The patient identification process is ongoing in healthcare. The process starts from the very first conversation a healthcare provider has with a patient. This identification process is intended to communicate information about the patient’s identity accurately and reliably throughout the continuum of care. In 2021, Black Book™ surveyed 1,485 health technology managers to help stakeholders identify gaps, challenges, and successes in patient identification processes from Q1 – Q3 of 2021.
Healthcare data creation has fast-tracked an absolute landslide of information, bringing with it many challenges in the identification and reconciliation of patient records. These challenges occur because of the ways disparate systems classify, store, protect, and share information. The more information that is shared, processed, and stored, creates significant duplication, and error.
One of the themes that have emerged in the healthcare market today are the increasing number of duplicate records. The crowdsourced poll of enterprise master patient index (EMPI) users revealed that prior to administering an EMPI tool, revealed that on average, 24% of an organization’s patient records were found to be duplicates. The increase has occurred year over year, consistently, in large part due to interoperability – or lack thereof - between providers duplication of records and not eliminating (said) duplicates. This has a significant impact on a healthcare’s bottom line.
The significant cost that occurs on an organization’s bottom line continues to grow year over year. The average expense of repeated medical care because of duplicate records costs an average of $1,950 per patient (inpatient stay), and over $1,700 per ED visit. Since the last time Black Book ™ surveyed the costs in 2018, the figures have nearly doubled. Ironically showing that a process that was meant to save money on the bottom line has contributed towards increasing costs and a decrease in revenue. Therefore, there have been no significant signs of improvement.
A continued evaluation of Black Book ™ survey respondents estimated that 35% of all denied claims resulted from inaccurate patient identification or information. This costs the average hospital $2.5 million (2020), and the US healthcare system over $6.7 billion dollars annually. As Black Book ™ continued to research it was found that hospitals without EMPI support tools reported current match rates of 17% when organization exchanged records. This is an important statistic because the EMPI match rates are supposed to ensure that every patient is represented only once. The more duplicates that are found results in lost revenue and increased costs.
The increase in costs and lost revenue are associated to the lack of interoperability in the patient identification process. Many of these systems still do not communicate and they store data in disjointed architectures. This creates an upsurge of identifiers that continue to be created.
Hospitals with EMPI support tools in place since 2016, reported consistently correct patient identification at an overall average of 94% of registrations and 88% of externally shared records among non-networked providers. Even with these high numbers of success no current patient identification techniques have resulted in 100% match rates.
The errors in patient identification have implications related to patient care and safety, payment, data sharing, and interoperability. Different patient identification processes have been implemented across the globe, but not one has provided an error free system. So, despite the increases in record sharing among providers, the increased risks, and costs from redundant medical tests and procedures, fragmented data continues to be trapped in siloes making the tracking of patients (and their data) especially difficult.
