Why Fail-Proof Patient Matching Is Critical to Disaster Response
By Mark LaRow
Some of the worst errors in medical care—from incorrect or missed diagnoses to unnecessary testing—occur when patient records aren’t matched to the correct individual. It’s a problem that can significantly impact a health system’s ability to respond with agility in times of crisis—including the coronavirus pandemic.
Patient-matching rates vary widely. A Pew Trust analysis estimates up to half of patient records exchanged between hospitals and other care facilities are not correctly linked. Within health systems, emergency departments (EDs) are especially vulnerable to high rates of unmatched records due to the urgency of care needs and the challenge of obtaining accurate demographic data. And while match rates are difficult to measure, a CHIME study suggests one in five records may not be accurately matched even within facilities where the individual has previously received treatment.
That’s a problem with wide implications for the coronavirus epidemic, given the surge in people seeking testing and treatment in EDs, the call for “all hands on deck” to support increased volumes, and the demand for rapid response. Each of these factors amplifies the need to match the right record with the right patient at the point of care.
The good news is that hospitals can take immediate steps to strengthen their record-matching capabilities and improve readiness for health disasters. Here are three approaches to consider.
Prevent duplicate medical records at the point of patient registration—especially in the ED. In times of good health, duplicate medical records carry a hefty price: Repeated medical care tied to duplicate records costs an average $1,950 per patient per inpatient stay and more than $800 per ED visit.
In times of crisis, repeat care not only adds cost to an already expensive visit but also delays individuals from receiving urgent care. Hospitals and health systems should educate staff about the need to complete all data fields, even during high-volume, high-intensity periods; verify spellings of names, address information, phone numbers, and employment information; and avoid skipping over steps in this process out of a desire to expedite check-in.
Add referential matching. Referential matching is a new plug-and-play solution that leverages a premastered database as an “answer key” to match and link people with their medical records with a much higher degree of success. For example, instead of comparing the demographic data from two records to see whether they match, referential matching pairs the demographic data from each record to a continually updated, highly curated reference database of identities that span the entire US population. In doing so, referential matching “sees past” demographic data that is out of date, incomplete, incorrect, or different from what is expected.
The referential system can either make the correct match or can immediately prompt registration staff to verify the data with the consumer at the point of registration. Referential matching systems have the added advantage of being able to supplement existing matching systems, rather than replacing them, so there is no danger of upsetting ongoing operations.
At Northwell Health, a not-for-profit, 23-hospital network in New York with 5 million patient records, a referential matching solution enabled quick resolution of 87% of mismatched records. It also significantly reduced claim denials resulting from errors in demographic or other identifying information. Notably, a Black Book survey found 33% of all denied claims result from inaccurate identification or information, costing the average hospital $1.5 million per year.
Seek ways to better connect telehealth systems to patient records. Telehealth has suddenly become very important because it allows providers to respond to the surge of health needs more quickly, more scalably, and with greater safety for caregivers and other patients. It allows some individuals to avoid ED waiting rooms, where they may be at risk of infection. It also directs high-risk patients to scarce inpatient resources and helps prepare staff for their arrival.
In tandem with these benefits, telehealth systems can also introduce challenges by creating more duplicate medical records, even for well-known patients. Due to interoperability shortcomings, these systems struggle with matching telehealth patients to existing EMRs. In a normal situation, data stewards in health care organizations would fix these duplicate telehealth records in the days or weeks following a patient encounter. But in the face of extreme volumes caused by the pandemic, this slow manual process will prove ineffective at a time when caregivers need immediate access to accurate medical records.
One approach to consider: Create an “identity bridge” between an existing EMR and telehealth system. While health care organizations can complete this technical integration independently, time is of the essence. Rather than taking weeks or months to implement the identity bridge, the more practical alternative is to subscribe to an SaaS solution that includes prepackaged interfaces and matching capabilities that enable the linking of records within a week.
A Vital Approach to Community Health
Achieving a complete patient picture of medical records gives providers the confidence they have all the information to make rapid and lifesaving decisions particularly necessary in a health care crisis such as the one now facing the global health community.
— Mark LaRow is president and CEO of Verato.