Online Extra: VA enhances patient identity matching

Dirty and fragmented data can make health care inefficient and lead to errors when multiple health records exist for a patient because of slight differences in a name or incomplete identifying information.

The Veterans Affairs Department has hired Initiate Systems Inc. of Chicago to eliminate duplicate records and improve the matching of all the right records with the right person in the Veterans Health Administration's Master Person Index system. The index system, which has 12 million entries, provides patient identity services across VHA by linking patient information residing in different systems throughout its medical facilities.

Initiate is using matching algorithms to identify and link records among VA's 1,300 clinics and hospitals, or even separate records within a single hospital, that refer to the same veteran, said Scott Schumacher, Initiate chief scientist. Initiate's contract with VHA is worth about $2.3 million for up to four years.

An algorithmic process follows a list of rules to determine whether data is the same or not to make a decision. For two name fields from different systems, format and content variations may exist in the way people report their name.

'When you're looking at two names that have been recorded differently, you're trying to decide if they're similar or not,' he said.

Some patients have more than one record because veterans may be treated in more than one hospital, be active military moving from the Defense Department to VA coverage, or registered for care under slightly different names, such as one with a middle initial and one without.

'If one of their veterans receives treatment in two different hospitals, and they don't catch that, there's a chance for conflicting treatment that has a health impact,' Schumacher said.

Initiate will apply scientific statistical probability to determine matches as part of its Identity Hub software to determine whether multiple records belong to the same person. Initiate will create a link that says two records belong to the same veteran and then provide application program interfaces to allow hospitals to use that information. Initiate will also provide a search capability of the database.

'We believe this is essential to improving matching and resolution capabilities to ensure the continued availability of the patient's electronic health record, providing care at the right time to the right patient,' said Elizabeth Franchi, data quality coordinator in VHA's Office of Health Data and Informatics.

Initiate's algorithm considers demographic attributes, such as name, date of birth, address, phone number, to compare records of persons. When the comparisons indicate a high statistical likelihood that the records are related, the algorithm'based on thresholds established by the business line'makes a match between two records, Franchi said.

VHA currently uses a deterministic algorithm, which is based on exact matching for identity and demographic data.

'Many opportunities are missed that have to be 'touched' by a person to make a match after the deterministic algorithm missed it,' she said.

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