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Patient matching: Hospitals can save millions by improving it

Inaccurate claims and EHR data cost the healthcare system $6 billion annually.

Beth Jones Sanborn, Managing Editor

For hospitals struggling with tight operating margins, and let's face it that's many of them, improving patient record matching and identification accuracy could save as much as $1.5 million every year, according to new research from Black Book.

Black Book surveyed 1,392 health technology managers to identify gaps and challenges in patient identification processes from Q3 2017 to Q1 2018. Results showed that the cost of medical care due to duplicate records averaged $1950 per patient per inpatient stay and more than $800 per ED visit.

Respondents also estimated that 33 percent of all denied claims stemmed from inaccurate patient identification or information. That made a serious dent financially, costing the average hospital $1.5 million in 2017 and the US healthcare system more than $6 billion dollars annually, Black Book said.

"Despite the increases in record sharing among providers, increased risk and cost from redundant medical tests and procedures because of fragmented data trapped in siloes makes tracking patients especially difficult," said Doug Brown, managing partner of Black Book Research.

The poll revealed that before implementing and administering an EMPI tool, roughly 18 percent of an organization's patient records were duplicates. However, hospitals with EMPI support tools in place since 2016 reported consistently accurate patient identification, with an average 93 percent of registrations and 85 percent of externally shared records among non-networked providers. Hospitals without the tools had match rates of just 24 percent when organizations exchanged records.

"Ultimately, the real challenge of identity management and parsing together a longitudinal health record has to do with integration and interoperability," said Brown. "Many systems still do not communicate and store data in disjointed architectures and an upsurge of identifiers continue to be created."

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com