Health IT Experts Seek Nationwide Strategy to Improve Patient Matching

Quality medical care today requires accurate patient matching—the process of linking an individual’s various electronic health records (EHRs), even if they are located at different providers. Clinicians need access to up-to-date health histories and other information, but current methods for patient matching are inadequate, and too many links are missed. When that happens, care can be delayed, or patients may receive inappropriate treatments. And incomplete EHRs can create costly record-keeping headaches for health care systems.

To address these challenges, a group of health IT experts called for a coordinated approach to improve patient matching in a recently published article in the Journal of the American Health Information Management Association. They say the strategy should encourage technology developers and health care organizations to work together to identify consistent standards for matching, ensure the protection of patient privacy, and develop an infrastructure that helps organizations share data more seamlessly.

“By enacting a nationwide strategy that embodies these characteristics, hospitals, technology developers, and the broader healthcare ecosystem can tackle one of medicine’s greatest challenges: the ability to better link patients to their records to improve care coordination and reduce costs,” the 16 authors say.

The findings emerged from a 2017 convening hosted by The Pew Charitable Trusts in conjunction with Dr. John Halamka, chief information officer of Boston’s Beth Israel Deaconess Medical Center. The authors, including Halamka, represent a broad cross-section of stakeholders, from hospital personnel and academics to health technology vendors, as well as Pew staff.

Although EHRs have become an indispensable part of patient care, some challenges persist. Up to half of medical records may not be correctly matched between hospitals or other care settings, such as when a provider refers a patient to a specialist. These errors arise for many reasons; confusion can occur when patients have similar names or if EHR systems use different formats for addresses. Whatever the reason, patients and health care providers may lack information that is critical for making informed care decisions.

A coordinated nationwide strategy would address this by ensuring that technology developers, hospitals, and related entities are using compatible approaches, as opposed to the current state of matching. Today, institutions often use technologies that help them keep records internally but may not effectively support the linking of records among facilities that use alternative approaches.

The authors write that any comprehensive strategy needs flexibility to support the varied matching solutions already in use, as well as emerging and innovative approaches. For example, biometrics, such as fingerprints or iris scans, may be widely available in the future. In the near term, standardizing basic demographic data elements, such as addresses, would help improve matching.

At the same time, to ensure that the strategy provides sufficient value to participants, the experts highlight the need to mitigate risks, such as the security or disclosure of data. For example, legal protections could help shield developers, health care providers, and others who are acting in good faith if data were illegally accessed or disclosed.

Making a nationwide strategy a reality will require action by both the public and private sectors. Health care providers and technology vendors should agree on standards and infrastructure design. Patients and privacy advocates should be included to ensure that policies are transparent—such as the approaches to protecting sensitive data—and that the components of any strategy are made public.

Meanwhile, the Office of the National Coordinator for Health Information Technology—the federal agency that oversees EHRs—could require that systems include certain data in specific formats when exchanging records and help measure how often records are not correctly matched. In addition, the Centers for Medicare & Medicaid Services could require that providers participating in incentive programs that depend on health information technology follow patient matching requirements to facilitate the exchange of data.

Electronic health records are an improvement over paper records, but finding better ways to seamlessly share patient information securely would greatly help protect patients, coordinate care, and save lives—while saving untold millions of dollars in health care costs. The nationwide strategy laid out in this journal article is a way to do just that.

Ben Moscovitch manages the health information technology initiative for The Pew Charitable Trusts.