Despite EHR, Patient ID Problems Persist

Scott Mace, for HealthLeaders Media , July 31, 2013

At the March HIMSS conference, Allscripts, Cerner, and others announced the CommonWell Alliance, a consortium of EHR vendors devoted to standardizing patient ID as part of improving healthcare interoperability. All the providers and vendors interviewed for this story see CommonWell's efforts as accelerating their own efforts to eliminate patient ID discrepancies across providers and EHR vendors, and thus accelerate the movement to accountable care.

"We certainly do a lot of work on all of those products, so it's probably not such a bad strategy," says Beth Just, MBA, president and CEO of Just Associates Inc., a Centennial, Colo., consulting firm that has helped hundreds of healthcare providers implement master patient indexes for nearly 20 years.

For now, the industry lacks a universal solution. For instance, Geisinger tested adding a patient photo to be kept on file some years ago, but patient resistance was so great, the company chose to abandon the experiment, Richards says.

Some healthcare systems, such as Cook County H&HS, are considering employing enterprise data warehouse technology to help eliminate duplicate patient IDs. Emerging health information exchanges, many of which are employing EMPI technology, also provide a possible solution.

For instance, Resolute Health's Bell was encouraged recently when Allscripts acquired dbMotion, which Resolute was already planning on using as its health information exchange. dbMotion, coupled with LifeMedID, could provide a more comprehensive patient ID solution, as Resolute moves to stand up its private health information exchange and integrate with state HIEs in Texas and share patient information with competing hospitals.

Providers are just beginning to explore biometric methods of identification. "One system that has been presented by Cerner is a palm vein scan, where the patient actually can go and do a self-registration," Hota says. Cook County H&HS hopes to begin pilot testing of such a system soon, he says.

Just notes that there is, as yet, no silver bullet, no one-size-fits-all solution for the patient ID matching problem.

"If you can't uniquely identify your patients within whatever data you're analyzing, you're going to misread and therefore make executive decisions that are not spot-on," Just says. "And you make some big strategic mistakes because of that."

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This article appears in the June issue of HealthLeaders magazine.

Scott Mace is senior technology editor at HealthLeaders Media.
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2 comments on "Despite EHR, Patient ID Problems Persist"

John Trader (8/1/2013 at 10:48 AM)
Although this is an informative article, it contains inaccuracies about the use of biometrics for patient ID in healthcare. First, the healthcare industry is not using fingerprinting and retinal scans for patient ID. Fingerprinting brings too much of a stigma of criminality for it to be a viable modality plus it requires physical contact with a hardware device which doesn't bode well for infection control in a hospital setting and retina scanning is too invasive and expensive to use as a means of identification. I think that perhaps what Scott meant to say was iris recognition biometrics, which is in fact being used by many hospitals across the country. Second, he mentions the use of palm vein biometrics for patient ID in the context that it is a biometric identification solution that will uniquely identify a patient which in fact, it is not completely. Palm vein biometrics rely on what is called 1:Few segmented identification which means that when a patient enrolls, and then is subsequently scanned when they come back into a medical facility, the back end search does not encompass the entire EHR system, but rather a segmented list of patients. This is not a true way of eliminating duplicate medical records and preventing fraud and medical identity theft at the point of service. When you mention biometric technology, it is vital that a factual explanation of the science behind the technology is properly presented so there isn't a continual perpetuation of misinformation and health care facilities can make educated decisions on what technology is the most appropriate to invest in. It's unfortunate that proper research and due diligence on biometrics wasn't conducted for this article, and what would have been more appropriate is not to even have mentioned biometrics at all if it isn't accurately described.

flp (7/31/2013 at 12:26 PM)
Great piece...and one of the reasons why systems in health care are more costly and complex. This issue first came up when hospitals installed IBM 1440 computers, circa 1960. And what if the patient uses an alias? Or shows up comatose in the ER? The real price (to the public) of a true EHR that can follow you everywhere is a unique person identifier – using biomarkers, cards, whatever. ONC is big on continuity /coordination of care, yet has not even ventured into this quagmire with any MU criteria...wonder why? It's not a technical problem, it's a political problem. Not an issue for other countries, but here in the USA it's a non-starter. So we probably spend hundreds of millions on technology and human work-arounds in the name of privacy. Then blame healthcare organizations for 'wasting' money running inefficient uncoordinated systems. And don't blame the vendors. As a former vendor I can guarantee you that if the feds came up with a unique identifier every one of them would have it in their system in a week. I have been in the HIT world for over forty years and I will say if you can 'solve' this one, you could knock an easy 2% of the cost of healthcare. Funny everybody wants it, but nobody is willing to 'pay' for it. Frank Poggio The Kelzon Group




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