- Patients largely agree that patient matching is an urgent issue and threat to patient safety, but have some security concerns about strategies for overcoming patient matching, according to a new report from Pew Charitable Trusts.
“The transition from paper to digital health records has transformed care delivery, but challenges persist with interoperability—the exchange of electronic data among different systems,” wrote Ben Moscovitch, the project director for health IT at Pew and author of the report. “One of the central problems is inadequate patient matching; that is, the ability to accurately link an individual’s electronic health records (EHRs) from multiple doctors’ offices or hospitals within or across health systems.”
A series of focus groups including a total of nearly 100 patients revealed that patients agree there are considerable risks that go along with insufficient patient matching. When a doctor doesn’t have access to a patient’s medical record, the record contains another patient’s information, or the record contains incomplete or inaccurate data, she cannot deliver the correct type of treatment.
Patients believe the healthcare industry must employ some strategies to overcome patient matching challenges, although some did have security apprehensions.
“Once informed of the problems, safety issues, and costs involved, participants across the different subpopulations generally expressed strong support for better matching and said the most important benefits would be timely access to health data, quicker and more comprehensive care, fewer preventable medical errors and patient misidentifications, and improved security and privacy,” Moscovitch explained.
Patients also offered feedback on specific proposed solutions to patient matching issues. For example, patients approved of using unique identifiers for patient matching. A numeric identifier, such as a national patient ID number, could be a cost-effective and efficient tool for overcoming barriers.
“Participants liked that a lifetime number would be low-cost, but they feared it might be easy to steal, and they voiced considerable confusion over how a single-use number would help solve the problem of mismatching, especially if a person was unconscious or in need of emergency care,” Moscovitch said in the report.
“Similarly, most participants did not like the idea of a self-selected code or number, because patients would need to remember it. Some also raised the possibility of human error, such as transposing numbers when entering data.”
Patients also largely approved of using biometric data to correctly identify patient records. This strategy could be effective even for patients incapacitated or in an emergency situation. Additionally, patients expressed interest because of their familiarity with biometric scanners, such as fingerprint scans on smartphones.
Patients did have some cost concerns for organizations serving primarily low-income patients.
Patients were less interested in using smart cards, which would contain microchips that would be updated with each hospital or clinic trip. These small cards could easily be lost or stolen, focus group participants pointed out. ID cards put too much onus on the patient, they said.
Patients also questioned the effectiveness of consulting third-party groups for patient matching. While the US Postal Service, for example, could confirm some patient demographic information, patients had concerns about security of their personal information.
And while patients did note some promise with using smartphone data for patient matching, they likewise found some flaws in the strategy. Specifically, these tools do not take into account patients who do not own a smartphone.
Patients were enthusiastic about the use of data standards. These standards could be developed by healthcare providers to ensure all hospitals and clinics collect the same input data.
“Participants thought this option would be easy and safe, could happen relatively quickly, and would avoid burdening patients with responsibility for remembering identifiers or otherwise ensuring that their records are accurately matched,” Moscovitch wrote. “However, participants questioned whether all health care providers and facilities could agree on standards and capture data in the same way, and some participants had concerns about the costs and feasibility of implementation across different systems.”
Working with patient focus groups was an essential part of this project, Moscovitch explained. Patient matching, while a key undertaking for healthcare organizations, is also an important issue for patients. Patient safety is at risk, and patients also have the power to play a role in improving patient matching.
Ultimately, it will be important for healthcare industry experts to consult patients about the key strategies for improving patient matching.
“Whatever approach is ultimately taken—whether biometrics, numeric identifiers, a smartphone app, or use of third-party data—technology developers and health care systems will need to account for patients’ priorities when addressing matching challenges and privacy concerns,” Moscovitch concluded.
“However, regardless of their preferred solution, patients agreed that data matching presents a critical barrier to effective interoperability and are eager to have the problem addressed so that clinicians and individuals have access to accurate, current health information.”