For a facility that treats a couple hundred patients, each of whom is known to the staff, proper patient identification is only a concern for new patients and identical twins. For large, multi-site treatment providers uniquely and properly identifying patients is a real challenge.
It’s estimated that 8% of all the medical records in the United States are duplicate records, in spite of the fact that many large organizations already use Enterprise Master Patient Index (EMPI) solutions minimize patient identification errors.
The problem is exponentially larger across the spectrum of healthcare in general. Consider that every individual patient must be properly identified by every one of their treatment providers, by each of their insurers, within each software system, at each level, up to and including the national level for specific requirements such as pandemic reporting to the CDC.
The monetary cost of patient misidentification is estimated to be over $6 billion annually across the U.S. healthcare system. This 2016 report provides some non-monetary quantifiers:
- Misidentification is the cause for 30% of medical errors and 35% of all denied claims.
- 86% of respondents to the report’s survey witnessed a medical error attributed to misidentification.
- Identity fraud due to stolen or shared identification cards impacts 2.3 million patients each year which is expected to grow at a rate of 20% annually.
It is remarkable that prior to 1996 the authors of the Health Insurance Portability and Accountability Act (HIPAA) foresaw this problem and proposed solving it by requiring use of a unique health identifier for every patient. That mandate was later overruled due to concerns about patient privacy and uncertainty as to whether it would actually help.
Though it was still in discussion as late as 2019, one industry expert suggests that a national patient ID won’t solve the problem, citing that the it is “fundamentally the result of proprietary systems unwilling to integrate or communicate”. He proposes that the solution will require a societal-level solution using “an algorithm-based enterprise master patient index (EMPI), augmented with other technologies, and combined with policies to improve data quality at point of capture”. If that sounds complicated, it is.
While waiting for society to solve the problem collaboratively, there are things that every provider can do today to improve patient identification internally. Among them:
- Implement policies and procedures to improve data collected at time of admission.
- Require at least 3 identifiers to be used at every contact and provision of service.
- Those might be the patient’s family and given names, address, date of birth, sex, medical record number, individual healthcare identifier, etc.
- Ask patients directly to verify their identifiers at every point of contact.
- If your organization uses multiple software systems, consider implementing an internal EMPI to ensure that identification is consistent and is maintained across those multiple internal systems.
- Leverage data from central patient registries to ensure consistency between organizations.
SMART integrates with central registries in certain locales and can be integrated with others and with EMPI solutions using SMARTBridge™. While these are added-cost solutions, the benefits they offer provide substantial value and reduce both risk and costs of dealing with patient misidentification. For the best in substance abuse EHR software news, keep checking back.