Why Mismatched Patient Records are a Problem

July 30, 2018

A survey from Imprivata has surprising findings about the magnitude of the patient matching problem.

Patient matching-comparing data from different EHR/EMR systems to see if data sources match and belong to the same patient to obtain a complete record of the patient’s health-is crucial, and patient misidentification has big implications for C-suite hospital leaders, according to a new survey of chief information officers (CIOs).

Imprivata, a healthcare IT security company, partnered with healthsystemCIO.com, on a suvey of CIOs at leading healthcare organizations. The survey showed that CIOs rate patient matching among their highest priorities but remain surprisingly unaware of the magnitude of the patient matching problem-both within their own institutions and between partner organizations.

Sixty six percent of respondents-primarily CIOs-said patient matching is or should be among the highest priorities of their health system leadership.

“This response is encouraging because it indicates not only that CIOs think patient matching is important, but also that patient misidentification has implications for other functional C-suite hospital leaders,” says Sean Kelly, MD, chief medical officer at Imprivata. “One implication is duplicate records (a duplicate medical record occurs when a single patient is associated with more than one medical record), which drive up cost and risk in multiple areas from revenue cycle to clinical.”

Yet, the survey showed that CIOs didn’t necessarily know the duplicate rate within their organizations (18% said they don’t) or across organizations (38%).

“These responses suggest the need for improved communication from teams who deal with duplicates, including health information management, to hospital leadership,” says Kelly.

Other significant findings connected patient matching errors with patient safety and information security: 17% of respondents reported a linkage to an incident of patient harm, and 40% related errors to a privacy breach. To address the problem, 15% of respondents have implemented a biometric solution (a biometric solution uses a physical feature of a patient such as their palm vein pattern, iris, fingerprint, face-for facial recognition-to identify the patient and match that patient to their unique medical record) and 53% are investigating biometrics, according to the survey.

“Healthcare executives have a lot of priorities and are under considerable pressure to deliver high-quality care in a cost-efficient way,” says Kelly. “However, their fundamental responsibility is to create an environment in which clinicians and patients have the utmost confidence that the right care is being provided to the correct patient at the right time. That trust between provider and patient can be established by using biometrics to accurately match patients with their unique medical records, at the point of registration and throughout the care continuum. This study should be a wakeup call not only to CIOs but also to their C-suite colleagues of the need to address the patient matching issue in their organizations.”

A problem

“Patient matching is a problem at all healthcare organizations, but the root cause can be wildly different at each one,” says Nick Hatt, senior developer at Redox, a healthcare integration company. “Despite the variance with cause, the outcomes are the same:  patients can be harmed, personal health information can be breached, and it can be costly to organizations.”

“The study asks several provocative questions of healthcare executives-most notably whether they’re aware of the percentage of duplicate records within their organization,” Hatt says. “A healthcare executive who does not know or understand the mechanisms behind the rate of duplicate patient creation is a cause for concern. The study finds that 17% of respondents indicated that patient matching had caused patient safety issues. In addition, an astonishing 40% reported privacy breaches. Both errors are costly, legal liabilities. It’s important for executive leadership to rally their organization, specifically the often-disparate health information management and IT teams, to solve these types of issues.”

Other unique findings

In response to a question about who holds the budget for implementing patient matching solutions, 52% of respondents said CIOs, but 21% claimed it would be the C-suite acting collectively and sharing costs, perhaps an indication of how many hospital budgeting decisions are made today-by committees-and that there is shared responsibility for both the problem and solution of patient matching.

“The benefits of implementing a patient matching solution would also be felt across a healthcare organization, with CIOs choosing lower percentage of duplicates as the clear frontrunner of benefits, and a long list of success indicators ‘tied’ for second place including: lower percentage of overlays, higher patient satisfaction, faster patient check-in times, increased data integrity, and fewer patient safety incidents,” Kelly says.

How to tackle patient matching issues

Patient matching problems need to be tackled on the front-end and the back-end, according to Hatt. “For example, on the front-end, better processes for registration staff during the initial interaction with the patients to reduce data entry errors.” A Johns Hopkins study also offers a model for how your organization can study patient matching errors and implement fixes, he says.

On the back-end, healthcare executives need to straddle the line between waiting for tools like a universal patient identifier (UPI) and trying to make do with the current technology provided by their EHRs, according to Hatt.

“Both Apple and smartphones’ push into healthcare may also lead us into a world where patients carry their identity in their pocket and sync it with the EHR automatically,” he says. “In the short-term, executives should look to understand how tools provided by EHRs and enterprise master patient index (EMPI) can prevent these errors. If healthcare executives are looking to adopt additional technologies, they should evaluate them carefully and understand their ability to integrate with EHRs and downstream systems and the likelihood for adoption across the organization.”

Awareness of the problem of patient matching is clearly growing, according to Kelly.

“Healthcare leaders, including the CIOs who responded to this survey, recognize the serious potential implications of patient matching errors, from patient harm to data breaches,” he says. “Addressing the problem by implementing a patient matching solution is a multi-stakeholder effort. Biometric-based patient matching, which establishes a one-to-one link between patients and their medical records, is a relatively cost-effective and trusted approach that organizations are employing today to achieve better bottom line results and increase confidence among clinicians and patients.”