ECRI Institute: Patient Matching Is a Leading Patient Safety Concern

Patient safety experts at the ECRI Institute were concerned enough about patient matching in electronic health records (EHRs) to put it on their annual “Top 10 Patient Safety Concerns for Healthcare Organizations” this year, for the first time since 2016.

Lorraine Possanza, DPM, JD, MBE, program director, Partnership for Health IT Patient Safety at the ECRI Institute, says patient matching’s spot on the list isn’t necessarily due to an uptick in adverse events tied to patient identification issues.

“I think it’s on there for several reasons—now that there’s an increased use of health information exchanges and more importantly, I think with the increased use of prescription drug monitoring platforms—I think the issue of matching became one of greater prevalence,” Possanza told the Journal of AHIMA in an interview.

Many states, such as Tennessee, have been turning to prescription drug monitoring platforms (PDMPs) to help curb prescription opioid abuse. PDMPs allow physicians find out whether patients they’re considering prescribing an opioid to are already being prescribed the medication by another physician. Possanza says increased reliance on the PDMPs has made it doubly important that demographic information in these databases is accurate.

“Physicians don’t want to be in a position where they have to deny a medication to a patient because someone with a very similar name is abusing that substance,” Possanza says.

To formulate the list, ECRI works with its federal patient safety organization (PSO), which—with its partner organizations—has collected 3.2 million patient safety event reports since 2009. According to ECRI, the “top 10 concerns are generally ranked according to the number of votes received, with the number-one item receiving the most votes. The list does not necessarily represent the issues that occur most frequently or are most severe.”

The top 10 patient safety concerns for 2020 include:

1. Missed and delayed diagnoses
2. Maternal health across the continuum
3. Early recognition of behavioral health needs
4. Responding to and learning from device problems
5. Device cleaning, disinfection, and sterilization
6. Standardizing safety across the system
7. Patient matching in the EHR
8. Antimicrobial stewardship
9. Overrides of automated dispensing cabinets
10. Fragmentation across care settings

Mary Butler (mary.butler@ahima.org) is associate editor at the Journal of AHIMA.