Wednesday, December 25, 2013

Cross-organization Patient Identification

A colleague asked me what I thought of this:

"To improve the quality and safety of patient care, we must develop a nationwide strategy to match the right patient to the right record every time," said Lisa Gallagher, HIMSS vice president of technology solutions, in a statement.

The innovator in residence, she said, "will create a framework for innovative technology and policy solutions to help provide consistent matching of patient health records and patient identification.”

I had two reactions, one after the other:
  1. That would be awesome (a nationwide strategy to match the right patient to the right record everytime).
  2. Good luck balancing privacy and accuracy.
I have been dealing with this issue for just about 29.5 years. That is a loooooong time. I have seen lots of ideas come and go. Alas, I have no great solution, but I do have a firm grasp on potential issues:
  • Very similar demographics: (two easily confused patients)
    • identical twin boys named John and James, for instance (yes, people do that)
    • father and son, same name, unlucky birth dates such 11/1/61 and 1/16/11. It happens and MANY clerks are so pleased to spot the "typo"
    • cousins born on the same day or with unlucky birth dates with the same name
    • mother & daughter have same name until marriage and updating the daughter obscures the mother, making the mother look like the maiden name version of the daughter
  • Very dissimilar demographics: (one patient looks like two)
    • maiden name to married name: add a birth date correction and all bets are off
    • legal name change, sometimes to deliberately leave behind the past--prison term, bad marriage, etc
    • heavy use of a nickname "Steve Jones" finally decides to go by "Steven Jones" because his dad, "Steven Jones," just died. Yikes.
  •  Privacy nut / identity theft: the patient deliberately gives false demographics or those of someone else.
I cannot imagine, in the absence of a national identity card, how a private American effort could even span different organizations within a given state, let alone across state boundaries.

Insurance companies could help, given their efforts to get bills paid across institutions, but I cannot see why they would and I can see why they wouldn't.

Man, I hope that I am wrong about this.

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