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A new national study by Verato, a company that specializes in master data management (MDM), states that 7 in 10 healthcare leaders say they often lose patients or members because of poor experiences, usually due to fragmented or siloed identity data. The study also found that 30 percent of respondents feel confident that their systems give a complete view of patients, while fewer than 6 percent feel prepared for the digital health challenges ahead.
According to the report, Bridging Gaps in Customer, Patient, and Constituent Experiences, patients visit clinics and repeatedly fill out the same forms. Verato emphasizes that this reveals a deeper crisis: healthcare still doesn’t truly understand “who is who.” This gap results in duplicate records, missed lab results, and even life-threatening errors.
Verato CEO Clay Ritchey states that identity is no longer just a back-office IT concern. It is the unseen factor driving patient trust, loyalty, and growth. Ritchey recently talked about the report’s findings with Healthcare Innovation.
The report states that 7 in 10 healthcare leaders say they often lose patients or members because of poor experiences. Could you speak about this?
Because we don’t understand identity, we have fragments of a person across multiple patient records. One of those records states that the patient has an allergy. The other one doesn’t. They are given a medication that they have an allergic reaction to. Examples where you know the wrong diagnosis was made because the wrong lab tests were used. Those are the clinical outcomes that occur when you get identity wrong.
All of us are thinking of ourselves more as consumers, not just patients, so our primary care physician would navigate our care into a health system, and we’d always go to that same health system. Now, brand loyalty is becoming more important. We’re starting to see consumers really starting to lose trust, because they’re seeing that their providers don’t really know who they are. Consumers are saying, I can vote with my service. I can go somewhere else to get the experience that I want.
Could you expand on the idea that consumers fill out paperwork multiple times?
Clinical problems can really go wrong when you get identity wrong. Health Systems are trying to overcorrect for that by asking you to fill out the forms over and over and over again, because they don’t trust that the record they’re looking at gets the full picture of you, so they’re getting it one more time before they deliver that care.
As you start thinking about the experience that you want as a patient whenever you are traveling and moving beyond the current health system that you’re in…maybe you’re a snowbird, and…in the winter, you go to Florida. In Florida, there are 1000s of organizations that are sharing information about you, and if all that information is in fragments, then when it finally gets down to Florida, they’re seeing a very small percentage of that data.
How widespread is this experience for patients?
A typical health system might have between 12 to 15 percent of the time fractional records of the same person, and so it is very prevalent. A typical customer has between 30 to 50 different sources of data where they’ve got information sitting in. There is about a 10 to 15 percent error rate in every single one of those systems. I believe that the problem becomes pervasive as you start thinking about how we really trust and use data to coordinate and curate care.
To what extent are you aware that it causes patients to make different choices, such as leaving a doctor?
Lots of studies have been done and show that a patient is six times more likely to change providers now with a bad experience than they were before. Ninety percent of us have a primary care provider that we go to on an annual basis, and they basically are the first person we talk to. They navigate our care. They refer us to specialists. If you’re a millennial or younger, only about 25 percent of that generation is navigating their own care. When they have a bad experience, they’re not relying on a primary care physician. They’re curating and coordinating their own care. That’s one of the things that health systems are starting to really understand when they think about the impact of the customer experience. It’s not just about the bottom line or quality outcomes. It’s also about their ability to attract and retain patients throughout their lifetime.
In this digital era, is data not more centralized thanks to EHRs?
That’s right. Every health system is either acquiring or being acquired, or they’re doing joint ventures with others. There’s a major roll-up happening in the industry. The reality is that our customers are saying: We are not able to identify those people at each of those different touch points, because that data is fractured and sitting in silos.
Could you explain the concept of the system-wide master data management (MDM) and its impact?
What a system-wide master data management system does, is that it basically creates a single source of truth for identity. It’s propagating identity across all of those systems that are either consuming data or providing data about that person. By doing so, you can now synchronize all that data and unify it under one master record for that patient. Historically, we have done that for health systems or payers inside the walls of their organizations. Now we’re starting to move towards a broader customer base. It’s not just about mastering data inside a health system, but also enabling that across all of the products and customers, so that everybody has a better experience.
Could you discuss how you can enhance the experience and strengthen connections?
When you master data…you’re helping create a single source of truth for all of the data that a health system knows about you. We’re also automating that data with native enrichment that we provide, which helps fill out the picture about this person. This will enable you to start thinking about who’s at risk in relation to social determinants of health and health equity. We have all this data about a person, we can calculate whether or not they live in a food desert. Maybe you’re flagged for prediabetic. This might be an opportunity for that health system to proactively reach out to that patient and offer a food program that would help that person stay prediabetic and not move on to being a chronic diabetic.
This type of data helps us really curate the right experience and the right outreach for those social workers, so that they can identify the risks of that patient and proactively get in front of it in both the fee-for-service world and also a shared risk world, where we’re really trying to look out for and prevent that chronic situation from happening.
What is your advice for leaders in healthcare?
Think about all of the fragmented data we just talked about, and then think about one of the fundamental goals of AI, which is to use all the data in your enterprise to train your model so that you can generate good outcomes. We talked earlier about all that fragmented data impacting the customer experience, the patient experience, and the ability for hospitals to capture revenue. Now we started layering AI on top of that. You have an even exacerbated problem of being careful, to really rely and trust that data that you’re training your AI on, so that you can really use AI in a responsible way that’s going to deliver better outcomes for your customers.
We have an opportunity to get data right. Use this opportunity as you’re investing in AI to also invest in the data infrastructure that you need to really feed AI and have the high-fidelity data that you need to have good results from your AI strategies. I think the place to start there is oftentimes at the basic, fundamental, seminal foundation of identity.
Our recommendation to folks is to go back to the drawing board. Think about identity, get identity right, and then everything else that you do with your data when we build on a sound, solid foundation of identity.
Could you also speak about identity on the provider’s side?
Everything we talked about today, mostly was about the idea of getting the patient identity right. There’s a whole set of equal problems on the provider’s side. For example, from a cybersecurity perspective, one of the things you see happen too often is bad actors calling in to help desks and impersonating a doctor and getting their credentials reset. Now they’ve got the keys to the kingdom of being able to come in and plant ransomware. We’re seeing an opportunity for our customers, to be able to do identity proofing and use our solutions to identify that doctor when they call in, so they can have certainty and know that they are who they say they are, and therefore they can minimize that risk of a bad actor. That’s one really important workflow.
We’re working with health systems, to help them pre-populate their credentialing systems by being able to identify the doctor and then be able to use our data.