Walk into any doctor’s office, hospital, or pharmacy and the first question you are most likely asked is some version of, “What is your name and date of birth?”

This is because patient matching in the U.S. healthcare system is done based on the patient’s name and date of birth. The problem is that there are many people who have the same name and date of birth. The larger the geographical area, the more common the name, the more likely that there will be two or more matches on the same name and date of birth.

Failure to properly match patients to their medical records can lead to preventable medical errors that can do harm to the patient. Each day preventable medical errors in the U.S. account for 10,000 serious complications and 1,000 deaths costing the patients their health or their life. A Johns Hopkins study found that preventable medical errors are the third leading cause of death in the U.S. behind heart disease and cancer. This is in large part due to incomplete information and poorly coordinated care.

Complete medical information begins with patient identity and matching the patient’s identity to their medical records.

A study conducted by the Bipartisan Policy Center analyzed the population of Harris County, Texas, the county in which the city of Houston resides. They found the population of Harris County at the time was 3.4 million people of which:

•      -    249,213 people had the same first and last name,
•      -      69,807 pairs of people had the same name and date of birth,
•      -        2,488 people were named Maria Garcia, and
•      -           231 people named Maria Garcia with the same name and date of birth.

This means that when a physician's office, hospital, or pharmacy queries their patient database for a match on Maria Garcia they could get 231 or more matches returned.

What normally happens when a doctor’s office, hospital, or pharmacy finds a duplicate record? According to the American Health Information Management Association (AHIMA), an association of health information management professionals, “traditionally, patient matching has been done by health information management (HIM) professionals who manually review possible duplicate patients and manually update paper and electronic systems as needed.”

Imagine the person at check-in manually looking up the patient records for 231 people named Maria Garcia with the same date of birth and trying to figure out which Maria Garcia is checking in. What do they do next? They set up a new patient named Maria Garcia and the problem is compounded.

AHIMA defines duplicate medical records as two or more health records accounts assigned to a single unique patient at the same facility. According to AHIMA, the average duplication rate in a hospital’s EHR system is approximately 10% of all patients.

Many patients who have the same name and date of birth like Maria Garcia in the example have many duplicate records because finding the one Maria Garcia is just too time-consuming.

The example of Maria Garcia is for one county in one state. Now imagine the results of this same search across multiple states or the entire U.S. and getting back potentially hundreds of matches.

Proponents of the current matching system will argue they use probabilistic matching algorithms when they find a match, adding more data such as address, phone number, and so on.  The problem with this approach is that these items are not persistent over time. A person moves and their address changes, they change phone numbers, and/or the patient’s name can change over time as they get married and/or divorced.

The fact is that matching patients based on patient name and date of birth does not work.

A 2005 RAND Corporation Research Brief estimated the failure to have a unique identifier and reliance on probabilistic matching cost the healthcare system $77 billion annually.

Why don’t we just create a national patient identifier? Let’s start with politics: it's not funded. Congress passed a law in 1999 prohibiting the Department of Health and Human Services from spending funds to create a unique patient identifier. And, the healthcare power brokers don’t want a national patient identifier. Therefore, let’s end with anti-competitive behavior: competitors don’t want it.  

Conclusion

In conclusion, the issue of patient identity and matching within the U.S. healthcare system is a serious issue that should not be overlooked. The common practice of relying solely on a patient's name and date of birth for identification has proven to be a recipe for errors, duplicated records, and costly consequences. As we've seen in the case of Maria Garcia and countless others, the potential for confusion and the risks to patient safety are substantial. With preventable medical errors ranking as a significant cause of harm and even death, it's evident that change is urgently needed. While some may argue for more sophisticated algorithms or additional data points, the persistent problem lies in the absence of a federated patient identifier. As we navigate the complex terrain of healthcare, let's not lose sight of the critical need for a federated patient identification system that puts patient safety at the forefront.

About iShare Medical

iShare Medical is the trusted online communication platform for sending, receiving, and integrating medical records nationwide. 

By signing up for an iShareID Direct Address and iShare Medical Messaging Account you will be able to send and receive Direct Messages across organizational boundaries to patients, providers, payers, and devices via our nationwide network of 2.8 million healthcare providers. This helps you to improve care coordination, reduce costs, and save time.   Plus, the iShareID Direct Address and iShare Medical Messaging account include access to and a listing in the iShare Medical Directory of Direct Addresses.  Sign up today and start sharing medical records now.

Share Medical is EHNAC Accredited for Privacy and Security and a DirectTrust Accredited Trust Anchor Health Information Services Provider and has since the inception of the DirectTrust Accredited Trust Anchor bundle in 2015.

Sign up today for iShare Medical Messaging and start sharing medical records now.  Call us today at 816.249.2555 or email us at info@isharemedical.com.