- The Trump administration is rolling out an initiative to choose one format for recording patient mailing addresses in EHRs and other health IT systems, with the aim of improving interoperability and patient matching in healthcare.
- The initiative, called Project [email protected], will bring together standards organizations starting next year to select an industrywide, unified healthcare specification for representing addresses within the year, the Office of the National Coordinator for Health IT said Tuesday.
- Promoting interoperability has been a key facet of the Trump administration's health IT priorities, though the COVID-19 pandemic has proved a wrench in the works. Compliance dates for two regulations promoting data sharing finalized by ONC and CMS in March have been pushed back twice this year to free up provider resources to tackle the novel coronavirus.
Health IT groups have been calling on the federal government to improve data standardization for some time now, and are likely to be cheered by the step, albeit small, of forming a project on the matter. Matching patients to the correct medical record is a big problem in the industry, as mismatching patients with past documentation can lead to erroneous diagnoses or treatments, and be time consuming and expensive to fix.
The new ONC initiative is a significant step toward better patient matching, according to Ben Moscovitch, Pew Charitable Trusts' project director for health IT.
"Targeted, bipartisan changes like these are some of the most effective near-term opportunities to improve matching and help get patients the care that’s right for them," Moscovitch said in a statement.
Healthcare organizations are still operating amid a distinct lack of data interoperability, hamstringing efforts to coordinate patient care across different sites of service. Research has shown that, in the absence of a unique patient identifier, standardizing demographic data like patient addresses could help hospitals and other providers match patient records, giving doctors a longitudinal picture of a patient's health needs.
But many such standards, such as the address format used by U.S. Postal Service, aren't being used across the healthcare ecosystem. One study published last year from Indiana University and Pew showed standardizing patient addresses could help providers link thousands of records each day that would otherwise not be matched.
Standardizing addresses was most promising for improving patient matching, compared to standardizing other data like telephone numbers or birth dates, researchers found. Using the USPS' format, like how to list street names or abbreviate words, improved match rates by up to 3%. The improvement rate jumped to up to 8% when both addresses and last names were standardized.
However, in its final rule forbidding data blocking released in March, ONC didn't standardize address format, sparking complaints among patient matching advocates. However, the agency did add previous address, email address and a standardized phone number to a list of data vendors and providers must be able to send and receive.
Compliance deadlines for the interoperability regulations have been twice delayed this year during the coronavirus pandemic. Now, hospitals and EHR vendors must be able to exchange certain types of medical data by April 2021, as opposed to November this year. Some other compliance dates were pushed back to 2022 or even 2023.
In a Tuesday blog post announcing Project [email protected], Steve Posnack, deputy national coordinator at ONC, noted there are many standards stewarded by many different health IT groups for address fields, but individual organizations usually choose which approach for representing data they want to use. Because of that variability, providers, payers and other entities rely on a variety of third-party tools and resources when it comes to managing their data.
ONC is collaborating with those standards groups, including Health Level 7 (HL7), the National Council for Prescription Drug Programs, the Health Standards Collaborative and X12, among others, to try to arrive at one lasting standard for representing mailing address, reflective of ONC's ongoing commitment to refining its final rule, Posnack said.