A Case of Mistaken Identity: The EHR Dilemma (Part 1 of 3)

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EHRI-thumb3When healthcare reform was first passed, the idea behind the legislation, as well as the legislation itself, was controversial. And while there are still critics who remain staunch opponents of the Affordable Care Act, many healthcare executives, by necessity, have embraced reform and all of its component parts.

The electronic health record is, of course, a cornerstone of reform, and as more and more hospitals integrate EHR platforms, a greater understanding is emerging of how this integration is improving or challenging standard hospital operations.

Scott Mace has written an excellent piece for the June issue of HealthLeaders magazine on the impact, or lack of impact, EHRs are having on improving patient identification.

The piece is in-depth and detailed, so we’ll take a few posts to break it down into its component parts, but here’s Mace’s discovery in a nutshell: “If you were to think that moving to electronic health records would eliminate mistaken identity in medicine, you would be, well, mistaken.”

This is pretty shocking until you realize the root core of the problem, something that many experts have been warning about all along: the “incompatibilities between different vendors’ EHR technology and the variety of identifiers generated by the other technological systems in use in hospitals and that come from many sources—everywhere from insurance companies to subsystems dedicated to labs or other diagnostics—and that have evolved in isolation from each other over the past 40 years.”

So what are your colleagues saying about this, frankly, predictable dilemma?

They’re pretty nervous actually. ACOs and value-based care demand that hospitals get it right. As Bill Spooner, CIO of Sharp HealthCare, explained to Mace, “Patient identification is a fundamental building block of the emerging accountable care organization trend.”

Frank Richards, CIO of Geisinger Health System in central and northeastern Pennsylvania, was slightly more adamant: “You have to be able to identify the patient across all the venues of care in order to be able to do analytics on the information to make sure that … the care is being delivered, and people are getting the care, and that they’re getting only the care that they need in a cost-effective manner.”

That’s the point in all of this. And the systems hospitals are using right now are overwhelmingly not helping them to achieve the level of effectiveness and efficiency demanded of them. Drawing on something else Spooner said, if the patients in your database aren’t linked out to your transaction systems, then how can you provide effective care management to those patients?

In our next post, we’ll take a look at how Geisinger is working around the EHR Dilemma. In the meantime, what have you experienced in your organization? How has the EHR improved your operations, and are there areas that it hasn’t improved?

-by Pete Fernbaugh

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