As anyone who’s ever had an elderly relative go through the healthcare system knows, maintaining consistent patient records is critical. Often, a patient will be treated in a hospital, sent to a nursing home and then sent back to a hospital as health conditions change, without there being any way to provide longitudinal information about the care that patient has received. Now, a new framework released by the Patient ID Now coalition seeks to bring public and private entities together in order to create a nationwide strategy that would standardize patient identification practices and bring a greater degree of safety to patient care.
The coalition, which was formed in January, consists of more than 40 healthcare organizations. In the framework report issued earlier this week, they quote a 2018 Black Book market research survey that found misidentification of patients costs on average $1,950 per inpatient stay and over $800 per emergency department visit, due to medical care procedures that are unnecessarily repeated. The report also says that, on average, denied insurance claims due to misidentification cost healthcare facilities $17.4 million.
“Today, there is no consistent and accurate way to link patients to their health information as they seek care across the continuum in the United States,” per the report. “Countless times every day, a patient record is mismatched or is duplicated in multiple disparate records. Medications are prescribed for patients lacking a complete medical history in their record; allergies are missed, diagnoses are lost or delayed, and duplicative tests are ordered. The problem of patient misidentification is so dire that one of the nation’s leading patient safety organizations, the ECRI Institute, named patient misidentification among the top 10 threats to public safety.”
Indeed, a report released in 2016 said that medical error could be considered the third leading cause of death in the United States.
Making a Start
In order to begin to combat the chaos and danger that is part of patient record-keeping at the moment, Patient ID Now proposes advancements across several sectors. First and foremost, the framework advocates for the development of a set of standards that could be applied to patient identification, reporting of error rates from incorrect patient matching, and setting baselines for minimal acceptable levels of accuracy. It also calls for an alignment with the guidelines already put in place by the National Institute of Standards and Technology (NIST).
Secondly, the report calls for robust privacy protections built on the foundations of HIPAA guidelines. It says that allowing patients to invoke more granular consent, giving them a clearer understanding of their privacy options and allowing them to change those options are all key to ensuring that any kind of national tracking system maintains anonymity and privacy whenever possible.
Third in the report comes the need to address standardization. It calls for the establishment of the minimum standardized data set needed for patient ID and matching; a standardized format for addresses and other data points; and linking with other programs such as HL7, an international nonprofit that has already established guidelines for the sharing of medical data.
The balance of the framework focuses on data quality, such as the ability for patients to make corrections to their own records, integration with other current medical data-sharing systems, equity and inclusion, and transparency in governance.
“Throughout the past year, the COVID-19 pandemic has highlighted the urgent need to address the issue of patient identification,” said Hal Wolf, president and CEO of HIMSS, a member of the Patient ID Now coalition. “The inability to accurately match patients with their records has severe patient safety and financial implications, and impedes health information exchange. The framework lays the foundation for a national strategy that saves lives, while protecting a patient’s choice and privacy rights.”
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