GAO Issues Long-Awaited Report on Patient Matching

Original story posted on: January 21, 2019

The report cites the need for more work by providers.

The Government Accountability Office (GAO) report on patient matching dropped last Wednesday. The industry had been waiting for the report since the 2016 passage of the 21st Century Cures Act, which included a provision for the GAO to report on the Office of the National Coordinator’s (ONC’s) patient record matching policies and related activities. 

The report concluded that more work is needed to ensure that patient health records are consistently and accurately matched. The GAO interviewed a total of 37 stakeholders, including ONC officials, provider and industry associations, representatives from physician practices, hospitals, health systems, health information exchanges (HIEs), and information technology vendors. 

The interviewed parties reported the following challenges:

  • Inaccurate, incomplete, or inconsistently formatted demographic information (i.e. patient first name, last name, middle name, date of birth, address, cell phone contact, etc.)
  • Patients’ records don’t always contain correct information, and health information technology systems and providers use different formats for key information such as names that contain hyphens.

These findings are very well-known to those who manage the master patient index in their healthcare facilities. Most health information management (HIM) professionals struggle daily with the management and resolution of these data discrepancies.

Stakeholders relayed that more could be done to improve patient matching, identifying several suggestions:

  • Establishing common standards for demographic data
  • Developing a data set to test the accuracy of matching methods
  • Sharing best practices and other resources
  • Implementing a national unique patient identifier
  • Developing a public-private collaboration effort
  • Instituting an ONC requirement of demographic data standards as part of the electronic health record (EHR) certification process; others suggested ONC facilitate the voluntary adoption of such standards

Finally, the report noted that many stakeholders emphasized that no single effort would solve the challenge of patient matching. This is an important finding since patient matching is not a one-and-done, technology-only solution. The people, processes, and technology approach used by many healthcare organizations incorporates staff education and training, daily maintenance of the master patient index by a data integrity team, and ensuring that the technology used to sometimes auto-match records are monitored for quality.

The healthcare industry has long recognized the need for accurate patient matching. As our systems become larger through mergers and acquisitions, technology disruption, and ingesting data from multiple sources, the patient’s demographic data will grow in complexity without data standards.

Program Note:

Listen to Julie Dooling report this story today on Talk Ten Tuesday, 10 a.m. Eastern. 

Comment on this article

Julie A. Dooling, MSHI, RHIA, CHDA, FAHIMA

Julie A. Dooling, MSHI, RHIA, CHDA, FAHIMA, is a director of HIM Practice Excellent for AHIMA.

Latest from Julie A. Dooling, MSHI, RHIA, CHDA, FAHIMA

Related Stories

  • Song of a Story-Teller: Patient-Focused Coding
    Have we lost the art of telling the patient's story? Coming off of two weeks of health information management (HIM) conferences and listening to presentations on incorrectly reporting combination codes and the importance of coded data for quality and data…
  • Are HIM Coding Professionals Qualified to Query for Clinical Validity? Part III
    Progress has been noted on this issue since first reported last July by ICD10monitor. Since the last Talk Ten Tuesday’s segment in August 2018 about whether HIM Coding Professionals are qualified to query for clinical validity, I am happy to…
  • The Role of HIM Professionals in the Revenue Cycle Part V
    How to enhance edits to achieve clean claims. The effective use of edits within a healthcare organization’s billing system may permit such organizations to not only identify documentation, billing, and coding issues to address, but also facilitate achieving an improved…