Sequoia Project highlights best patient matching practices
- The Sequoia Project and Care Connectivity Consortium released a revised scheme for managing patient identities, including a model for determining an organization’s adeptness at accurately matching patients with other organizations. The project is a nonprofit setup to advance interoperability nationwide, and the consortium is a provider group whose founders include the Mayo Clinic, Geisinger and Intermountain.
- The 77-page framework also includes “minimal acceptable principles” that organizations should embrace, such as ensuring patient identifiers are consistent and are not changed or reused.
- It also includes proposed rules to enhance matching algorithms for cross-organizational patient identity matching and management. For example, organizations should use case insensitive matching and normalized traits to confirm a match.
Patient matching is a major concern as more and more medical devices and software platforms are capturing disparate pieces of patient health information. Hospitals spend countless hours and millions of dollars trying to resolve mismatches and other patient record matching issues caused by lack of interoperability.
ECRI’s Patient Safety Organization identified 7,613 wrong-patient events voluntarily reported by healthcare organizations between January 2013 and July 2015 because of medical record mix-ups.
Currently, there is no national patient identifier system, and Congress continues to ban federal funding to develop an NPI. Tech companies have been reluctant to share proprietary information for fear of losing market share.
In a recent Black Book Research survey, hospitals without enterprise master patient index support tools reported match rates of just 24% when records were exchanged externally, compared with 85% at hospitals that used EMPI. Hospitals that lacked an EMPI also reported more duplicate patient records, repeat medical care and claims denials.
According to the report, inaccurate patient identification and data are responsible for about a third of all claims denials — costing hospitals an estimated $1.5 million in 2017 and the U.S. healthcare system $6 billion overall.
The Sequoia Project/CCC effort hopes to fix that.
“This paper provides a roadmap for advancing our national patient matching strategy. We hope to see organizations adopt these minimal practices and maturity model for patient matching with their external health information exchange partners,” Eric Heflin, CTO for The Sequoia Project, said in a statement.