By - To effectively track the spread of the COVID-19 pandemic, government leaders must formalize standards and patient matching must be quick and accurate, according to an op-ed published in npj Digital Medicine.
Gathering patient data from health systems, laboratories, and other resources allows researchers and public health experts to conduct contact tracing, which determines where a COVID-19 patient tested positive and if that patient has put other individuals at risk of contracting the virus. Once this is known, health experts can make recommendations about how to mitigate the virus.
To ensure accuracy, patient matching is a must.
Ben Moscovitch, project director of Health Information Technology at Pew Charitable Trusts; John D. Halamka, president of the Mayo Clinic Platform; and Shaun Grannis, vice president of data and analytics at Regenstrief Institute, wrote that contact tracing and vaccine deployment work hand-in-hand for the reopening of the country and an effective pandemic response.
“In order to be effective, EHRs—both those held within a single facility and those in different health-care organizations—must correctly refer to a specific individual,” wrote Moscovitch, Halamka, and Grannis. “Unfortunately, patient matching rates vary widely, with health-care facilities failing to link records for the same patient as often as half the time.”
READ MORE: 4 Ways Congress Can Leverage Health IT to Curb COVID-19
Currently, patient matching utilizes demographic data, such as name, date of birth, or address.
But if an individual changes her last name, or if an address has been changed, then patient data can be flawed and there could be fatal consequences.
Since patients do not typically receive care at just one health facility or health system, accuracy becomes more difficult. And although national standards, such as the ONC interoperability rule, are currently being adopted across the country, not all EHRs possess the same capabilities.
As a result, laboratories and health systems are lacking key identifiers, such as addresses and phone numbers.
The authors noted patients’ addresses were utilized in roughly 90 percent of cases in Wisconsin, compared to only 55 percent in Indiana. The authors also said some phone numbers were linked to the provider and not the patient.
READ MORE: 3 Consequences of Patient Matching, Health Record Issues
Accurate patient data must be analyzed to scale and deploy an effective vaccination strategy. Providers must know if a patient has received a vaccination, or trouble could follow.
“These patient identity and matching problems are not new to health care; however, the current pandemic has exposed deep-seated and long-standing deficiencies in the underlying technology infrastructure that serves as the backbone to patient matching and medicine,” the authors continued.
While long term solutions require extensive research, development, and implementation, there are short term solutions that could enhance patient matching rather quickly, they said. But it would require collaboration between government agencies and healthcare providers.
Standardizing data elements, such as phone numbers and addresses, is critical to patient matching and it could be done with the help of US Postal Service (USPS) formatting, wrote the authors. USPS address formatting can increase matching by up to 3 percent, according to a 2019 study published in the Journal of the American Medical Informatics Association. While this percentage does not seem high, it could increase tens of thousands of matches per day.
However, USPS does not share its free address standardization web tools to healthcare providers. The agency only allows it for shipping purposes.
READ MORE: Congress Could Enhance Patient Matching, Mitigate COVID-19
The authors said USPS should make its service open to health IT developers, which would allow for address standardization, especially during COVID-19. If not, the ONC or Congress should step in and encourage USPS to open up its tools to healthcare providers, they said.
Second, technology systems that share data among health-care providers, pharmacies, laboratories, and registries should also use more data for matching. Such data should go beyond demographic information that can easily change over time. This will help to distinguish among people with similar names or phone numbers.
The ONC rule reads that EHRs must have the capability of sharing contact information, such as phone numbers, email addresses, previous addresses, and more. With the advancement of patient portals, EHRs should have access to a high percentage of email addresses.
However, the authors noted that this rule only applies to EHRs and not other systems such as laboratory systems or registries that could enhance contact tracing. The experts said ONC could work with state and local health officials to promote these standards and regulations.
“COVID-19 is challenging our health-care system in unprecedented ways; the likely vaccination campaign to contain the virus will do the same,” Moscovitch, Halamka, and Grannis concluded. “That is all the more reason for stakeholders to do their part and urgently address our patient matching problems.”
“Otherwise, tracing this pandemic and future illness is certain to face delays. And the complex vaccination campaign that could provide a reprieve will become even more complicated—without delivering the vital protection our country needs.”
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June 04, 2020 at 08:30PM
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