Program to increase transparency into the disparity of patient matching performance in technologies and implementations
May 2, 2019 – Verato®, the market-leading provider of cloud-based patient matching solutions, today announced a response to the Patient Matching RFI included in ONC’s proposed rule “21st Century Cures Act: Interoperability, Information Blocking, and ONC Health IT Certification Program.” Verato’s response recommends that ONC develop a new program to benchmark the performance of patient matching tools that are used throughout the healthcare industry. There is a wide disparity in how well different patient matching technologies work, but hospital systems, HIEs, and insurers who depend on them, have no way to assess those differences.
High quality patient data and health information sharing are entirely dependent on the quality of patient matching technology. Because our healthcare system is highly distributed, many enterprises must contribute data to the care of individual patients. Every participating enterprise must perform patient matching at consistently high levels or data will be missing or wrong. This situation is only going to get worse as the country scales toward nationwide-interoperability. With more organizations across geographies participating in health information sharing, patient match rates will degrade exponentially. Participants with poor patient matching capability will inject errors into the entire network, and these errors will compound, creating significant new risk to patient safety. Adverse impacts can include clinicians lacking access to the complete patient record or, worse, making care decisions based on data for the incorrect patient. As a result, patients may receive the wrong care or not receive the care needed. Poor and inconsistent patient matching also has serious implications on healthcare costs through duplicative testing and unnecessary treatments.
While there have recently been new studies and recommendations to improve patient matching by establishing and enforcing standardized data formats for addresses and last names, the potential impact of this recommendation is limited. Most high-performing, best-of-breed patient matching solutions already standardize and re-format demographic attributes to standard forms before matching (e.g. Boulevard would be converted to Blvd.) before matching algorithms are applied. So, the benefits cited with this approach are limited to health enterprises utilizing the most rudimentary patient matching technologies.
“It seems unconscionable that we do not have minimum standards for patient data integrity,” said Mark LaRow, CEO of Verato. “Patient safety is at stake. The government establishes safety standards in food processing, industrial operations, pharmaceuticals, and pollution. Patient matching should be treated the same way since patient safety is ultimately at stake. Ensuring that the patient matching tools offered by vendors meet minimum standards would be the first step. But a necessary second step would be to establish quality standards for patient matching at health enterprises too. We have seen that even the best patient matching technology can be implemented poorly at a health enterprise. To make our distributed health enterprise work, every participant must play their role in data integrity and must commit to doing it consistently well.”
In response to ONC’s RFI, Verato outlines a path for ONC and CMS to collaborate on building a common test data set of real patient identities with which to benchmark patient matching technologies. Then, the EHR Reporting Program could serve as a platform for certified health IT developers to test their products. This would be a first step in bringing transparency to the performance of various commercially available technologies. The results of this effort could be used by ONC to create baseline targets and associated timelines for improvement. Patient matching technology vendors who are not certified health IT developers–and therefore are not participants in the EHR Reporting Program–could voluntarily test their products.
However, benchmarking the vendor technology is just the first step toward improving nationwide patient matching. The essential next step is to ensure that real-world implementations of these technologies also meet consistent baseline levels. To achieve good matching performance, patient matching products must be highly tuned to accommodate unique characteristics of the patient population, data sources, and data collection methods—and this tuning is very complex. Healthcare organizations could be using a state-of-the-art matching product that exceeds ONC’s vendor baseline and still fail to achieve good matching results. In the letter, Verato recommends that ONC conduct a study to identity a feasible approach to testing real-world patient matching implementations.
“Without standards, measurement, and rules, this federated interoperable environment will never work well enough,” continues LaRow. “Basic patient safety and wellness are at stake. If ONC does not pick up this responsibility, then we ask, who will?”
Verato offers a cloud-based matching platform that links and matches identities across disparate databases or organizations with the highest accuracy rates in the industry. Verato leverages an extensive self-learning database of U.S. identities as a reference, or universal answer key. And because it is cloud-based, the Verato platform is less expensive, faster to implement, and more scalable than traditional matching technology. Verato is based in McLean, VA. For more information, visit https://verato.com.