How HI Professionals Can Play an Active Role to Improve Patient Matching

Today, there is no nationwide strategy to connect patients to their health data. Patient misidentification happens in two ways: one, through overlaid medical records, where two or more patients’ information is combined into one record because of similar demographic information; and two, through duplicate records, where a patient may visit several healthcare settings and have disparate and incomplete records at each, rather than them being combined into one complete record.

Without the ability of clinicians to correctly connect a patient with their medical record, lives have been lost and medical errors have needlessly occurred. Both overlaid and duplicate records pose real safety concerns to patients. With overlaid records, a patient may be treated based on another patient’s health information.  In addition, overlaid records create privacy concerns for patients, potentially giving one patient access to another’s medical information, or even being billed for another patient’s procedures.  Duplicate records mean that clinicians may be working from incomplete information about a patient’s conditions.

The lack of a national strategy on patient identification and matching also causes major financial burdens to both patients and healthcare providers. The expense of repeated medical care due to duplicate records costs an average of $1,950 per patient inpatient stay, and over $1,700 per emergency department visit. Thirty-five percent of all denied claims result from inaccurate patient identification, costing the average hospital $2.5 million and the US healthcare system over $6.7 billion annually. In a recent survey by the Patient ID Now coalition, 72 percent of respondents agreed that there are delays in billing and reimbursement due to inaccurate patient information, and 70 percent said patients received duplicative or unnecessary testing or services.

The challenges with accurately matching patients to their complete record also creates barriers to interoperability. While Congress prioritized interoperability and digital data exchange in the 21st Century Cures Act and other legislation, progress toward these national priorities is inhibited by patient matching issues. Addressing the issues with patient misidentification that are preventing appropriate health information flow would assist in transitioning the US to a healthcare delivery system that focuses on high-value, cost-effective, and patient-centered care.

How HI Professionals Can Act

This Patient ID Week, May 13 through 17, you can help push for solutions to the problems around patient misidentification. HR 7379, the MATCH IT Act of 2024 would improve patient matching within the healthcare ecosystem by improving standards within certified health information technology (IT) and would provide preliminary ways to begin measuring where patient match rates stand across healthcare.

Join AHIMA by visiting our Action Center to write to your members of Congress and urge them to support this vital piece of legislation. At the center, you can also share your story about your experiences with patient misidentification to help AHIMA convey why this issue is so important. Participation in these campaigns contribute toward your component's points for the AHIMA Grassroots Advocacy Award.

While the issue of patient misidentification is a great one, it takes all of us working in health information to work toward a solution.  

Do you work at a healthcare organization that is interested in endorsing the MATCH IT Act of 2024? Reach out to advocacy@ahima.org for more information.

Kate McFadyen is the senior director of government affairs advocacy and public policy for AHIMA.