Why unique patient identifer is needed to cut errors
Correctly matching patients to records is a key to reducing medical miscues, says Russ Branzell.
With an epidemic of medical errors killing more than 250,000 Americans annually, the healthcare industry needs to make patient identification a national priority, according to Russ Branzell, president and CEO of the College of Healthcare Information Management Executives (CHIME).
Speaking at WEDI’s 25th Annual National Conference in Salt Lake City, Branzell told the audience that the problem of patient misidentification is as pervasive today as it has ever been, and he contends it directly impacts patient safety, referencing a study published earlier this month by Johns Hopkins researchers who found that medical errors are now the third leading cause of death in the United States.
In addition, Branzell noted that in ECRI Institute ranked identification errors as the second most crucial patient safety concern, as part of its top 2016 patient safety concerns.
“Somewhere in this country right now, someone is being harmed, injured or possibly killed just due to misidentification,” he warned. “That’s how grave the issue is today.”
Despite the widespread adoption of electronic health records under the Meaningful Use program, Branzell believes correctly identifying patients and accurately matching their EHRs as they are shared across healthcare organizations continues to be a vexing problem. In fact, he argues that the MU program should never have been established by the federal government until it dealt with the problem of patient misidentification.
“It would have made a little bit more sense to fix that one problem before we launched and spent millions and billions of dollars in all these other places and encouraged propagation of electronic health records across so many different platforms, in many cases all with their own proprietary ways of matching patients,’” Branzell says. He contends that there are literally hundreds of proprietary algorithms in the EHR marketplace for the purposes of matching patients. “We stopped counting at the hundreds, by the way, because there was no point in counting more,” he noted.
When he was a chief information officer for Poudre Valley Health System in Colorado, Branzell said the provider organization was associated with four different health information exchanges—all with their own patient matching algorithms, and none of them worked with each other. “We went from about 100 interfaces to about 1,000 interfaces in a short amount of time,” he lamented.
Mariann Yeager, CEO for The Sequoia Project, a non-profit chartered to advance implementation of secure, interoperable nationwide health information exchange, said that patient matching continues to be one of the biggest impediments to data sharing. Nonetheless, Yeager is encouraged by the progress that Utah-based Intermountain Healthcare made in increasing successful match rates among exchange partners from 10 percent to 95 percent.
Calling them “one of the best health systems in the nation,” Branzell praised Intermountain Healthcare for its 95 percent patient matching rate for internal providers. “But, on their best day, they still have a 5 percent mismatch rate,” he noted. “You have a 5 percent chance of not being correctly identified if you show up in their health system. Do anyone of you or your loved ones want to be that 5 percent?”
Making matters worse, Branzell noted that the patient matching rate falls to 50 to 60 percent between Intermountain Healthcare and external providers in its local communities. “Now, think about the rest of the country where they don’t have great health systems, HIEs or willingness to share records,” he added. Branzell also revealed that duplicate medical records at Intermountain Healthcare, “which still occur every single day there,” costs the provider between $4 million and $5 million per year.
Current law inserted into every budget passed by Congress since 1999 has prevented the Department of Health and Human Services from spending funds on a national patient identifier that could solve the problem of misidentification, Branzell said. “We still have a prohibition for Health and Human Services, which makes no sense whatsoever,” he added.
To work around the congressional logjam, CHIME in January launched a $1 million National Patient ID Challenge aimed at developing a solution that ensures 100 percent accuracy of every patient’s health info to reduce preventable medical errors. “Five nines (99.999 percent accuracy) isn’t enough,” argues Branzell. “100 percent accuracy is all we’ll accept.”
CHIME teamed with crowdsourcing platform HeroX to run the year-long competition that is open to innovators from around the world to develop a solution that is private, accurate and safe. To date, 345 innovators from 39 countries have registered to compete; of those, 113 have entered the Concept Blitz round, a process by which participants get feedback from an expert panel of judges before moving onto the next round.
On June 1, CHIME will name as many as three winners from the Concept Blitz round, each receiving a $30,000 prize. The winner of the $1 million National Patient ID Challenge will be announced in February 2017.
Branzell said he has talked to the CEOs of the major EHR vendors, who have all committed to adopt the solution when it comes to fruition. “I have zero doubt, with what I’ve seen through this process, that we’ll have a solution in place,” he concluded. “All the technology, software, algorithms and engineering exist. It just requires people to put it together correctly.”
That cannot come soon enough for The Sequoia Project’s Yeager, whose organization supports one of the largest clinical data sharing networks in the U.S.
“It’s all over the map. There’s absolutely no consistency,” she said. “There’s no consistency between federal agencies, between markets and between health systems. Unfortunately, not having a common (approach) holds us back.”
Speaking at WEDI’s 25th Annual National Conference in Salt Lake City, Branzell told the audience that the problem of patient misidentification is as pervasive today as it has ever been, and he contends it directly impacts patient safety, referencing a study published earlier this month by Johns Hopkins researchers who found that medical errors are now the third leading cause of death in the United States.
In addition, Branzell noted that in ECRI Institute ranked identification errors as the second most crucial patient safety concern, as part of its top 2016 patient safety concerns.“Somewhere in this country right now, someone is being harmed, injured or possibly killed just due to misidentification,” he warned. “That’s how grave the issue is today.”
Despite the widespread adoption of electronic health records under the Meaningful Use program, Branzell believes correctly identifying patients and accurately matching their EHRs as they are shared across healthcare organizations continues to be a vexing problem. In fact, he argues that the MU program should never have been established by the federal government until it dealt with the problem of patient misidentification.
“It would have made a little bit more sense to fix that one problem before we launched and spent millions and billions of dollars in all these other places and encouraged propagation of electronic health records across so many different platforms, in many cases all with their own proprietary ways of matching patients,’” Branzell says. He contends that there are literally hundreds of proprietary algorithms in the EHR marketplace for the purposes of matching patients. “We stopped counting at the hundreds, by the way, because there was no point in counting more,” he noted.
When he was a chief information officer for Poudre Valley Health System in Colorado, Branzell said the provider organization was associated with four different health information exchanges—all with their own patient matching algorithms, and none of them worked with each other. “We went from about 100 interfaces to about 1,000 interfaces in a short amount of time,” he lamented.
Mariann Yeager, CEO for The Sequoia Project, a non-profit chartered to advance implementation of secure, interoperable nationwide health information exchange, said that patient matching continues to be one of the biggest impediments to data sharing. Nonetheless, Yeager is encouraged by the progress that Utah-based Intermountain Healthcare made in increasing successful match rates among exchange partners from 10 percent to 95 percent.
Calling them “one of the best health systems in the nation,” Branzell praised Intermountain Healthcare for its 95 percent patient matching rate for internal providers. “But, on their best day, they still have a 5 percent mismatch rate,” he noted. “You have a 5 percent chance of not being correctly identified if you show up in their health system. Do anyone of you or your loved ones want to be that 5 percent?”
Making matters worse, Branzell noted that the patient matching rate falls to 50 to 60 percent between Intermountain Healthcare and external providers in its local communities. “Now, think about the rest of the country where they don’t have great health systems, HIEs or willingness to share records,” he added. Branzell also revealed that duplicate medical records at Intermountain Healthcare, “which still occur every single day there,” costs the provider between $4 million and $5 million per year.
Current law inserted into every budget passed by Congress since 1999 has prevented the Department of Health and Human Services from spending funds on a national patient identifier that could solve the problem of misidentification, Branzell said. “We still have a prohibition for Health and Human Services, which makes no sense whatsoever,” he added.
To work around the congressional logjam, CHIME in January launched a $1 million National Patient ID Challenge aimed at developing a solution that ensures 100 percent accuracy of every patient’s health info to reduce preventable medical errors. “Five nines (99.999 percent accuracy) isn’t enough,” argues Branzell. “100 percent accuracy is all we’ll accept.”
CHIME teamed with crowdsourcing platform HeroX to run the year-long competition that is open to innovators from around the world to develop a solution that is private, accurate and safe. To date, 345 innovators from 39 countries have registered to compete; of those, 113 have entered the Concept Blitz round, a process by which participants get feedback from an expert panel of judges before moving onto the next round.
On June 1, CHIME will name as many as three winners from the Concept Blitz round, each receiving a $30,000 prize. The winner of the $1 million National Patient ID Challenge will be announced in February 2017.
Branzell said he has talked to the CEOs of the major EHR vendors, who have all committed to adopt the solution when it comes to fruition. “I have zero doubt, with what I’ve seen through this process, that we’ll have a solution in place,” he concluded. “All the technology, software, algorithms and engineering exist. It just requires people to put it together correctly.”
That cannot come soon enough for The Sequoia Project’s Yeager, whose organization supports one of the largest clinical data sharing networks in the U.S.
“It’s all over the map. There’s absolutely no consistency,” she said. “There’s no consistency between federal agencies, between markets and between health systems. Unfortunately, not having a common (approach) holds us back.”
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