Patients are well-positioned to vet health information and help address patient matching challenges.
Patients may have a key role to play in the healthcare industry’s pursuit of addressing patient matching and health data exchange challenges, according to a new report from the Pew Charitable Trusts.
With the industry well on its way to completing a transition to digitized patient records, providers and health data managers are encountering an issue with patient matching. Known as the practice of determining whether health records refer to the correct specific individual, patient matching is essential to ensuring quality healthcare, the Pew report authors explained.
“Yet in order for patients, doctors, nurses, and other clinicians to have this information, EHRs must be able to share data among the many different hospitals, offices, and other facilities where individuals seek care—especially when health care providers are seeing new patients and need to obtain information from previous care providers,” the report authors said.
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“Effective data exchange also helps clinicians get information to treat individuals with chronic conditions— approximately a third of Americans—and older adults, who often see more than 10 different physicians at dozens of office visits per year.”
Patient matching has presented as a considerable problem throughout the country. Lacking data standards, typos, missing patient information, default or null values, similar information, information changes, and identity fraud can all lead to duplicative or mismatched medical records.
Within a singular organization, patient matching can be as low as 80 percent, the report revealed, meaning one in five patients cannot be matched to their medical records. Match rates between organizations can be as low as 50 percent.
And when patient matching remains inadequate, patients are exposed to numerous safety problems. If a mismatched record does not contain a major allergy to a medication, the patient becomes liable to an adverse reaction, for example. Lacking patient matching can also result in costly repeated tests or delays in care.
This most recent Pew report highlighted various strategies to improving patient matching, including a strategy for enlisting patient expertise in medical records matching.
“Efforts to improve matching may be able to leverage patients’ ability to engage in their health care by giving them a more active role,” the report authors wrote. “Such an approach would represent a paradigm shift in matching, but it may face challenges in ensuring widespread adoption and utility for different patient populations—such as elderly, disabled, and low-income individuals.”
Pew developed the strategy in partnership with the RAND Corporation. Using different health technologies, Pew and RAND researchers say patients can help verify medical records information.
For example, using a patient’s unique smartphone number on file, the patient can verify whether the medical record belongs to her.
During patient intake, the administrative worker would send an automated text message to the patient’s cell phone. The text will generate a confirmation code. If the message and code align with the patient’s cell phone number, the clinic or hospital will know they are accessing the correct patient chart.
The report authors also proposed using smartphone apps that contain unique patient demographic and health-related information. When connecting the smartphone to the provider’s EHR, healthcare professionals will be able to determine whether the patient information and the EHR data match.
“This information, in aggregate, would improve matching by ensuring that health care organizations can match records based on accurate, up-to-date data, including identifiers unique to an individual,” the report authors explained.
“These applications could serve as virtual clipboards to replace the patient manually filling out demographic data on paper forms when arriving at facilities. Instead, a patient would enter this information only once, which would then be reused and sent electronically in lieu of at least some data needed on paper forms.”
Of course, there are some challenges, the report acknowledged. For one, these strategies are not ideal in an emergency situation, or a situation in which the patient is unable to participate in the verification process. Additionally, pediatric patients may not have their own smartphones, negating the tool as a unique identifier.
Provider focus group also told Pew they had concerns about patients entering their own medical information, stating that this could still generate errors or typos. Additionally, infrastructure concerns about building new APIs could prove burdensome.
However, focus groups and researchers agree that creating patient-empowered strategies for patient matching holds some merit.
Experts looking to develop this strategy may look into the feasibility of adding a phone number as a form of patient identification, convene to iron out the technology details, and work to build a prototype, the Pew researchers recommended.
The report also addressed other solutions to the patient matching challenge, including developing and using other unique patient identifiers such as a national patient identifier, using demographic standards, and using referential matching.
Regardless of approach, there are essential themes for expert consideration, the report stated.
“First, regardless of the approach taken, a nationwide strategy will require coordination to identify the needed best practices; commitments from health care organizations and technology developers to implement agreed-upon standards; and patient involvement,” the report authors concluded.
“Second, no solution currently exists that could achieve perfect—or even near-perfect—match rates for all patients, but actions can be taken to better link records. Third, although some opportunities exist to make meaningful, incremental progress in the near term, more robust change will require the use of new approaches and technologies.”
Date: October 5, 2018