Patient-matching standards must be improved, government report shows

Providers, vendors and others continue to struggle to accurately match patients to their health information, and they blame incomplete and inaccurate patient data, according to the Government Accountability Office.

Patients' safety could be at risk if both the data and matching strategies aren't improved, the companies told the GAO, and they suggested adopting standards so demographic data are recorded and stored the same way every time.

"GAO's report shows that better patient record matching across providers will improve patient care," Sen. Elizabeth Warren (D-Mass.) said in a statement. Warren and several other senators wrote the provision in the 21st Century Cures Act that mandated the GAO report, "Approaches and Challenges to Electronically Matching Patients' Records Across Providers."

Sometimes, hospitals work with other organizations in the same region, where patient overlap may be more common. In Texas, 23 providers established standards for recording patient names and other information, which improved automatic matching.

Some providers and vendors interviewed by the GAO called on the Office of the National Coordinator for Health Information Technology to issue standards for data collection and formatting, while others thought that sort of standard-setting should be left to industry organizations. Either way, those interviewed generally agreed that standards would make automatic matching easier.

Automatic matching can cut down on the need for manual review, which providers use to match patients to their records. Providers also told the GAO they use digital tools—such as those that algorithmically process demographic data—for automatic matching.

Some providers are turning to patient-centered approaches in which the patient is the agent of interoperability, thereby taking the burden of matching away from providers. Patients might use smartphone apps to share their data with providers. This was one of the solutions Pew Charitable Trusts proposed in October 2018. It's also the notion behind Apple's Health app, which lets iPhone users download their health records from participating organizations.

Another patient-centered approach could be a national patient ID system. While some interviewed by the GAO were in favor of such a system, saying it would be the best approach, others were more skeptical, saying that development of such a system is unlikely. That's due in large part to the ban on spending federal funds for developing a national patient ID.

Because patient-centered patient-matching approaches—whether through an app or a national ID—aren't yet the norm, the burden of patient-matching still largely falls on providers and vendors. To facilitate better matching, stakeholders told the GAO that organizations should share best practices with each other. The ONC might also disseminate best practices.