Electronic Medical Records ≠ Accurate Data

As our healthcare systems race to implement Electronic Medical Records or EMRs, the amount of data that will be available and accessible for a single patient is about to explode.  “As genetic and genomic information becomes more readily available, we soon may have up to 1,000 health facts available for each particular patient,” notes Patrick Soon-Shiong, executive director of the UCLA Wireless Health Institute and executive chairman of Abraxis BioScience, Inc., a Los Angeles-based biotech firm dedicated to delivering therapeutics and technologies that treat cancer and other illnesses.  The challenge is clear: how can a healthcare organization manage the accuracy of 1,000 health facts?

As the volume of individual data elements expands to encompass 1,000 health facts per patient, there is an urgent need for electronic tools to manage the quality, timeliness and origination of those data.  One key example is simply making sure that each patient has a unique identifier with which to attach and connect the individual health facts.  This may seem like a mundane detail, but it is absolutely critical to uniquely identify and unambiguously associate each key health fact with the right patient, at the right time.  Whenever patients are admitted to a health system, they are typically assigned a unique medical record number that both clinicians and staff use to identify, track, and cross-reference their records.  Ideally, every patient receives a single, unique identifier.  Reality, however, tells a different story, because many patients wind up incorrectly possessing multiple medical record numbers,  while others wind up incorrectly sharing the same identifier.

These errors, known respectively as master person index (MPI) duplicates and overlays, can cause physicians and other caregivers to unknowingly make treatment decisions based on incomplete or inaccurate data, posing a serious risk to patient safety.  Thus, it is no wonder that improving the accuracy of patient identification repeatedly heads The Joint Commission’s national patient safety goals list on an annual basis.

Assembling an accurate, complete, longitudinal view of a patient’s record is comparable to assembling a giant jigsaw puzzle.  Pieces of that puzzle are scattered widely across the individual systems and points of patient contact within a complex web of hospitals, outpatient clinics, and physician offices.  Moreover, accurately linking them to their rightful owner requires the consolidation and correction of the aforementioned MPI errors.  To accomplish this task, every hospital nationwide must either implement an MPI solution directly, hire a third party to clean up “dirty” MPI and related data, or implement some other reliable and verifiable approach.  Otherwise, these fundamental uncertainties will continue to hamper the effective and efficient delivery of the core clinical services of the extended health system.

Unfortunately, this issue doesn’t simply require a one-time clean-up job for most healthcare systems.  The challenge of maintaining the data integrity of the MPI has just begun.  That’s because neither an identity resolution solution, nor an MPI software technology, nor a one-time clean-up will address the root causes of these MPI errors on their own.  In a great majority of cases, more fundamental issues underlie the MPI data issue, such as flawed registration procedures; inadequate or poorly trained staff; naming conventions that vary from one operational setting or culture to another; widespread use of nicknames; and even confusion caused by name changes due to marriages and divorces – or simple misspelling.

To address these challenges, institutions must combine both an MPI technology solution, which includes human intervention, and the reengineering of patient registration processes or other points of contact where patient demographics are captured or updated.  Unless these two elements are in place, providers’ ability to improve patient safety and quality of care will be impaired because the foundation underpinning the MPI will slowly deteriorate.

Another solution is the use of data profiling software tools.  These tools allow the identification of common patterns of data errors, including erroneous data entry, to focus and drive needed revisions or other improvements in business processes.  Effective data profiling tools can run automatically using business rules to focus on the exceptions of inaccurate data that need to be addressed.  As the number of individual health facts increases for each patient, the need for automating data accuracy will continue to grow, and the extended health system will need to address these issues.

When healthcare providers make critical patient care decisions, they need to have confidence in the accuracy and integrity of the electronic data.  Instead of a physician or nurse having to assemble and scan dozens of electronic patient records in order to catch a medication error or an overlooked allergy, these data profiling tools can scan thousands of records, apply business rules to identify the critical data inaccuracies, including missing or incomplete data elements, and notify the right people to take action to correct them.

The time has come in the age of computer-based medical records that electronic data accuracy is now a key element in patient safety; as critical as data completeness.  What better way to manage data accuracy than with smart electronic tools for data profiling?  Who knows?  The life you save or improve may be your own.

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