need for EHR interoperability to support patient movement across different health systems (see, for example: Integration and Interoperability Are Essential for Growth of Digital Pathology). However, I probably have focused too much on technical and strategic barriers to interoperability and spent insufficient time addressing faulty patient identification problems as a barrier to interoperability. Here's the link to my note on this issue (see: The Quest for a Fail-Safe Patient Identification Solution in the U.S.) and below is an excerpt from from that note:
The search for as solution to the patient ID problem has been exacerbated by the broad adoption of EHRs with a single system spanning a large health system and scores of people responsible for the correct patient ID when entering data....The sole solution to the problem is the adoption of universal health identifier such as that being used in countries like Australia but there is little chance of such a system being adopted in the U.S.
A recent article discussed how patient mismatching hinders data exchange (see: Pew and Massachusetts eHealth Collaborative Find the Frequency of Patient Mismatches Exceeds ‘Desirable Levels for Effective Data Exchange’) with an excerpt from it below:
EMPIs may help clinical laboratories ensure their patients and medical records are properly matched with medical laboratory test results and specimens Mix-ups between patients and their medical records, known in the healthcare industry as “patient mismatching,” happen far too frequently in hospitals and clinics worldwide.....A recent study by Pew Charitable Trusts (Pew) in collaboration with the Massachusetts eHealth Collaborative (MAeHC) revealed that the rate of patient mismatching is difficult to measure.....“An increased demand for interoperability—the exchange of electronic data among different systems—is fueling the desire for improvements.....From experience, medical laboratories understand the challenges of matching information on a clinical laboratory test requisition to the right patient and can often see patient mismatches on a daily basis. About $1,950 in medical care costs per patient during a hospital stay, and $1.5 million annually in denied claims per hospital, are associated with inaccurate patient identification....“Patient matching is a fundamental function of being able to get the right records, for the right person, at the right time, so that timely decisions can be made about his or her health. There has to be a mechanism to ensure that you’re actually getting a copy of the records for the right person,” [according to an expert on this topic].
An effective EMPI (enterprise master patient index) is a large part of the solution to the patient mismatch problem; EMPI is defined in the following way (see: Enterprise master patient index): an enterprise master patient index or enterprise-wide master patient index (EMPI) is a patient database used by healthcare organizations to maintain accurate medical data across its various departments. Patients are assigned a unique identifier so they are represented only once across all the organization's systems. However and in addition to deploying a sophisticated EMPI, a unique healthcare identifier would be an additional measure to help ensure that EHR interoperability does not increase the harm to patients with mistakes propagated from one hospital to others.
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