By Dan Cidon
In just a few short months, the novel coronavirus and the disease it causes, COVID-19, have put the entire healthcare system under an extraordinary amount of stress.
From empty primary care practices and strained ICUs to disrupted medical supply lines and broad guesstimates about the prevalence of disease in the community, COVID-19 has exposed dangerously weak links in the care continuum.
First responders, frontline clinicians, public health officials, and researchers have been heroically working around the clock to deliver patient care and respond as quickly as possible to rapidly changing conditions.
To successfully curb the contagion, however, they will need ongoing support and creative solutions for some of healthcare’s most fundamental problems—specifically, patient identification and matching.
Identifying Infrastructure Gaps That Impact COVID-19 Responses
On the surface, electronic data integrity might not seem like the most pressing issue to address during a global pandemic. While hospitals and frontline care workers just try to cope with the influx of patients, urgency to meet demands means that basic demographic elements needed to track and manage COVID-19 effectively are not being captured. For an industry already overwhelmed, the absence of those data elements can have far-reaching consequences for treatment, testing, and research.
Lack of comprehensive medical data can greatly impair a provider’s ability to know how many people have the virus, the geographical location of confirmed cases, and the effectiveness of treatment.
Epidemiologists are already feeling the impact of data collection shortfalls, according to Janet Hamilton, MPH, executive director of the Council of State and Territorial Epidemiologists (CSTE), who spoke during the March 26 meeting of the Office of the National Coordinator Health IT Advisory Committee (HITAC).
Approximately 40 percent of patient demographic data has been missing from commercial laboratory test feeds for COVID-19. Normally, for other reportable diseases, only 10 percent of data elements are missing. The lack of demographic elements such as phone numbers, addresses, and other critical contact information results in significant delays when trying to notify patients of their status and trace contacts to contain spread of the disease, Hamilton stated.
Gaps in data generation and health information exchange can also directly affect the treatment plans for vulnerable individuals. Having access to a comprehensive medical history can make a huge difference, for example, in the care someone with preexisting conditions receives for COVID-19.
Tackling COVID-19’s Supersized Patient Identity Management Needs
Symptoms of COVID-19 run the gamut from almost non-existent to immediately life-threatening and can escalate quickly from one to the other. As a result, patients who may initially seek a telehealth consult or visit an urgent care facility for mild discomfort could be admitted to an unrelated hospital within a matter of days.
Variations in the availability and speed of testing could also mean that COVID-19 testing results from the first visit are still pending upon admission and may get lost along the way – especially if the laboratory is missing vital demographic data elements.
The challenge is compounded by the way healthcare organizations assign unique identifying numbers to medical records. A patient who presents at urgent care or primary care initially will get one identifier that is associated with their record. When the patient visits the emergency department (ED) and is admitted to the hospital, it’s very likely that the ED will not know about the previous encounter. And the information about the admission will not necessarily make its way into the same disease registry as the first event, leaving researchers unaware of the patient’s outcomes.
Without any system linking these care sites and registries, the patient is likely to start accruing multiple identification numbers for different fragments of his record, and providers would have to rely on the patient himself to communicate his history. Health information professionals who live day-to-day in the trenches of medical records management are no stranger to the challenges in maintaining data integrity, especially when patients are acutely ill and have difficulty communicating. That is how important information falls through the cracks.
An effective “people-process-technology” strategy for safeguarding patient data quality and establishing a unifying identifier can help. Patient matching algorithm technology can assist in automating demographic data matching and comparing records in real-time between disparate clinical and financial data sources. In addition, strict data governance practices including standardized naming conventions and patient registration protocols must also be established.
While patient matching has long been a serious industry issue, COVID-19 is reinforcing why we need to address it. Providers need access to the full picture of every patient they treat, and epidemiologists need to consolidate data from multiple sources to track the spread of the disease and determine where more aggressive containment strategies need to be employed.
Collaborating Across the Industry to Stay One Step Ahead of Coronavirus
As the coronavirus pandemic advances quickly, healthcare stakeholders must move even faster to safeguard their communities.
Healthcare organizations need to keep data integrity and patient identity management high on the priority list as a way to support public health and accelerate the research community’s ability to gain visibility into the emerging patterns of the disease.
If today’s healthcare systems have any gaps in their patient identity management processes, especially in terms of sharing information with public health, disease registries, or other entities, now is not the time to take the foot off the data management gas pedal.
We are going through a lot of pain right now as a nation, and we need to relieve the pain points in patient identity management so providers can focus on making the best possible decisions for their patients and bring us through to the other side of this pandemic.
Daniel Cidon is CTO of NextGate.