Healthcare Analytics, Population Health Management, Healthcare Big Data

Quality & Governance News

CHIME: Patient Matching Crucial for HIE, Care Coordination

By Jennifer Bresnick

- The healthcare industry is in need of much more robust, accurate, and sophisticated patient matching techniques if it is to take full advantage of health information exchange and care coordination technologies, say CHIME leaders in a letter to the Senate Committee on Health, Education, Labor and Pensions (HELP). 

Patient matching and identification

Ensuring that patient data travels with them across the care continuum is at the crux of the industry’s efforts to improve patient safety, care quality, and population health management, yet the nation lacks a unified patient matching strategy due to a number of challenges, including patient privacy concerns and technical obstacles.

“We must first acknowledge that the lack of a consistent patient identity matching strategy is the most significant challenge inhibiting the safe and secure electronic exchange of health information,” state CHIME President and CEO Russell P. Branzell, CHCIO, LCHIME and Charles E. Christian, CHCIO, LCHIME, FCHIME, FHIMSS, Chair of the CHIME Board of Trustees.

“As our healthcare system begins to realize the innately transformational capabilities of health IT, moving toward nationwide health information exchange, this essential core functionality – consistency in patient identity matching – must be addressed,” they added.

“Patients and care providers are missing opportunities to improve people’s health and welfare when information about care or health status is not easily available. As data exchange increases among providers, patient data matching errors and mismatches will become exponentially more problematic and dangerous.”

READ MORE: APIs, EHR Data Integrity, Patient Access Key to Value-Based Care

CHIME has consistently championed the development of a large-scale patient matching solution that would help providers unlock the full potential of blossoming health information exchange networks, even going so far as to offer a $1 million reward for a scalable, 100 percent accurate record matching strategy. 

“This needs to be the year of positive patient identification,” Christian said at the time, a sentiment strongly echoed in his letter to Congressional leaders.

“CHIME calls on Congress to remove the prohibition barring federal regulators from identifying standards to improve positive patient identification,” Christian and Branzell say, referring to the battle over a national patient identifier (NPI) that has simmered since the advent of HIPAA.  While the landmark 1996 legislation included a provision that would allow for the development of an NPI system, Congress has refused to apply funding to the problem since then, effectively killing the idea.

Lawmakers cite patient privacy concerns as the main reason why a nationwide patient matching system has been shelved for so long: a single identification number raises the potential for devastating breaches of confidentiality and identity theft, opponents have said.  As healthcare information becomes an increasingly attractive target for cyber criminals and high-profile data breaches make headlines on a depressingly regular basis, patient privacy advocates believe that a national patient matching identifier may simply stress a delicate system beyond its breaking point.

CHIME disagrees, however, arguing that the health IT landscape has grown too complex to function properly without a unified approach to locating and matching patient records.  In order to meet care coordination and population health management goals that are consistent with the Triple Aim, patients need a longitudinal health record that can provide a comprehensive history of their journey across multiple health systems.

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“With the removal of the outdated prohibition, we believe then that the nation can sincerely engage in a dialogue on finding solutions to solve this fundamental patient safety problem,” CHIME states.  “We would emphasize that a consistent strategy does not mean a single technology or solution, but an approach that will facilitate the realization of the full benefits and cost savings of nationwide health information exchange, while protecting patient safety and privacy.”

“Robust information exchange and nationwide interoperability can flourish only once we can confidently identify a patient across providers, locations and vendors.”

CHIME isn’t the only organization recommending that the industry must make patient matching and data portability a top priority.  Led by WEDI, HIMSS, and MGMA, the “Virtual Clipboard” initiative hopes to streamline the patient intake process, providing healthcare organizations with a simple, standardized way to match patients as they enter the system and populate their EHRs with automated, verified data.

“We’re not really very close to having a ubiquitous experience for the patient yet,” WEDI President and CEO Devin Jopp, EdD, told in January. “I would posit that meaningful use expected this was just going to naturally happen, but the reality is that we’re going to have to be a lot more active as an industry to really take action and do this.”

The Virtual Clipboard project hopes to “lower the barrier” that is preventing healthcare providers from creating and exchanging accurate patient records without the risk of duplication or confusion that could cause patient safety risks, Jopp said.  A national patient identifier would help to do the same thing, just as a social security number ensures the validity of many major transactions related to employment, education, and finances.

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As EHR adoption reaches critical mass and the complexity of the healthcare continuum continues to grow, the development of a patient matching standard for the healthcare industry is becoming a necessity, CHIME reiterates to the Senate HELP Committee.  “Foundational to the vision espoused by the Committee to improve information exchange and improve patient care, is the ability of providers to accurately and consistently match patients with their data.”

“We believe longitudinal care records should consist of provider, payer and patient-generated data, and be accessible to all members of a patient’s care team, including the patient, in a single location. An information-rich record, supported by widely adopted standards, will improve a patient’s ability to manage consent privileges and diminish privacy concerns related to the digitization of personal health information (PHI).”

“CHIME, once again, commends the Committee on their continued leadership on health IT policy and appreciates the opportunity to provide comments on this important work.”


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