Patient matching and patient safety: Key issues and solutions

Patient matching, linking individuals to the correct medical records, is a longstanding issue in healthcare, though it has received heightened attention now that health records have turned digital. Incorrectly matching patients to health information can have dire consequences.

First and foremost, patient matching is a patient safety issue. "If you take the medical information of two or more different people and combine it into the same record, that is a recipe for disaster," said Michael Nelson, vice president of strategy and business development at Equifax Identity and Fraud Solutions, at the Becker's Hospital Review 6th Annual Meeting in Chicago. "Conversely, if you're unable to link a patient's records across multiple sites of care where they've been treated, you end up with an incomplete record […] If you have a duplicate record in healthcare, it could cost somebody their life."

The reasons for duplicate records, which lead to mismatches, are not unknown, with the key factor being issues with data integrity. When individuals change addresses, phone numbers or even their names, their records don't automatically keep up.

Mr. Nelson offered the example of the St. Francis Hospital in Columbus, Ga., which was facing record duplication rates upwards of 25 percent, mainly due to changing addresses, missing Social Security numbers and missing birth dates.

To address the issue of duplicate records at St. Francis and elsewhere, Mr. Nelson suggested using a unique patient key assigned to each "golden record." Despite the ongoing controversy surrounding national patient identifiers — opponents are concerned with the privacy protections of the identifiers and fear a single identifier could leak an individual's entire medical history to anyone who gets a hold of it — Mr. Nelson said they are necessary on several levels.

More accurate matching using a unique key, he said, can help prevent overlays and duplicate records at the front end of registration and stop any errors before they move through the system. Additionally, providers may reduce their risk of malpractice. "If you have incomplete information you may be negligent in the way you are treating the patient," he said.

On the macro level, unique keys could be helpful to public health reporting and aggregating more accurate information. Accountable care organizations, too, would reap benefits, as the key could be utilized to match claims data to clinical data and consumer data.

However, Mr. Nelson did point out the care with which he chose his words. "I talk about this as a key," he said. "I don't talk about it as an identifier. As soon as you use that word, warning bells go off to consumer groups."

More articles on patient matching:

In new challenge, CHIME to award $1M for winning patient matching solution
5 ways HIEs and public health registries can work together
HIEs' top 8 interoperability obstacles

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