USPS Tools Can Improve — But Not Solve — Patient Matching Problems
By Rachel Podczervinski
The Patient Matching Improvement Act of 2020, introduced in August and referred to the U.S. Senate Committee on Health, Education, Labor, and Pensions, was touted as a bipartisan effort to both improve patient record matching and strengthen the nation’s COVID-19 response efforts by ensuring healthcare organizations have access to the United States Postal Service (USPS) address-formatting tool to improve patient record linkages. While allowing use of the USPS tools would help address inadequate patient matching, which endangers patients and complicates contact tracing initiatives, it unfortunately is not enough to fully resolve what has become one of healthcare’s most intractable problems.
On the upside, leveraging USPS address-formatting tools will correct and standardize address formats, so when a patient matching algorithm analyzes those fields they will look the same across all health data systems, including those in hospitals and COVID-19 testing labs. In fact, a 2019 JAMIA study found that not only was standardizing address fields independently associated with improved matching sensitivities for public health (0.6%) and HIE (4.5%) datasets, but specifically that integration of USPS data can increase matching by up to 3%, which equates to tens of thousands of correct matches.
And while that is a significant improvement, it falls short of addressing a plethora of other issues that contribute to the dismal match rate. According to the JAMIA study, 18% of patient records are duplicates. As a result, approximately 1 in 5 are incomplete, which can lead to delayed, excessive, or unnecessary care—as well as hamper robust contact tracing efforts that are key to gaining control over the COVID-19 pandemic.
For example, according to U.S. Census data, 12% of the nation’s population moves from one location to another every year. Which increases the chances that the address of record for a patient who has not been seen by a provider in several years is incorrect. Nor can USPS standardization tools fix human errors including transposed numbers, misspelled names, and blank demographic fields—all of which contribute significantly to the current state of mismatched patient records.
At Just Associates, we conducted our own internal analysis of 25 million patient records from 18 different client MPIs. We found that, on average, 10% of all address fields were blank or contained invalid or default data elements. When those findings are coupled with the high frequency with which the U.S. population moves, the 3% improvement with the use of USPS tools becomes far less impactful in the big picture.
This is not to say that USPS tools should not be leveraged by healthcare organizations in their quest to eliminate duplicate records and improve match rates. Even a 3% improvement moves us in the right direction both with accuracy and patient safety. Rather, to truly move the needle on eliminating duplicate and incomplete patient records, we need a multi-faceted solution that brings together USPS tools, third-party data, expert analysis and intervention, and industry-wide standardization.