- The vast majority of patients support the use of unique identifiers to improve patient EHR matching, according to new original research by Pew Charitable Trusts.
The organization teamed up with Public Opinion Strategies and Hart Research Associates and conducted 11 focus groups in June 2017 and January 2018. The focus groups included 95 participants from Colorado, Texas, Tennessee, Pennsylvania, and Virginia.
Pew gathered feedback from parents of children 12 years old and younger, family caregivers of patients with chronic or serious illnesses, Medicare beneficiaries, frequent users of the healthcare system, infrequent users of the healthcare system, Democratic primary votes, and Republican primary voters as part of the survey.
“In general, participants were unaware of the problems with patient matching but did understand the issues surrounding the transfer of records between health facilities, largely through personal experience,” wrote Pew. “Some recalled having their records confused with another person’s.”
After being informed of the safety issues and costs associated with poor patient EHR matching, most focus group participants were strongly supportive of improving patient health record matching.
Pew found participants “overwhelmingly” supported the use of unique identifiers to improve matching, reduce medical errors, and provide clinicians with a more complete picture of patient health.
“Participants viewed unique identifiers — specifically biometric solutions — as more secure than other approaches, such as using demographic data,” stated Pew.
Biometrics were the top-rated solution among all participants.
“Focus group participants preferred this option because it would help unconscious patients, not need to be remembered by the patient, and be more accurate and secure than other approaches,” wrote Pew. “Participants also indicated a familiarity and comfort with biometrics, particularly fingerprint scans, largely because of their widespread use in smartphones and airport security.”
Still, some participants had reservations about the patient EHR matching solution.
“Some mentioned the cost of scanning equipment and whether it would be prohibitive for providers in low-income and rural communities, and others had questions about the effectiveness of iris scans,” noted Pew.
Despite these concerns, most focus group participants supported the method as being effective, cheap, and easy to implement.
Comparatively, the use of smart cards as a form of patient identification was largely dismissed. Smart cards posed a significant security risk since they could easily be lost, stolen, or forgotten.
“Many participants also felt a smart card would put complete responsibility on patients to carry it with them and not lose the card,” researchers added.
Participants had mixed feelings about using either lifetime unique numeric codes or randomly-generated, single-use numeric codes for patient identification.
“Participants liked that a lifetime number would be low-cost, but they feared it might be easy to steal, and they voiced considerable confusion over how a single-use number would help solve the problem of mismatching, especially if a person was unconscious or in need of emergency care,” stated Pew.
“Similarly, most participants did not like the idea of a self-selected code or number, because patients would need to remember it,” the organization continued.
The idea of using smartphone apps for patient identification also generated conflicting responses for focus group participants.
“Some focus group participants welcomed the use of a smartphone app, because it could cut down on waiting room paperwork,” wrote Pew. “This especially appealed to participants who already conduct many personal activities, such as financial tasks, on their phones.”
However, many stated a concern that a smartphone-based solution would be ineffective for patients in emergency situations, seniors, or low-income individuals.
“Participants also said that seniors, even those with smartphones, may not be able to effectively operate an app or may face challenges reading the text,” Pew stated.
Finally, focus group participants generally supported improvements in standards use across healthcare organizations, but mostly doubted the effectiveness of using third-party data to enhance patient EHR matching.
“Patients in the focus groups questioned the accuracy of third-party data and worried that their health and financial information could be commingled and exposed, again citing the Equifax breach,” Pew noted.
Overall, Pew’s newest research indicated a high level of enthusiasm among healthcare consumers for unique patient identifiers that leverage biometrics to improve EHR matching accuracy.