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Needle in a haystack
president and chief clinical officer at Virtua Health, the
hospital’s parent organization.
With 3.4 million patients in Harris Health System’s database,
similar names and dates of birth pose a challenge when
After a review of the incident, “we realized that we did not
matching patients with their medical records.
have a process in place to safeguard against human error,”
Blaber said. “As an institution, we should have had a fail-
Percentage of times ...
safe, where we forced her to confirm that she had the right
... two or more patients shared the same last
patient—going through multiple means of identification.”
and first name
Virtua now uses four identifiers for all transplant pa-
7.3% or 249,213 patients
7.3% or 249,213 patients
tients—name, date of birth, last five digits of the Social
... five or more patients shared the same last
Security number and the match number from the United
and first name
Network for Organ Sharing—and there are multiple points
2.2% or 76,354 patients
100%
0%
at which a second staff member is required to confirm
... two or more patients shared the same last name,
those details.
first name and date of birth
“We knew this was not our best day,” Blaber said. “We 0% 2.2% or 76,354 patients 100%
2% or 69,807
knew we had to do better.” 0% 2% or 69,807 100%
The patient who should have received the transplant got
a kidney about a week later, according to the hospital. 2,488 Number of patients named
Maria Garcia
Same name Number of Maria Garcias sharing the same
A classic example of how data can be misleading came 231 date of birth
after a Houston-based health system reviewed its patient
population, and found it had 2,488 patients named Maria
Garcia, 231 of whom had the same date of birth.
If any of those Maria Garcias aren’t matched with their The House of Representatives in June 2019 voted to over-
correct record, a physician may not be fully informed of turn the ban. The Senate did not follow suit.
their medical history—a particular concern if, say, some- “For 20 years we’ve not been able to discuss” a national
one has “a disease or ailment that requires certain care,” patient identifier, said Julie Pursley, director of health infor-
said Jose Serna, senior manager for patient access manage- mation management practice excellence at the American
ment at the system, Harris Health System. Health Information Management Association. While most
It’s even more challenging to match patient records be- agree a national patient identifier wouldn’t be the ultimate
tween hospitals, where match rates can be as low as 50% solution, it could be a helpful piece of the puzzle.
to 60%. That’s a foundational challenge for interoperability, Many hospitals today have seen success rolling out new
noted Ben Moscovitch, the Pew Charitable Trusts’ project technologies and best practices to aid with patient match-
director for health information technology. If a hospital ing, such as biometrics, algorithms and staff training.
can’t identify a shared patient at a nearby facility, it won’t be
able to get their records. “Bottom line is that effective patient Need a hand?
matching is critical to achieving interoperability,” he said. At Harris Health System, Maria Garcia wasn’t the only
That makes seamless patient matching a particular problem. About 249,000 of the system’s patients shared a
point of concern as companies are rushing to develop first and last name with at least one other patient, accord-
vaccines, antibody tests and other methods to support ing to an analysis the system completed years ago—which
immunity to COVID-19. Generally, immunization regis- made patient matching a time-consuming task for registra-
tries have been plagued by many of the same matching tion staff, who manually searched for the correct record by
issues as the rest of the healthcare ecosystem. There could asking for a patient’s name and date of birth.
also be challenges integrating Harris Health, which treats a large immigrant popu-
COVID-19 or antibody tests into lation, also faces challenges since “a lot of our patients
THE TAKEAWAY medical records, as many pa- don’t have Social Security numbers,” a data element many
Inaccurate patient tients are visiting third-party healthcare organizations use to bolster matching rates,
identification labs or drive-through sites. said Amber Wingo, the system’s administrative director of
remains a To ease patient-matching patient access and revenue cycle systems. “Combined with
problem, leading struggles, some countries have the common names and the (other) commonalities, that
to duplicative issued a national patient identi- was one of our big issues,” she said.
medical costs and fication number. The U.S. is not Besides patient-care concerns, poor patient matching
denied claims, but one of them—Congress for de- has steep costs. Inaccurate patient identification accounts
hospitals have had cades has prohibited HHS from for roughly $1,950 in duplicative medical care costs per in-
success rolling out using funds to develop a unique patient and $1.5 million in denied claims per hospital each
new technologies
and best practices. patient identifier, citing issues re- year, according to a survey by Black Book Market Research.
lated to privacy and security. So to get around those challenges, Harris Health imple-
June 8, 2020 | Modern Healthcare 17