- Five senators requested the Government Accountability Office (GAO) consider several key issues during an upcoming planned study on patient EHR matching and devise clear recommendations ONC should take to improve patient matching methods.
US Senators Elizabeth Warren (D-MA), Orrin Hatch (R-UT), Sheldon Whitehouse (D-RI), Tammy Baldwin (D-WI), and Bill Cassidy, MD (R-LA) issued these requests in anticipation of findings the federal agency is required to submit to Congress by December 2018 under the 21 Century Cures Act.
“Correct patient matching is necessary for sharing patient information between providers, ensuring efficient use of health care resources, and improving the quality of health care,” the senators wrote in the letter addressed to Comptroller General Gene L. Dodaro.
Senators stated the Congressional ban keeping HHS from funding a single, nationwide unique patient identification system has led to the creation of proprietary patient identifiers often specific to certain health systems.
“Given this Congressional ban, HHS's ability to lead the development of solutions to patient matching is limited,” they clarified.
Taking these limitations into account, senators suggested GAO provide clear recommendations for steps federal agencies — especially ONC — can take to improve patient matching methods.
“In evaluating the impact of patient matching efforts on factors like privacy and security of patient information, we hope you will at the same time consider the impacts on medical fraud, medical identity thefts, and medical reimbursement,” they stated. “We appreciate the opportunity to work with GAO, and look forward to its recommendations on steps to improve patient matching.”
Senators also requested GAO extend the parameters of the study by also providing data on the prevalence of patient data errors and mismatches, as well as the costs and risks associated with these errors.
“Patient misidentification can lead to inadequate, inappropriate, and costly care and, in the worst cases, patient harm or death,” the senators maintained. “A 2012 survey conducted by The Council of Health Information Management Executives found that one in five physicians encountered mismatched information that led to inadvertent illness or injury at least once over the previous year.”
Senators pointed to existing data on the financial consequences of patient EHR matching errors as being cause for concern. A 2016 report of nurses, physicians, and IT practitioners found the total estimated cost of denied claims from patient misidentification at a typical hospital amounted to $1.2 million a year.
As part of the study, GAO will also review and evaluate the effectiveness of the alternative steps ONC and private sector health IT experts have taken to resolve issues with patient matching.
Several efforts to improve patient matching by both federal entities and healthcare stakeholders are currently underway.
In August, the Regenstrief Institute’s Center for Biomedical Informatics (CBMI) began work to develop an automated patient EHR matching solution using a $1.7 million grant from the Agency for Healthcare Research and Quality (AHRQ).
“Matching the correct individual to his or her health data is critical to their medical care,” said CBMI Director Shaun Grannis, MD, MS. “Statistics show that up to one in five patient records are not accurately matched even within the same health care system. As many as half of patient records are mismatched when data is transferred between health care systems.”
During the five-year project, Regenstrief researchers will develop and test evidence-based solutions to improve patient matching accuracy.
For its part, ONC launched a patient matching algorithm challenge in June. The federal agency will award up to six cash prizes to the top-performing innovators amounting to $75,000.
“While numerous recommendations have been issued over the years to tackle different aspects of patient matching, it is important to recognize that the entire health care system can impact its performance – from data capture at patient registration to the technology and algorithms along the way,” said ONC Director of Standards and Technology Steve Posnack, MS.