100% of the U.S. population now has a Universal Patient Identifier: Q&A with Experian Health leader on why this matters

The urgency to move quickly and vaccinate the population has introduced an entirely new set of challenges for providers regarding patient identity. Many continue to leverage existing processes and solutions already in place, manually handling the pain points that come with them, but now at scale and at an unprecedented rate. As the rollout moves forward, the strain on provider resources will only deepen, as will the risks associated with patient misidentification. The data mess behind the scenes Many patients are registering for the vaccine through a patient portal. While the self-service nature of signing up for the vaccine via a portal is beneficial, patients are unfortunately able to register for a portal account more than once. In fact, some of our clients have reported seeing as many as 1,800 duplicate records created per day. Those duplicate records are generated from some individuals who forgot their log-in account information and opted to create a new account, and others who simply forgot they had an account. With the sense of urgency to secure a vaccination appointment, consumers are moving at a rapid speed and simply want to grab a spot with the quickest credentials available. Regardless, multiple registrations for a single patient will create duplicate patient information. Duplicate records are not only costly (the estimated cost of remediation is $96 per duplicate pair), but they are an incredible drain on staff productivity, and ultimately, they are detrimental to patient safety. Multiple records of a single individual pose a risk for potential allergies, reactions, medical history and more. Even more, it is detrimental specifically to the efficacy of the vaccine as it will be harder to gauge in real time how many patients have been vaccinated, and at what stage, and make it more difficult to truly understand what percentage of the patient population has actually been vaccinated. UIM: not another stop-gap solution Experian’s Universal Identity Manager (UIM) platform is tailor-made for a situation like this as it was developed to create a single view of the same patient with their most current information. The matching technology accurately identifies patients and matches records within and across disparate healthcare organizations, providing a more complete understanding of who a patient is, despite the data gaps or errors that may exist in patient rosters. With it, providers are not only preventing duplicate and overlaid patient records but UIM can also minimize errors and fraud in patient records. It additionally improves staff productivity by decreasing the need for record reconciliation—a benefit likely welcomed by many if they are continuing to see anywhere near 1,800 duplicate records per day. When integrated with a solution like Precise ID, providers can both reconcile duplicate records, and effectively stop them from being created in the first place. By automating the patient portal enrollment process, healthcare organizations can remove the manual processes associated with portal enrollment, optimize critical IT staff resources while securing patient information and support a positive patient experience. State-of-the-art identity proofing, risk-based authentication and knowledge-based questions help providers securely verify each patient’s identity as they enroll for the patient portal. Explore how Experian Health can help resolve and enhance identities as part of the vaccine management process and beyond, not only by resolving duplicate records, but also by enhancing records with the best demographic and social determinants of health data available.

Published: March 10, 2021 by Experian Health

How has the pandemic affected consumer attitudes around patient access? What do consumers want when it comes to accessing care? These are the questions providers must answer if they are to survive the pandemic and lay the groundwork for future financial success. Experian Health’s recent patient access survey offers a glimpse of what patients hope the digital front door will look like in 2021 and beyond. Wherever you are in the digital patient access journey, there\'s an opportunity to improve the experience for patients to one that will not only survive the tumult of the pandemic, but also thrive in the years ahead.

Published: February 24, 2021 by Experian Health

Health plans have been fighting against inaccurate member data, incomplete member profiles and duplicate records for years. Without a watertight way to keep track of patient identities so health data is reliably linked and accessible across multiple services, payers can’t always be confident that the record in front of them matches the member they have in mind. The pandemic has brought this into sharp focus: positive COVID-19 test results aren’t always following members from service to service, and as the vaccination program rolls out, knowing who has had the disease and who has been vaccinated could be difficult to monitor. As health data expands exponentially and the need to share and connect member records becomes more urgent and complicated, the challenges facing health plans will only grow. Could a unique patient identifier (UPI) be the answer? 4 member matching challenges that health plans could solve with a UPI 1. The healthcare ecosystem lacks 21st Century Cures Act data coordination The lack of integrated systems to transfer member data securely contributes to safety issues, payment delays and potential audits and fines. Over a third of denied claims for health systems result from inaccurate patient information, costing them  at least $6 billion per year. While this would seem not to impact the payer, the inability to properly link claims to members could lead to an inability to understand the risk represented by the members being covered. Or worse, an inability to anticipate and monitor trends in members health and provide proactive healthcare options. A unique patient identifier can connect the dots between different parts of the healthcare ecosystem so duplicate and incomplete member data can be detected and eliminated. With a more complete picture of who a member is, health plans can make decisions based on accurate information and exchange data safely and securely. There’s a far lower risk of acting without knowing about recent treatment or test results, or communicating using the wrong address (or even to the wrong member). 2. Healthcare providers have outgrown traditional matching tools With the volume and variability of health data to be matched, traditional matching tools are no longer fit for purpose. For example, an enterprise master patient index (EMPI), which links all versions of a patient’s record across several facilities, may seem reliable. However, by relying on a single source of demographic data, EMPIs likely replicate errors and outdated information, and may combine records for patients who share certain demographic information (for example, if two patients have similar names and the same date of birth). Instead, payers should consider a matching solution that combines member roster information with comprehensive third-party reference data. Member records are matched using referential and probabilistic matching, and connected using a UPI. This gives health plans a more complete picture of their members, built on reliable health, credit, and consumer data sources, and allows all parties to understand the person at the center of it all. 3. Discrepancies in member data make care coordination impossible Members may use different names or nicknames, their address may change, and they may even share a Social Security Number (SSN) with someone else. How can health plans help to coordinate care if they’re not sure they’re tracking the right member? A single electronic health record (EHR) can follow the member throughout their healthcare journey with a UPI, so health plans can be confident that the person on the phone or in the office matches the record on screen. They can monitor and respond to gaps in care, allowing them to better coordinate care for better patient health, improved member engagement and money-saving operational efficiencies. 4. Members present to multiple facilities, inhibiting care plan tracking How can health plans reliably track medication adherence, especially when members present to multiple locations? Is there really a gap in care, or did the member just attend a different facility? And if members go to different pharmacies, how can a pharmacist be sure the prescription is going to the right person? All of this can create risks to patient safety and increased costs for payers. A UPI can help. Experian Health has teamed up with the National Council for Prescription Drug Programs (NCPDP), which sets standards for pharmacy services to exchange electronic healthcare data. A framework has been built for a UPI-based patient matching solution that the entire US healthcare network can use. Not only will this improve patient safety, it’ll minimize staff time spent on reconciling incorrect records, thus boosting financial performance too. When it comes to mismatched records, prevention is better than cure. With a Universal Identity Manager, health plans can have confidence in the accuracy and security of the data they’re using and sharing, promote patient safety, and improve staff productivity. Contact us to learn more.

Published: January 26, 2021 by Experian Health