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

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EHRI-thumb4Yesterday, we started looking at four of the technologies hospitals are using to help bridge the gap between their EHR platform and other platforms in their organization that are hindering proper patient identification, as reported on by Scott Mace in the June issue of HealthLeaders magazine.

We discussed duplicate-detecting algorithmic technology, commonly called EMPI (enterprise master patient index) technology and EHR supplier technology, such as self-registration kiosks.

Today, we’ll tackle the final two technologies being used: payer-assembled data forms and smart cards.

Salem Health in Oregon is looking to set up a communitywide central repository for its coordinated care organization (the state’s version of ACOs), since three different EMR systems in the area means “no one EMR is a single source of truth in this community,” Cort Garrison, MD, MBA, CIO, said.

Because insurance companies already have a common database covering 70 to 80 percent of Salem’s patient population, Garrison is hoping to use that database as an “agnostic” patient ID system.

Once again, the vendor-supplied EMPI just isn’t enough, he added. “We could get there by using that technology alone, but I think we can get there faster by using a different source.”

Lawrence Carbonaro, director of patient access, purchasing, and HIM at Memorial Hospital in New Hampshire, has started using smart cards that look like credit cards, but are embedded with memory chips, Mace reports.

“You also have the patient’s photo on the card, so when a patient presents anywhere [in the hospital], they have to have the card,” Carbonaro said.

Once they swipe the card, he explained, it pulls up the patient’s EHR; so far, “we have not had instances of anybody with a card where we’ve misidentified them by pulling the wrong medical record. There are several security questions patients can answer in the event that they don’t have their card.”

Other systems that are adopting smart cards include Vanguard Health Systems, which is using LifeMedID in some of its markets, to positive results. Many Vanguard members have seen overhead related to patient ID matching go down, and according to a Vanguard CIO, his location hasn’t had one duplicate record or “one patient identity theft, and I’m here in south Texas, where that happens a lot.”

As usual, healthcare systems around the country adopt and adapt to the latest complications wrought on them by the market, by the government, and by themselves.

But the overarching problem still exists. EHRs aren’t helping hospitals identify patients more accurately, and there’s no universal solution to this problem. When each system has to come up with its own solution, the situation continues to play into the fragmentation of the healthcare industry that reform is trying to solve.

As one consulting firm observed to Mace, there is “no silver bullet, no one-size-fits-all solution.”

“If you can’t uniquely identify your patients within whatever data you’re analyzing, you’re going to misread and therefore make executive decisions that are not spot-on,” Beth Just, MBA, president and CEO of Just Associates, Inc., observed. “And you make some big strategic mistakes because of that.”

As healthcare executives, what are your thoughts on the last three posts? Have you experienced similar issues with integrating your EHR with other platforms and processes? What can the vendors offer that would help you resolve these issues? What can the government do?

-by Pete Fernbaugh

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