Harris Healthcare’s Data Integrity Solution Business Unit – which includes patient data integrity powerhouses Just Associates, Inc., and QuadraMed Corporation – have entered a strategic partnership with RightPatient to integrate biometric patient identification into its existing suite of master patient index (MPI) management solutions.
Doing so provides important protections against front-end contamination of the MPI and EMPI and helps eliminate the patient misidentification and safety issues created by “dirty” patient identification data. This is especially important now as spikes in remote patient registrations due to COVID-19 have led to a sharp increase in duplicate patient records.
“Biometric protections from RightPatient perfectly complement our existing suite of patient data integrity solutions by guarding against creation of new duplicate and overlaid patient records at the point of registration, while we focus on creating and maintaining a pristine MPI/EMPI environment and supporting rapid and accurate patient identification,” said Lora Hefton, executive vice president of the Harris Data Integrity Solution (DIS) Business Unit. “This partnership advances our ability to address key health information issues by reducing the volume of potential duplicate medical records while securing patient information and minimizing the ongoing cost of maintaining quality patient data.”
Mohu Sultana, CEO of RightPatient adds: “We live in a very uncertain time. Increased cybersecurity threats put hospitals at risk of losing millions of dollars due to medical identity theft. The long-term impact of COVID-19 is also a critical factor in properly treating patients as we move forward – hospitals must know who is who to ensure proper treatment plans. Reliable patient identification is more important than ever. Our partnership with Harris demonstrates the commitment of both organizations to protecting the entire community against financial loss while ensuring patient safety.”
RightPatient provides the healthcare industry with the most accurate, scalable, hygienic, and versatile HIPAA-compliant, cloud-based photo biometric patient identification service that also publishes patient photos in health records, wristbands, and other applications to improve patient safety.
With easy implementation and seamless integration into any electronic health record (EHR) system – including the SmartID Platform from QuadraMed – RightPatient solutions reduce denied claims, lower medical errors because of misidentification, and prevent duplicate medical records. They also ensure accurate patient identification at any point along the care continuum while protecting medical records against unauthorized access, ransomware attacks and other data breaches.
From data analysis to cleanups, Just Associates performs the critical tasks necessary for hospitals and health systems to achieve and maintain a highly accurate and quality MPI. Its state-of-the-art suite of identity management solutions and services includes continuous duplicate detection with IDSentry – which features HIM workflow and dashboard tools and identifies more true duplicates than systems relying on basic and intermediate patient matching algorithms – as well as IDManage for ongoing MPI management and IDResolve for customized MPI clean-up services.
QuadraMed brings together the expertise, systems knowledge and technology that enable delivery of tailored, value-added solutions that improve healthcare organizations’ financial outcomes and business processes while supporting delivery of quality patient care. Its flagship SmartID Platform is a HIPAA-compliant EMPI management platform that diagnoses, treats, and cures errors, delivering real-time duplicate and overlay detection and robust enterprise-wide patient search based on a probabilistic algorithm with up to 99% accuracy in matching patient records.
To learn more about integration of RightPatient into the MPI/EMPI patient matching and data integrity management solutions from Harris DIS, visit Just Associates’ virtual booth during the AHIMA21 Virtual Conference, taking place through Sept. 22, 2021.
On Mar. 9, 2020, the U.S. Department of Health and Human Services (HHS) finalized “two transformative rules that will give patients unprecedented safe, secure access to their health data.” Issued by the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS), the Final Rules implement interoperability and patient access provisions of the 21st Century Cures Act and support President Trump’s MyHealthEData initiative.
In its release announcing the Final Rules, HHS noted that together “these final rules mark the most extensive healthcare data sharing policies the federal government has implemented, requiring both public and private entities to share health information between patients and other parties while keeping that information private and secure, a top priority for the Administration.”
Cures Act Final Rule implements the interoperability provisions of the 21st Century Cures Act, passed by Congress in 2016 to promote patient control over their own health information while still allowing providers to choose the IT tools that let them provide the best care for patients without excessive costs or technical barriers.
Specific to patient matching, the Cures Act Final Rule adopts as standard the first version of the United States Core Data for Interoperability (USCDI v1), making its use a requirement as part of the new application programming interface (API) certification criterion.
According to ONC, adoption of the USCDI standard “supports improved patient matching through the exchange of USCDI and its patient demographic data elements.” The Final Rule integrates additional data elements to the patient demographics data class to improve patient matching:
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Karen Proffitt
“Any improvement strategy must include data standardization and promote a more consistent, comprehensive collection of patient data at all entry points,” said Karen Proffitt, MHIIM, RHIA, CHP, vice president of industry relations and chief privacy officer, Just Associates. “The Final Rule requirement for adoption of USCDI standards, including historical data and more relevant data elements such as phone number and email address, represents a significant step toward improving interoperability and minimizing MPI errors overall.”
Interoperability and Patient Access Final Rule gives patients access to their health information when they most need it, in a way they can best use it. It is focused on driving interoperability and patient access to health information by leveraging CMS’s regulatory authority over Medicare Advantage, Medicaid, CHIP, QHP issuers and FFEs to free patient data.
Specific to patient matching, which was one of two requests for information included within the proposed rule, CMS noted that while “accurate patient identity management is critical to successfully delivering the right care to the correct patients,” patient matching challenges are beyond the scope of the current rule. However, the comments provided will be taken into consideration for potential future rulemaking.
“As a healthcare community, we must recognize the critical role improved data capture and MPI data quality play in enabling patients to have more comprehensive access to their health information by ensuring complete and accurate data is available for viewing or transmitting,” said Proffitt.
She adds, “any process to incorporate patient verification of data along the way could be very beneficial.”
Patient data integrity experts from Just Associates, Inc., a nationally recognized leader in patient matching and health information data integrity and management, will be at the 2019 Annual AHIMA Convention & Exhibit to provide insights into best practices for Master Patient Index (MPI) clean-up. During the conference, taking place September 15-18, 2019, at McCormick Place Lakeside Center in Chicago, Just Associates (Booth #2012) will also showcase IDManage, which delivers ongoing support to maintain an MPI’s data integrity without draining internal resources.
IDManage leverages both technology and Just Associates’ unique data integrity expertise to rapidly identify, validate, and reconcile duplicate records before they can infiltrate and contaminate downstream and outside systems. IDManage can deliver cost savings as high as 40%. It is the focus of “IDManage: An Innovative Approach to Ongoing Duplicate Record Management,” which takes place on September 17 at 12:15 p.m. (CT) in the McCormick Place – HIM Expert Theater Andersonville. Presented by Rachel Podczervinski, MS, RHIA, Just Associates’ Director of Identity Solutions, and the HIM Assistant Director of a large west coast health system, the presentation examines the benefits the health system has experienced from turning ongoing MPI management over to Just Associates.
“Duplicate records remain an intractable problem throughout the healthcare industry. Recently, Black Book Research projected that the typical MPI has a duplicate rate of 18%, which can cost nearly $1,200 per record in added clinical and administrative expenses,” said Lora Hefton, Just Associates’ COO and Vice President of Operations. “Just Associates offers a new approach that starts with crafting a creative, cost-effective MPI management strategy to quickly resolve numerous possible duplicate records and then delivers solutions to maintain the ongoing integrity of patient data.”
To learn more about Just Associates’ MPI clean-up services and IDManage, visit Booth #2012 at AHIMA and speak with one of the firm’s data integrity experts. While at the booth, play the “Money Tree Trivia” game for a chance to win prizes, including Apple AirPods.
Any patient matching improvement strategy must look beyond technology and emphasize the people and processes that play a critical, yet often overlooked, role in ensuring data integrity. That was the message Just Associates, Inc., shared with the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) in response to requests for information on patient matching in conjunction with proposed rules to advance interoperability.
In its letter to the ONC, Just Associates noted that while it supports the focus on interoperability and usability and agrees with the importance of accurate patient matching, it does not believe that the concept of a “technology alone” solution is realistic. Any improvement strategy must also include data standardization and promote a more consistent, comprehensive collection of patient data at all entry points.
“Every technology has its flaws when it comes to patient matching and the importance of training staff, developing and maintaining comprehensive data governance policies, ensuring executive support for data governance and vigilant efforts on measuring and reporting data quality are critical. We cannot ignore the ‘people and process’ aspects to obtaining high levels data quality,” the letter stated.
Just Associates also provided feedback to the ONC on the importance of consistently defined and used format constraints and identified key issues that must be addressed to accurately measure algorithm performance. The suggestion was also made to align with the Children’s Hospital Association’s temporary demographic conventions for newborns to address the unique challenges with pediatric matching.
In its letter to CMS, Just Associates concurred with the suggestion that more standardized data elements be used across all appropriate programs to immediately enhance matching rates, noting that “data collection standards and their consistent application by health plans, providers and exchange organizations are critical for matching accuracy.
“Equally important,” the letter continued, “is the development of data definitions for these elements to ensure common understanding of exactly what data is being collected and in what format.”
Other advice offered by Just Associates in response to CMS suggestions included avoiding mandating the use of specific matching algorithms, data sources or software solutions, a move that would likely be premature and overly prescriptive. The firm also stated its support for implementation of a CMS-wide identifier, noting its potential to enhance accuracy and assist in duplicate record reconciliation verification processes.
By Beth Haenke Just, MBA, RHIA, FAHIMA, founder and CEO, and Karen Proffitt, MHIIM, RHIA, CHP, vice president of industry relations/CPO, Just Associates, Inc.
Beth Haenke Just
The introduction of overlays into a medical record system can be so subtle that they often go unnoticed until one causes an adverse event, HIPAA violation or billing error—making them a primary source of patient errors, expenses and lost revenues in hospitals today.
Caused when the information of two patients is co-mingled within one medical record, the dangers of overlays have intensified with the proliferation of electronic health record (EHR) systems, which accelerate the rate at which multiple internal and external systems can be infected with dirty data. Compounding the problem is an overreliance on technology-centric solutions to resolve possible duplicates.
The American Health Information Management Association (AHIMA) puts the average duplicate rate at between 8 percent and 12 percent. A more recent survey by Black Book found an average of 18 percent. Meanwhile, an analysis of EMPI cleanup projects Just Associates completed between 2012 and 2016 showed that as many as 1.3 percent of these possible duplicates are actually potential overlaid records.
Karen Proffitt
When it comes to overlays, there are three challenges facing health information management (HIM) professionals tasked with maintaining the integrity of patient records: 1) identifying and resolving existing overlaid records, 2) determining the root cause(s) and 3) implementing policies and procedures that will prevent the creation of new ones.
The birth of an overlay
The most common way an overlay is created happens at the time of registration when an incorrect patient record is selected, core demographic information is changed, and a new visit is added. Occasionally, the records of two different patients are erroneously merged during the duplicate resolution process.
Overlay creation can also be traced back to multiple departments. A study in the Journal of AHIMA involving an eight-hospital, multi-state healthcare organization found that most of the errors happened in the emergency department (ED) and, to a lesser extent, in registration, scheduling and ancillary areas such as lab and radiology.
The hospital system that was the subject of the study had been tracking and keeping detailed statistics on overlay errors for five years, beginning with the implementation of an EHR system. This provided researchers with the rare opportunity to analyze a considerable sample size of 555 errors, from which they determined an error rate of one in every 10,734 admissions. That is the equivalent to more than nine errors per month, of which 97.5 percent were caused by user oversight. The study also identified an upward trend in overlays attributed to growth of the health system and higher utilization of error identification tools that reveal more issues than manual methods.
For example, 54 percent of overlays were found by registration users while data integrity change reports that made use of EHR tools found 31 percent. Clinicians were a distant third, identifying just 6 percent of errors. Patients also found overlay errors via patient portals, which could have allowed them inappropriate access to highly-sensitive protected health information (PHI) — access that could lead to HIPAA violations.
Proactive EHR tools found most overlays within 10 days of their occurrence, and most were corrected in 30 days. This is important because the longer an overlay goes undetected, the less likely it will be found. When it is found, the older overlaid record is much more time-consuming and expensive to correct.
The high cost of overlays
To determine just how costly overlays are, it is necessary to cast a wide net, as few studies have been done to establish industry averages. Factors contributing to the full financial impact of an overlay include denied and delayed claims, lost revenues and resources required to identify and correct the error.
Time is a huge factor in the costs associated with overlay correction resources. For paper-based overlays, it can take between 60 and 100 hours, while EHR-based errors can take months depending upon system complexity. A survey by the College of Healthcare Information Management Executives (CHIME) further found that respondents typically had at least two people dedicated to “data cleansing,” including overlay correction.
