First Things First: How Getting Patient Identification Right Helps Achieve Your Strategic Initiatives
Patients continue to expect (and demand) better from their healthcare providers.
Gone are the days when they would quietly fill out the same form multiple times or re-repeat their insurance information to yet another clerk. Patients are increasingly willing to see if the health systems across town can offer a better experience.
That patient experience revolves around a simple question: How well do you know me?
Because when it comes down to it, patients sitting in a cold exam room wearing nothing but a paper gown deserve to feel confident that you know exactly who they are.
That’s why you have to get patient identification right before you can pursue strategic initiatives like population health, value-based care, and more meaningful patient engagement. The stakes for patient identification are high—and enterprise master patient index (EMPI) technology can provide a foundation that helps you accurately identify and engage your patients, no matter where they present.
The Many Pitfalls of Bad Data
From duplicates to outdated (or disconnected) information, health systems are riddled with bad data that comes with high costs. First and foremost, patients lose trust in their providers if they are presented with outdated information (or worse, someone else’s information).
Inaccurate person identification introduces inefficiencies, billing errors, and data gaps that can create clinical, patient safety, or legal risks. Health systems must also invest time and resources in data remediation. In the short term, this adds up to lost revenue.
But the long-term costs are much higher.
Accurate data is critical to communicating with consumers and ensuring they return for follow-ups. Dissatisfied patients are likely to tell their family or friends about their poor experiences, which can reduce referrals.
Of course, the biggest risk that bad data exposes lies in care delivery. Already, nearly 40 percent of US health providers report an adverse event stemming from a matching error in the past two years.1
The COVID-19 pandemic gave us a fresh look at the costs of inadequate patient identification. Health systems failed to connect the influx of COVID tests with existing patient records, often delaying results notifications. The problem recurred when patients received vaccinations outside their usual care settings. Throughout the pandemic, inadequate patient identification made contact tracing slow and arduous, if not impossible.
Why Patient Identity Underpins Your Strategic Initiatives
Accurate patient identification underpins many health systems’ most pressing initiatives by providing trusted data for patient care, analytics, reporting, and other purposes.
At the patient level, accurate identification ensures that every interaction is captured and linked across systems and locations, giving clinicians a connected, up-to-date view of a patient’s history and care. Connecting this data can improve:
- The patient experience by reducing duplicate tests and eliminating redundant paperwork
- Outcomes through gained visibility into care provided elsewhere in the system
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores (and, therefore, reimbursement)2
As patients access care across a growing array of digital and brick-and-mortar touchpoints, a connected view of each person becomes even more important. For example, patients who receive a test at an urgent care clinic want that data to be visible to their primary care provider. (And if the name on the building is the same, they expect that seamless integration.)
Beyond the patient experience, a shared identity data management solution acts as a backbone for every transactional and analytical application throughout the system. These underpin key initiatives, including:
Managing populations at scale: Population health management is a growing priority, especially in the emerging value-based care ecosystem. However, many community organizations still rely on paper-based systems or spreadsheets. A unified patient identity data platform helps bring together those disparate records, giving healthcare leaders insights about the patient population and their social determinants of health.
Patient attribution for value-based care: Many population health initiatives are tied to value-based financial models that encourage a holistic, proactive approach to patient care. Participating organizations receive financial incentives for meeting cost and quality targets for a group of patients, known as an “attributed population”—but, first, an organization must understand that population. Better patient identification helps leaders know exactly who they’re serving so they can tie care and outcomes to attributed populations.
Quality reporting: When Accountable Care Organization (ACO) financial incentives hinge on reporting, it’s worth ensuring that the data is accurate, complete, and trustworthy. For example, larger health systems tend to have higher rates of duplicate records. More duplicates tend to produce lower-than-expected quality scores that diminish financial incentives. By reconciling fragmented records with a patient identity platform, the organization can know exactly how many unique patients had positive outcomes that merit quality care incentives.
Patient engagement: In an increasingly competitive market, many systems seek to improve the patient experience through better patient engagement. A single platform for patient identity management can streamline the experience while fostering trust that each patient is known and understood. And more engaged patients tend to have better outcomes: one study found that patients in engagement programs increase prescription refills by 36 percent while reducing overall medical costs by 45 percent.3
How EMPI Supports Patient Identification
Healthcare systems have long turned to electronic health records (EHRs) as their system(s) of record. In fact, many systems have deployed EHRs from multiple vendors to support different departments. HIMSS Analytics reports that the average hospital now uses 18 disparate EHRs across its entire system.4 While someone may say, “We use Epic or Cerner or MEDITECH — that’s just one system.” The reality is often more complex, with siloed EHRs for physician offices, mother-baby units, or cancer centers.
EHRs also lack the sophisticated matching algorithms essential for accurate patient identification.
As more health transactions take place beyond the EHR itself, health systems need a better arbiter of identity data.
In recent years, health systems keep adding to their health IT stacks while struggling to connect patient data across systems. However, this has further complicated the problem. According to Gartner, “By 2023, 35 percent of healthcare delivery organizations will have shifted workflows outside the EHR to deliver better digital experiences.”5
That’s why more health systems are turning to an EMPI solution to finally solve the patient identity challenge.
Gartner describes EMPIs as “crucial tools for reconciling patient identity and addressing medical record matching challenges needed for high-quality healthcare delivery and health information exchange.”6
EMPIs link data across systems, providing a 360-degree view of each person that includes a clear line of sight to their data history. This longitudinal view can be shared upstream and downstream with the providers and systems that need it, while resolving identity inconsistencies between systems.
For example, an EMPI could reconcile records between your EHR and CRM to determine if Melissa P. Johnson and Melissa Jonson, with similar birthdates, are the same person or two distinct individuals.
Understand Your Patient and Business Needs to Identify the Right EMPI
Since an EMPI will connect data from systems across your organization, bring the affected groups together to discuss your patient identification strategy.
- Your chief medical information officer (CMIO) has insights about patient safety, coordination of care, workflows, and outcomes.
- Your chief nursing officer (CNO) and/or chief nursing information officer (CNIO) brings input about quality and patient safety needs, as well as how workflows affect front-line staff.
- Your chief financial officer (CFO) can explain the revenue cycle impacts and how better patient identification can improve revenue capture.
- Your analytics or population health management team can discuss what data and insights they need to improve their operations.
Together, discuss what efficiency, accuracy, and the patient experience look like in your organization. Identify the symptoms of poor data quality and determine how an EMPI can address the underlying causes.
With your team in place, look for an EMPI vendor who is proven to facilitate real-time data exchange. Discuss how the EMPI can be customized to your unique processes and workflows. Explore the data stewardship capabilities to provide the level of transparently you need to see the provenance of the patient records. Ensure that the EMPI can match identities for both patients and providers, as staying on top of providers’ current affiliations and status is essential for reimbursement.
Finally, make sure your EMPI will be able to scale to your future growth, particularly if mergers or acquisitions are on the horizon. A good EMPI can streamline the post-M&A integration processes, allowing you to easily reconcile duplicate records across systems.
With an EMPI providing accurate, trustworthy patient identification, your organization will be empowered to achieve your strategic initiatives—while ensuring you can greet each patient with confidence.
Notes
1. The State of Patient Matching in America, eHealth Initiative Foundation and Lyniate EMPI by NextGate, February 2020 | New Survey Addresses the State of Patient Matching in the U.S. | Lyniate
2. PatientEngagementHIT. “What Are HCAHPS Scores, Why Are They Important to Patient Satisfaction?” PatientEngagementHIT, September 19, 2022. https://patientengagementhit.com/features/patient-satisfaction-and-hcahps-what-it-means-for-providers.
3. Stoy, Robyn. “Patient Engagement in the Time of Covid-19.” BioPharma Dive, May 25, 2020. https://www.biopharmadive.com/spons/patient-engagement-in-the-time-of-covid-19/578439/.
4. Sullivan, Tom. “Why EHR Data Interoperability Is Such a Mess in 3 Charts.” Healthcare IT News, October 11, 2018. https://www.healthcareitnews.com/news/why-ehr-data-interoperability-such-mess-3-charts.
5. Gartner, Predicts 2021: Healthcare Providers Must Accelerate Digital Transformation to Address Disruption, Sharon Hakkennes, Barry Runyon, Mike Jones, Mark Gilbert, 25 November 2020
6. Gartner, Quick Answer: What to Look for in an Enterprise Master Patient Index Solution, Pooja Singh, Barry Runyon, 8 April 2022
Gevik Nalbandian has more than 30 years of deep industry and executive management experience. As the vice president of software engineering at Lyniate, he provides the strategic leadership for the identity management group and several interoperability technology groups.