Friday, November 16, 2012

Patient Identification Pitfalls Plague HIE Networks

As NAHAM members well know, managing patient identities is one of the hidden problems of health information exchange (HIE) and electronic health record (EHR) technology.  Every patient needs a single and unique identifier tied to his records, and a simple typo or a misspoken birthday can leave a patient with duplicate records, potentially compromising his care. 

Many hospitals use their own master patient indexes (MPIs) to check if patients have an existing record, but the emergence of HIE means new challenges in ensuring accuracy across multiple providers for millions of new patients. Unique identifiers must be the same across the entire HIE for the network to function, and NAHAM has been working to provide a toolkit to members to assist with that goal.

According to a white paper on EHR Intelligence, establishing a unique identifier can also be accomplished with the help of a system-wide enterprise MPI (EMPI).  An EMPI provides its own identifier that spans the entire network, requiring accurate and complete data across every department or healthcare provider contributing to a patient’s care.

Quality control during the admissions process is the first step towards ensuring accuracy, but staff performing the data entry is often under conditions that require them to be as speedy as possible: mishearing the spelling of a surname or transposing a letter in a street address can accidentally create an entirely new record and identification number for a patient who may have visited the facility before. Without consulting the patient, it’s nearly impossible to tell if the original data is correct or if a mistake was made previously and the new input is the proper information.  Implementing safeguards in patient record software to prevent these small mistakes may seem like an easy task, but human error will always find a way to defy technology. 

HIE vendors are trying to work around these problems with a variety of innovative ideas such as biometric data or cloud-base solutions, but patient records are continually developing collections of changeable data.  The goal of HIE and EHR is to manage this data cleanly, effectively, and with the maximum benefit to the patient, but the margin for error only grows wider as more and more providers try to collaborate and share information. 

HIE systems must be capable of preventing mistakes caused by duplication or accidental deletion of records, but healthcare providers themselves are ultimately responsible for being certain that the patient in front of them matches the information on their computer screen.

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