- A nationwide patient matching strategy should be led by the private-sector and spearheaded by a neutral coordinating organization to ensure flexibility, transparency, and standardization, according to several healthcare industry leaders.
In a recent AHIMA op-ed, CommonWell Health Alliance Executive Director Jitin Asnaani, Beth Israel Deaconess Medical Center CIO John D. Halamka, MD, AHA Vice President for Health IT and Policy Operations Chantal Worzala, and others weighed in on the industry’s persistent problem with accurate patient EHR matching.
Health IT developers have yet to achieve 100 percent patient matching accuracy. In 2017, a CHIME challenge prompting innovators to develop a solution capable of ensuring 100 percent accuracy was suspended after participants failed to meet the contest’s criteria.
In light of the industry’s frustrations with patient matching, healthcare experts offered a list of several characteristics a patient matching strategy should include.
First, experts recommended the patient matching strategy be led and facilitated by a neutral coordinating organization with balanced stakeholder representation. This coordinating entity would manage the development, policies, and evolution of the patient matching strategy.
“This organization would identify needed policies, ensure that solutions complement one another, and assess whether approaches are overly burdensome to resource-constrained organizations — such as critical access hospitals,” explained industry experts in the op-ed.
“This organization should maintain policies for patient identification, support improved data quality, establish criteria for solutions, develop rules, and identify standards that technology developers and hospitals would agree to follow,” the group continued.
Experts also clarified the nationwide strategy should be led by the private sector. However, federal entities could financially support and assist efforts to develop a nationwide strategy. Federal entities could also enact incentives for healthcare organizations that adhere to the strategy’s standards.
In addition to a nationwide patient matching strategy, experts also suggested stakeholders support a universal health data exchange policy.
“Creating a universal policy supported by a trusted entity would define how and what data can be used for matching, and set privacy rules and other appropriate policies salient to matching,” explained experts.
The ONC Trusted Exchange Framework and Common Agreement (TEFCA) is one example of a national framework and set of standards designed to streamline health data exchange. While TEFCA is voluntary, the framework could help to yield significant improvements in interoperability and health data exchange if health information exchanges (HIEs) across the country opt to participate.
According to healthcare industry experts, another necessary element of a nationwide patient matching strategy is transparency.
“The success of a nationwide strategy relies on ubiquitous implementation by healthcare organizations and acceptance by patients,” wrote experts. “To achieve large-scale buy-in, the components of a nationwide strategy should be publicly disclosed. Earning that support must also include ongoing input from patients, providers, technology developers, and others.”
While the nationwide strategy would be a cohesive framework designed for implementation across state lines, experts clarified specific states may implement privacy and health data exchange policies differently. Federal regulation should only establish minimum requirements that states are able to expand on.
By extension, the framework should also be designed with flexibility at top-of-mind.
“The framework for a nationwide strategy should support different technologies and solutions that can work together to improve matching to the greatest extent possible,” recommended experts. “The trusted entity could help build an infrastructure that allows seemingly incompatible solutions—such as different biometrics—to be used more effectively for matching.”
Experts also recommended the patient matching strategy include multi-factor identity authentication to ensure accuracy.
“Improving patient matching relies on each healthcare organization correctly identifying patients. Authenticating that individuals are who they say they are — including through the use of multi-factor authentication such as confirming registration via email or using smartphones — can help improve identification,” wrote experts.
To promote standardization, experts emphasized that health IT developers and healthcare organizations should implement a set of agreed-upon standards all participants must meet. Standards may include a minimum demographic data set, as well as a strategy for resolving errors when patients are incorrectly matched.
Specifically, the strategy should enable patients to attest to the accuracy of the information contained within their EHRs and correct any matching errors.
Finally, experts stressed the importance of patient empowerment when developing a nationwide patient matching strategy.
“Because individuals have different preferences regarding with whom and for what purposes their information is shared, systems should support this,” wrote experts.
“Patients should be encouraged to speak with their healthcare providers to understand the benefits and drawbacks of sharing data, and when exchanging information can legally occur among providers absent explicit consent,” the authors continued.
Including these elements in a nationwide patient matching strategy could help to improve patient matching accuracy and health data exchange.