Address standardization is a first step in achieving matching certainty

Healthcare organizations involved in matching records to patients say more efforts lie ahead, and jurge consideration of patient identifiers.

The challenging task of matching patient matching got a boost from the decision by the Office of the National Coordinator for Health Information Technology and the Department of Health and Human Services to release specifications for cross-industry standards for representing patient addresses.

Absent a unique patient identifier – probably years away from being established, if it ever is, because of privacy concerns – a patient’s address provides a step forward in enabling healthcare organizations to match patients to their healthcare and claims records.

However, many admit that the use of addresses to aid in patient identification is only a single step along the path of ascertaining matches, especially in an age when most patient information is electronic and services can be provided in a variety of settings.

Organizations that deal with the complexities of exchanging patient data are encouraged by the ONC’s announcement and expressed willingness to continue to work.

“Civitas Networks for Health supports ONC’s Project US@ Initiative, which uses USPS standards to improve patient matching,” said Lisa Bari, CEO of Civitas Networks for Health, which supports information exchange providers.

“For many years, Civitas’ members who work with patient-level data have developed substantial expertise in patient matching out of necessity, due to the lack of a federal or national unique patient identifier and the Congressional ban on funding this work,” she added. “ONC’s efforts with Project US@ are a very positive, common-sense development towards more coordination and leadership on this issue.”

Charles Stellar, president and CEO of WEDI, said further development of related standards for linking records with patients lies ahead. “Although issuing a unified, cross-standards specification for patient addresses is an important step toward minimizing the chance of mismatched medical records, WEDI continues to advocate for implementation of a robust national patient identification process to further reduce the opportunity for matching errors,” he noted.

Charles Stellar, WEDI

Bari termed the use of the USPS address technical specification as providing “incremental improvement (that) doesn’t solve all patient-matching issues.”

Organizations lauded ONC’s collaborative approach in coming to consensus on the patient address initiative, and note that more will need to be done to ensure consistent adoption in the industry.

“Project US@ aims to support health IT developers and health systems that already use these standards and thereby require them, making only minor changes and refinements to what they already do,” said Robert Tennant, vice president for federal affairs of WEDI. “The Project US@ Technical Specification and AHIMA Companion Guide will hopefully support accurate patient matching while maintaining mailability.

“However, for this technical specification to significantly impact the industry, it must be widely used,” Tennant added. “It is critical that health IT developers incorporate this approach into their software and that other stakeholders – providers, payers, researchers and others – adopt this standardized address format.”

Healthcare organizations are likely to adopt the new address standard going forward, and many likely “will not attempt to retrofit non-standard addresses already in their systems,” Tennant believes.

Standardizing patient addresses does not solve all matching issues, Bari and Tennant agree, and much relies on industry organizations to move quickly to adoption.

“Ultimately, should the industry not adopt this standard voluntarily, ONC may look to require EHRs to leverage this standard as part of a future iteration of Certified EHR Technology,” Tennant believes.

The use of such patient-related factors in identity matching does not obviate the need for a more universally accepted, consistent approach for always achieving positive matches.

“Other nations have addressed record matching by issuing a unique national patient identifier. HIPAA, passed in 1996, included a provision requiring the development of an NPI, but there has been an ongoing congressional hold placed on HHS working on this issue,” Tennant noted. “This prohibition was lifted recently in House legislative language, and efforts continue on the Senate side to lift the ban on HHS.”

“There are many other factors involved in accurate patient matching, including the development of a unique patient ID, which has been very contentious in the past,” Bari said. “Civitas is a member of the Patient ID Now Coalition, which advocates for the development of a unique patient identifier that could help reduce matching issues.”

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