Radiology group uses EMPI to clean up duplicate records

Doctors doing less documentation and patients get a single identifier, says Brian Frohna.


Like many large radiology practices, Southwest Diagnostic Imaging in Phoenix interprets a massive number of imaging exams—a total of 2.6 million annual exams across 35 imaging centers and 12 hospitals that include delivery systems such as Banner Health, HonorHealth and IASIS Healthcare.

And like other similar practices, SDI has struggled to reconcile and exchange data and imaging files from multiple systems and locations. Too often, critical information has been missing or was incomplete, and some radiologists could not access patient studies from a hospital, even when it was in close proximity.

Patient recordkeeping was so chaotic, because of the large number of settings served by the practice, that one patient had 50 different patient records with 50 different account numbers.

To make patient data more accessible and accurate across the enterprise, SDI in early 2017 selected and implemented an enterprise master patient index and provider registry from NextGate.

An EMPI is a database used to maintain the consistency and accuracy of demographic and medical data within provider departments, employing a patient identifier to match and link patient records across a healthcare enterprise.



“We needed a single ID number for each patient to be aware of what information we already had in billing, if a patient was already placed in an outpatient practice and to minimize duplication of records,” says Brian Frohna, MD, chief technology officer at Southwest Diagnostics as well as a practicing radiologist.

Further, with the partnerships that the organization has with other clinicians in the region, it was important to be more aware of imaging studies that patients had elsewhere, Frohna adds.

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The NextGate software handles patient record reconciliation and accurately links imaging files to the correct patient in real time.

Having more information available significantly improves workflow for radiologists at Southwest Diagnostic Imaging, as physicians were doing 10 to 20 addendums daily. An addendum is the addition of extra information in an imaging study. “That really is an interruption in our workflow and also redundant work,” Frohna says.

Now, the EMPI, running in the background, handles patient record reconciliation and links imaging files to the right individual in real time, with more data flowing to the documentation system, enabling physicians to have fewer addendums and to be more confident that they have the right patient and the right information when documenting.

The EMPI uses probabilistic and other algorithms to compare and match patient records. The software further supports health data exchange and a longitudinal view of patients’ medical histories, including imaging exams.

Many clinicians don’t fully appreciate what automated record reconciliation software can do for their practice, Frohna believes. “Anyone in a complex care environment with multiple systems and trading data back and forth, at some point will find themselves confronted with patient duplications. It may not seem like a big problem when a practice is small, but as it gets bigger, it becomes a huge problem. We manage 100,000 duplicate records every year, and that had to be addressed manually with employees merging them. Now, we’re down to 1,000 or so duplicate records a year.”

In the past year, SDI has cleaned up more than 5 million records across 18 IT systems, prevented creation of 100,000 duplicate records in the first six months, reduced the number of addendums by radiologists by 75 percent and implemented a centralized patient index that is the source of truth for clinical, operational and financial performance.

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