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A Powerful Response to the Duplicate Record Crisis

By Karen Proffitt MHIIM, RHIA, CHP

Modern-day EHRs may be powerful at managing overall patient populations, but their inflexible matching rules and/or rudimentary “fuzzy logic” algorithms produce duplicate record rates as high as 12%. And while robust EMPIs do a credible job of reducing duplicate rates, their expansive, expensive design can be superfluous for the job at hand.

Duplicate record creation and its associated problems are wide-ranging, often beginning at registration and impacting multiple downstream systems where they lead to a plethora of patient safety issues including delayed, lost or incorrect diagnoses and treatment, duplicative testing, wrong patient orders, and even wrong-site surgery. Consider the patient safety and financial impacts of mis-matched patient records, as compiled by the PatientID Now coalition:

  • The 2016 National Patient Misidentification Report cites that 86% of respondents said they’ve witnessed or know of a medical error resulting from patient misidentification.

  • At one hospital, 25% of clinicians surveyed indicated that the duplicate record rate affected the quality of care their patients received and 30% reported reordering tests due to lack of access to previous records.

  • On average, 35% of all denied claims result directly from inaccurate or incomplete patient identification or information, costing the average facility $1.2 million each year.

  • Another survey indicates that 33% of all denied claims result from patient identification at an annual cost to the U.S. healthcare system of more than $6 billion.

  • In an American Hospital Association study, 45% of large hospitals reported that difficulties in accurately identifying patients across health information technology systems limits health information exchange.

When we know the risk of dirty data to patient care and the revenue cycle, why are there still so many obstacles to a truly clean MPI?

The solution isn’t simple. But it does exist. It requires a multifaceted approach including advanced matching algorithms, enhanced workflows, and improved business intelligence reporting—all of which can be found in IDSentry™ from Just Associates.

IDSentry leverages a powerful advanced algorithm that identifies more true duplicates than other systems—even when multiple discrepancies exist across patient demographic data. It also offers superior workflow features that reduce required resources and accelerate productivity.

The solution works by first creating an interface between a hospital’s source system and IDSentry with the purpose of conveying new, updated, and merged patient registration and demographic data (i.e., Personal Identifiable Information or PII.) The PII is interfaced through HL7 messages sent from the hospital’s system to IDSentry to create a mirror-image of patient demographic records. Without storing visit or encounter-level data, the IDSentry database utilizes previous name, birthdate, Social Security Number, address, phone number and other demographic data fields for advanced duplicate record detection. An HL7 merge message can also be sent from IDSentry to the source system to merge confirmed duplicate medical records.

The application consists of four distinct components: Processing Engine, Database, Workflow and Dashboard. These components are installed on a designated server within the facility’s secure data center. IDSentry’s online MPI workflow component facilitates easy duplicate pair review/reconciliation. Automatic merge criteria are defined to lessen resource requirements and allow key staff to focus on business-critical initiatives. Finally, the Business Intelligence reporting and dashboard provide HIM leaders and teams with tools and key MPI management metrics needed to remediate potential duplicate records and reduce MPI errors.

Ultimately, IDSentry identifies more “real” duplicates than EHRs that use only basic or intermediate patient matching algorithms. Even more compelling, however, is the cost/benefit ratio. Since IDSentry is delivered as a subscription service, healthcare organizations benefit from a total cost of implementation, support and use that is offset significantly by reduced overall organizational costs of repeated patient testing, emergency room delays and claims denials—all of which can quickly add up to hundreds of thousands of dollars per year.