On Thursday afternoon, Oct. 10, during the CHIME Fall CIO Forum, being held at the Westin Kierland Resort and Spa in Scottsdale, Ariz., healthcare IT and health information management (HIM) leaders discussed a topic whose importance has been receiving increasing attention lately, in what was billed as a “Special Plenary Session: The Future of Patient Identification: Challenges and Strategies for Achieving True Interoperability.” Russell P. Branzell, president and CEO of CHIME (the College of Healthcare Information Management Executives) chaired a panel discussion along with industry leaders, on the topic of patient matching. Joining him on the panel were Stacie Durkin, RN-C, founder, Durkin & Associates, Kansas City, Mo., and a member of the Patient Identity Practice Brief Work Group at the Chicago-based American Health Information Management Association (AHIMA); Joey Sudomir, vice president, Texas Health Partners, Arlington, Tex.; and Bill Spooner, senior vice president and CIO, Sharp HealthCare (San Diego).
Among the numerous topics discussed were the role of vendors in resolving the issue; the large element of patient safety; the potential for biometric technologies to aid in establishing community-wide patient matching systems; and the roles of the federal government and of health information exchanges (HIEs) in advancing the U.S. healthcare system forward in the patient matching area.
With regard to vendors, Durkin said that “I think our vendors really need to understand what we go through as providers.” Spooner averred that, with regard to Sharp, “I think our vendors have been really good” on the issue. “I’d have to push them really hard to make them better.”
Biometrics was clearly seen by the panel as being embryonic in its potential to resolve patient matching issues. When Branzell asked Durkin whether she had seen any best practices for the use of biometrics in patient matching initiatives, she said that she had not. Sudomir offered that Texas Health Resources, “our parent company, is using the palm-vein matching system, but that’s within one organization, so it’s only effective for one system. But there is beginning to be some potential guidance on thumbprints and fingerprints.” And Spooner quickly added that “We’ve heard suggestions that a whole community should adopt a common technology. That could be effective, but it could really be prohibitively costly.”
Asked about the role of the federal government, all the panelists agreed that the federal government had a role in this area, though with different emphases.
Asked whether there should be a federal role in resolving this issue, Durkin said, “Absolutely. I liken it to federal involvement in highway safety. You establish the rules of the road for everybody.” Sudomir said, “In the end, work on this really needs to be harmonized with meaningful use” and care management efforts.
In his final question to the panel of discussants, Branzell said this to them: “If you could define your dream for patient-matching identification, what would it look like? And give a realistic timeframe.” Spooner said, “I think it’s most important that I achieve accuracy within my own community. I’d just really like to find a solution, and I really think there could be some good pilots, in a community like my own. I applied to Farzad [Mostashari, M.D., then National Coordinator for Health Information Technology] for $1 million last year, but he gave it to someone else. But you could do that short of Congress having to pass some law. And there would be a role for HIEs. The HIE could definitely be the clearinghouse.”
“My goal,” said Durkin, “would be that there’s one record for one person, no matter where the sources of information are coming from. A timeframe for that I would hope that we could do it sooner than later, but if we continue down the path and there’s a lot of active work around identity management, realistically, it could be done in three years.”
“Just give us a national patient identifier and we’ll knock it out in 12 months, right?” Sudomir responded. “But I agree with Bill, it’s important to start at the community level. I think it’s realistic to say that within five years across enterprises, we would have the ability to within 75-80-percent accuracy, match identities. But it’s going to take collaboration, and some quick work. The government obviously is going to operate with a little bit more efficiency than they have been. Because I think it’s very important for this work to catch up with meaningful use criteria. Perhaps in Stage 3? But it’s a worthy cause.
“Yes, it’s a worthy cause,” Spooner replied, “but I wouldn’t want us to put this into Stage 3 without thinking this through carefully.”