Misidentifying a patient can lead to serious consequences: Medical errors, financial loss, a negative impact on the patient, and a loss in clinical productivity. About 35 percent of all denied claims result from incorrect patient identification or information, costing the average hospital $1.2 million each year.
In health care, interoperability is essential for strategic initiatives. According to the Healthcare Information and Management Systems Society (HIMSS), “interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Data exchange schema and standards should permit data to be shared across clinician, lab, hospital, pharmacy, and patient regardless of the application or application vendor.”
While great progress has been made, challenges like duplicate rate and electronic access to the right information for the right patient persist. 30% of all identity information stored in database is incorrect or out-of-date. Duplicate records are not anomalies.
And patient-matching is time-consuming. “The American Health Information Management Association (AHIMA) conducted a member survey on the topic in 2015 and found that most organizations were spending time weekly doing manual patient-matching cleanup. It’s a significant problem.”
Without a national patient identifier (NPI), patients’ names and birth dates are the key factor for identification. But something as small as a middle initial can mess with a patient’s identity, not to mention the amount of identical names stored in EHR systems. Mismatching patients and records can lead to wrong diagnoses or treatment errors.
But there are many obstacles on the road to developing an NPI that could help with interoperability and also with population health. Congress continues to ban federal funding and tech vendors are hesitant to share their proprietary information for fear of losing market share.
Health IT solutions must address patient ID challenges and better patient-matching. The health care industry needs to look at innovative ways to ensure ID security to improve the patient experience of care (including quality and satisfaction).
Identity data is prone to so many errors and mixing patient identities could lead to dangerously disorganized patient records. Verifying patient identities can prevent fraud and improve the patient experience, which is especially important regarding the increasing rates of medical identity theft and data breaches.
Clean data and accurate consistent data exchange are essential for better patient-matching. Accurately matching patients to their medical records across different healthcare settings is the key element of an efficient health system.