Electronic Health Records

Integration & Interoperability News

ONC takes new look at EHR patient matching techniques

By Jennifer Bresnick

Patients with very common names may be able to have a little more confidence about getting the right EHR file the first time if the Office of the National Coordinator’s new collaborative project succeeds in its goals.  The ONC’s Patient Matching Initiative will help identify best practices for lining up records with the right people in order to reduce the possibility of errors and confusion.

Patient matching can be a tricky area as health information exchanges (HIEs) start getting more connected and more physicians are adding their John Smiths to their systems.   Whether it’s a mixed-up name or a simple typo that creates a duplicate file, the dangers of being treated based on inaccurate or incomplete information are well known.

“Mismatches, which already occur at a significant rate within individual institutions and systems, will significantly increase when entities communicate among each other via HIE —a Meaningful Use Stage 2 requirement — that may be using different systems, different matching algorithms, and different data dictionaries,” stated HIMSS in September of 2012. “The multitude of different solutions and the lack of a national coordinated approach pose major challenges for our health information infrastructure and result in millions of dollars of unnecessary costs.”

With the idea of a national patient identifier (NPI) still being viewed warily by privacy experts, HIEs and health systems have turned to probabilistic algorithms that pull up files based on names, ages, addresses, and other basic information.  However, records can be inadvertently merged if two similarly-named patients happen to be around the same age and live in the same town, which could have serious consequences for treatment.

“From a programming perspective, the [NPI] number is the way to go,” argues Greg Roderick, CIO and Senior Vice President of Healthcare Holdings Group.  “We’re always going to get possibility matches back if you use an address or a name.  With a number, you’ve got definitive.  You eliminate errors.  People shouldn’t be afraid of that number.  It’s just a number.  We want to be sure that we have everything on you, just like we do with your social security number.  I don’t want someone to say ‘we’re 86% sure that your name matches this file’ before they start looking at that chart and making a decision based on my information.”

However, the ONC’s focus will be on bringing together a group of more than 20 federal agencies to examine and current matching practices and make recommendations about a future path, says Lee Stevens, Policy Director of the State HIE Program.  “By identifying and recommending standardization of the basic attributes most commonly used for patient matching, we are looking to improve patient safety, care coordination and efficiency.”

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