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D.C. Report: Patient Matching Discussed in Capital by Stakeholders, Feds

May 23, 2012
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Washington Gathering Discusses Patient Matching At an invite-only event held in Washington this week, CHIME members, federal officials and other health IT stakeholders met at the Bipartisan Policy Center to discuss the issue of patient matching.  The briefing was well attended with leading CHIME members, foundation firms and top officials from CMS and ONC looking at various approaches to accurate patient matching.  One of the central issues discussed was the appropriate level of federal involvement.  A unique patient identifier has long-since been taken off the table, government officials indicated, but there remains a need for common standards and methodologies to match data with the correct patient. The dominant policy question that emerged, centered on the fact that if most care is delivered locally, what kind of national policy would reinforce safety, not hinder it.  Examples included forcing more transparency into how false negative / positive error rates are produced and possible standards around how performance data is gathered and presented.  Other conversations focused on the need for uniform and consistent intake / registration procedures, to make sure “dirty” data doesn’t complicate matters further.

CHIME Policy Steering Committee members Neal Ganguly and Bill Spooner both made presentations describing how CentraState and Sharp are respectively addressing patient mismatches. While CentraState has a relatively low error rate of false positives and false negatives, there’s a concern about what happens when broader rollout of regional and statewide health information exchange begins, Mr. Ganguly said.  Meanwhile, Mr. Spooner’s presentation outlined Sharp’s 20-year “journey” to patient matching.

Ahead of Wednesday’s briefing CHIME did a survey (summary available here and graphs here) finding that many hospitals are using a mix of approaches and technologies; error rates are still high, even with the use of two or more matching strategies; nearly one in five respondents have suffered an adverse event that can be tied to a patient mismatch.

Policy Steering Committee members, Russ Branzell and Randy McCleese also were in attendance.

ONC publishes Request for Information on NwHIN On May 15 ONC published a Request for Information on the topic of the nationwide health information network (NwHIN).  The public has 30 days to comment on these “rules of the road” that will “enable secure health information exchange over the internet.”  These comments will help ONC develop a proposed rule in the future.  The RFI indicates that a national framework or set of rules must be in place for HIE because different sets of regional rules would result in gaps in policies, technological capabilities and other factors that would interfere with data exchange at a broader level beyond direct one-to-one exchange, and ultimately prevent better care coordination.  According to ONC, the NwHIN will be a “continually expanding ecosystem of electronic exchange activities for which stakeholders would be able to select the appropriate set of standards, services, and policies to meet their electronic exchange needs.”

CHIME will comment on the RFI and CHIME members who are part of the Advocacy Leadership Team interested in helping develop comments are encouraged to contact Jeff Smith by Tuesday, May 22.

HHS Makes it Easy to Track Healthcare System Progress This week, the Department of Health and Human Services debuted a website called the Health System Measurement Project which “tracks government data on critical U.S. health system indicators.”  Aside from national data, the website also presents “population characteristics such as age, sex, income level, and insurance coverage status.”  The front page of the website details changes in the healthcare system based on the Affordable Care Act, HITECH under the American Recovery and Reinvestment Act, and Medicare Part D.  Some of the data shown illustrate the gap in health insurance offered by small businesses versus large businesses from 2005 to 2009.

Making this data available to the public will help people follow the changes in healthcare as the system adopts electronic health records. It allows the public to see the evolution of the healthcare system including where improvements have been made in the system, and where gaps in care or coverage need to be addressed.  Government Health IT reports, “A user can look at data on a given topical area from multiple sources, compare trends across measures and compare national trends with those at the state and regional level.”

FCC Chair Genachowski Advocates for Mobile Body Area Networks The chairman of the Federal Communications Commission, Julius Genachowski spoke in favor of using mobile body area networks (MBAN) at an event at George Washington University on Thursday.  He detailed the benefits of the devices including their main use – they allow doctors to remotely monitor patients’ vital signs in real-time.  These devices would be an improvement to many tools currently being used because they have wires that are usually attached to monitors or beds and keep the patient from being mobile.