- Healthcare providers and other stakeholders should work toward common healthcare data standards for recording patients’ demographic data in order to deliver improved patient matching, according to healthcare professionals interviewed by the GAO.
For its report to Congress on patient record matching, GAO interviewed 37 representatives from physician practices, hospitals, health systems, health information exchange organizations, and health IT vendors, and reviewed reports by ONC and other agencies.
Some respondents said it would be helpful if ONC laid down requirements for demographic data, such as types of data collected and how it is formatted, through the electronic health record (EHR) certification process.
Other respondents said that industry organizations should reach agreement on implementing standards for demographic patient data.
Some interviewees pushed for EHR vendors to standardize the data their products allow providers to collect. Others said that ONC should play a leading role in getting industry groups to agree on and implement common data standards. A hospital representative told GAO that having demographic data standards built into EHRs could minimize the amount of time needed to train staff on how to format the data they collect and to check on whether they formatted the data correctly.
Respondents also identified several challenges to implementing common demographic standards:
- It could be difficult to reach consensus across various industry organizations on what standards to adopt and implement.
- Patient preferences about data collection, such as reluctance to share Social Security numbers, could affect standardize data efforts.
- It could be time-intensive for providers to train their staff on how to collect data in accordance with standards or staff would not always follow standards.
- EHR systems differ in how they allow staff to record demographic data, which could affect providers’ ability to implement standards.
- Standardizing data records would not prevent inaccurate or outdated data.
Texas providers implement healthcare data standards
The GAO cited the example of 23 Texas healthcare providers that implemented standards for how staff record patient names, addresses, and other demographic data in 2017. This effort increased the providers’ ability to match patient medical records automatically.
A respondent from one of the providers told GAO that when patient records are not matched automatically or when staff have questions about the accuracy of the process, they must conduct a manual review to resolve the issue. As a result of the standards, the organization has seen a significant reduction in the need to manually review records that failed to match automatically.
Respondents from three of the Texas providers estimated that the standards helped decrease the amount of manual review to resolve patient matching issues by around 90 percent.
These providers shared with the GAO lessons learned about developing and implementing standards:
• Allow enough time to get buy-in from staff and test for effects on other IT systems
• Communicate the benefits of standardizing data to clinical and administrative staff
• Train staff members on how to enter data and then assess them to identify problems and opportunities for improvement
The GAO also cited the example of a California children’s hospital that worked with other hospitals in the area to implement standards for how staff record a temporary name for newborns who do not have a name at birth.
After implementing the standards, clinical staff were able to easily match patient records and have access to information on the care the newborns received in other hospitals.
Beyond implementing and developing standards, respondents recommended that providers, ONC, and other stakeholders develop a data set to test the accuracy of matching methods, share best practices and other resources, implement a national unique patient identifier, and develop a public-private collaboration effort to improve patient matching.
“Multiple stakeholders noted that no single effort would be sufficient to improve matching, given the factors that contribute to matching challenges,” the report concluded.