Tag: universal patient identifier

Since the Health Insurance Portability and Accountability Act (HIPAA) heralded the mainstreaming of electronic medical records over two decades ago, healthcare organizations have been slowly making the shift from paper-based patient information to online records. Digital records are more efficient, no doubt, but the transition hasn't been smooth. There are challenges and risks in managing and protecting patient data online. With patient information flowing through multiple systems, devices and facilities, it can be extremely difficult to guarantee the accuracy and freshness of the data. Patients move to a new house, change their name or switch doctors. They may go for years without any interaction with the healthcare system. How can hospitals and other providers be sure that the records they hold are correct for each patient who walks through the door? Incorrect patient matching is a major source of revenue leakage for many providers, with around a third of claims denied on the basis of inaccurate patient identification. When it costs $25 to rework a claim and around $1,000 for each mismatched pair of records, that's a lot of lost revenue. In 2017, the total lost revenue for the average hospital was around $1.5 million. Clearly this a financial headache for providers, but it's also a major patient safety issue. How can patients get the right treatment at the right time, if their physician is looking at an out-of-date record, or worse, the record of a completely different patient? Good health outcomes rely on good data. Matching patient records: the old way Traditionally, healthcare providers might use a patient matching engine (an enterprise master patient index or EMPI) to identify patients and match up their records from different parts of the health system. These work by checking demographic data to compare the details on each record and combine the ones that are likely to refer to the same person. This can usually handle a simple change of name or address, but for anything more complex, it'll likely hit a roadblock. EMPIs are limited by their reliance on a single data source – the data that's visible to them in patient rosters. So what happens if that demographic data is wrong? What if there are typos or spelling mistakes? How do you differentiate between a misspelled name and a completely different person? Any errors in the data are inherited by the matched record, and as a result, EMPIs are often plagued by gaps, mistakes or outdated patient information. A new solution for patient matching: Universal Patient Identifiers A better solution is to combine the information in patient rosters with comprehensive reference and demographic data held by data companies such as Experian, to create a more complete picture of each patient. A universal patient identifier (UPI) can be assigned to each patient and stored in a master identity index, so that whenever and wherever they pop up in the health system, the referential matching technology knows exactly which data is theirs. When health systems implement UPIs, you can connect disparate data sets and have confidence in the fact that every new data point will be instantly checked and updated. You'll know that the Maria currently seeking diabetes treatment in Austin is the same Maria who was treated for asthma in Houston last year. You'll know that Thomas sometimes goes by Tom. You're far less likely to have a patient turn up at the pharmacist and be given a prescription that belongs to another patient with the same name. It's more efficient for clinical and admin staff, and copes more efficiently with patient mobility. Highlighting the importance of reliable patient matching technology, Karly Rowe, Vice President of Identity Management and Fraud Solutions at Experian Health says: "When you send us your patient demographic information, we will provide you with the insights and identifiers that you need to better manage your patient identities. The benefits are improved patient safety, better care coordination, better patient engagement, and overall driving better efficiencies and financial benefits." Not all reference data is created equal Of course, referential matching is only as good as the data it’s trying to match. Some vendors repurpose data matched for credit checks, using patients’ Social Security Numbers. But this data can be equally vulnerable to inaccuracies. Experian offers access to the industry’s broadest and most trustworthy datasets and provides ongoing monitoring to constantly check the accuracy of that data. Our healthcare-specific algorithm is finely tuned to meet the data needs of the healthcare industry, without any risky repurposing. With this in mind, ValleyCare Health System in California used Experian Health's Identity Verification solution to give patient access staff the freshest demographic information, including more accurate names and addresses, leading to a 90% reduction in undelivered mail. Janine Edwards, Patient Access Services Quality Assurance and Training Coordinator at ValleyCare told us: “Since implementing Identity Verification, we’ve improved the accuracy of patient demographic information throughout ValleyCare Health System. More valid data up-front means better revenue cycle results on the backend.” The entire health ecosystem relies on knowing who patients truly are. With the highest quality reference data and powerful unique patient identifiers, Experian goes beyond the limits of conventional methods to give providers the highest confidence in matching and managing patient identities. To start resolving your patient identities today, contact us to see how many duplicate records we can fix.

This week, Experian Health is a proud partner of National Health IT Week. U.S. National Health IT Week is a nationwide awareness week focused on catalyzing actionable change within the U.S. health system through the application of information and technology. Comprehensive healthcare reform is not possible without system-wide adoption of health information technology, which improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers. Initiated in 2006 by the Healthcare Information and Management Systems Society (HIMSS), National Health IT Week has emerged as a landmark occasion for using health IT as part of the overall solution to improve America’s healthcare as a bipartisan, federally led, market driven initiative. While the healthcare industry has transformed in the last decade as health organizations have moved to electronic health records (EHRs), it brings us one step closer to the vision of comprehensive care coordination, but fully achieving care coordination across the vast health enterprise is still a long way ahead. While a recent American Hospital Association (AHA) survey showed that nearly all reported hospitals (96 percent) possessed certified EHR technology in 2015, the Office of the National Coordinator for Health Information Technology reports that there is very little coordination of patient data across the healthcare ecosystem. Much of this disconnect begins with the inability to transfer data in a secure manner that will match, manage and protect patient identities across enterprises. "As hospitals must now deal with hundreds of thousands of electronic patient records, spanning multiple systems and departments, the traditional technologies to managing patient information are no longer sufficient," says Karly Rowe, Vice President of New Product Development, Identity and Care Management Products for Experian Health. "Leveraging sophisticated matching technology and outside data sources, can improve patient identification and prevent duplicate or overlapping records which result in inappropriate care, redundant tests, and medical errors – as well as make data accuracy higher for clinical, administrative, and quality improvement decision purposes." To solve the industry problem of matching, matching and protecting patient identities across the healthcare ecosystem, we must start by creating a universal patient identifier (UPI) to make patient data truly interoperable. For example, one of the biggest challenges in managing patient data begins when patients move, change names, or switch doctors and their EHR doesn’t follow them. They have to start over, trying to recall events and dates in their medical history with a new doctor, who is tasked with providing care without the detailed insight into the patient’s medical record. But if that same patient had a universal identifier that allowed healthcare providers to communicate with another healthcare provider about a patient, the new provider would know all the ins and outs of that patient’s history, leading to a more holistic approach to care and higher patient satisfaction. Simply put, a UPI can be thought of as a mechanism to link all patient information and associate it with the right individual based on patient data. This is similar to how credit bureaus link an individual’s credit history to the right individual to ensure accurate reporting. Using a similar model, patient data — and supporting patient demographic data — can be used for the common good to improve patient safety, increase quality of care and reduce mistaken identity risks. The benefits of a UPI extend across the entire healthcare system as well, as it improves the quality of patient identities, which can have duplicate, overlapping and incomplete records. Additionally, a UPI can help eliminate incorrect medical treatments; deliver current and accurate patient data; and prevent identity fraud, HIPAA breaches and incidental disclosures of protected health information (PHI). Ultimately, this will build patient trust through increased visibility and record accuracy. Knowing that preventable medical errors, many of which are the result of incorrect patient identification, are the third leading cause of death in the United States. The creation of a UPI will allow the healthcare industry to facilitate accurate information exchange to stop problems before they start. For example, if a patient shows up to fill a prescription and is mistaken for another patient with the same name and given the wrong prescription, there could be fatal interactions with other medications that patient is taking. The National Council for Prescription Drug Programs (NCPDP) has already started using this technology to establish national patient safety identifiers. A national patient safety identifier, or UPI, is a vendor-neutral, cost-effective solution that will link patient data at scale efficiently and accurately to improve patient safety and care coordination. Identity management is a critical, underlying component to every interaction, and healthcare is no exception. To fully achieve the goal of comprehensive care coordination, creating a UPI to help match, manage and protect patient data is the first step in achieving the interoperability of patient data. Participate in National Health IT Week’s Virtual March and help catalyze actionable change within the U.S. health system through the effective use of health IT.

Your organization would make a great participant in our Universal Patient Network. We’ve developed a unique solution leveraging Experian’s demographic data to establish a universal patient identifier, which has higher match performance than standard industry tools. We would like to offer YOU an opportunity to leverage our Universal Identity Manager (UIM) Batch product at NO CHARGE.* What you give: Patient demographic data in a secure file/message What you get: File with Universal Patient Identifier (UPI) and identified duplicates (at your specific frequency) How you benefit: Information exchange, care coordination, patient safety, operational efficiency and financial savings Your organization can address duplicate issues and be at the forefront of promoting a universal patient identifier. Contact Experian Health today to learn more! Visit www.experian.com/umpi, email experianhealth@experian.com or call 1 888 661 5657.   *Offer is limited to Experian Health’s UIM Batch Process product and shall remain open for such time as Experian Health may decide.