A Case of Mistaken Identity: The EHR Dilemma (Part 2 of 3)

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EHRI-thumb2As we established yesterday, the multiple technological platforms into which EHRs are being incorporated have challenged, rather than improved, many organizations’ ability to execute proper and accurate patient identification, this according to Scott Mace in the June issue of HealthLeaders magazine.

The question becomes: how do providers deal with this in a value-based environment that demands accurate and efficient care management?

The easiest solution would be a national patient identifier, but the law forbids such a system, and if the law didn’t, most citizens wouldn’t comply with one, to put it mildly.

So, providers are left to rely on other technology, some of it old technology, to augment their EHRs.

Yes, that’s right. We can hear the heavy sighs of delirium at the idea of needing more technology to pick up the slack of the new technology.

Mace outlines four technologies that different systems across the country have adopted to improve their patient identification abilities: 1.) duplicate-detecting algorithmic technology, commonly called EMPI (enterprise master patient index) technology; 2.) EHR supplier technology, such as self-registration kiosks; 3.) payer-assembled data forms; and 4.) smart cards.

Geisinger Health System in central and northeastern Pennsylvania has chosen to go with an EMPI that is separate from its EHR, Epic, mainly because Epic’s master patient index only works efficiently with Epic, CIO Frank Richards said.

For a growing system that is looking to continue expanding, it can’t afford to rely solely on Epic in the event that Geisinger purchases a hospital with an incompatible billing or lab system. Therefore, at an expense of $1 million each year, the system maintains a separate EMPI, Mace writes.

Richards explained: “We’d need an army of people to check every one of these, so it’s well worth it. So once I’ve identified that person A from hospital X is the same person from Geisinger, I’ll then capture their identifier, their medical record number, from hospital X and so I’ll have that forever, and so the next time I don’t have to match on all of these parameters. I know that this person coming from this organization has this patient identifier. Over time, it gets more efficient.”

Cook County Health and Hospitals System in Chicago relies on a “current matching strategy [for] when somebody’s not within the system [and] using their other identifiers: their name, their date of birth, their Social Security number, a variety of things.” Being a public hospital, patients don’t always have the info required or their data has some problems with it, CIO and CMIO Bala Hota said.

Cook’s EHR supplier, Cerner, provides a self-registration kiosk that is, of course, compatible with their EHR platform. Hota observed, “The advantage is it’s fully integrated into our existing electronic record and so we won’t have to worry about designing and implementing a project to integrate some external system.”

This also relieves Cook’s staff of the manual matching that was so prevalent before and the workload such a system entailed.

Tomorrow, we’ll look at the other two methods by which healthcare organizations are dealing with patient identification and the EHR. However, we’re curious if your organization is experiencing similar dilemmas with your EHRs and patient identification? If so, how have you chosen to deal with these problems?

-by Pete Fernbaugh

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