The overriding theme in healthcare is data integration. 

Health information exchange, accountable care, interoperability and the merging healthcare industry are forming an environment where electronic patient data is being combined at a record pace.  With dreams of a national patient record database, initiatives are brought forth in hopes that we can improve care, decrease costs, and create a healthcare industry that is more accountable for care across the continuum.  I am more optimistic than most that this can become a reality.  I am downright gleeful to personally witness the increased rate at which we are sharing data to improve care, innovate, and conduct incredible medical research.  However, many of these organizations are using systems that simply make EMR data available to partners.  Sharing is not enough.  This data needs to be cleaned and duplicate records need to be combined in order to gain full advantage from this interconnected healthcare system.  Integrating this data correctly is vital to saving cost, administrative time, and mitigating errors in the delivery of care.  Silo’d patient data is dangerous.

One would think that it should be easy to combine patient records.  Type in a patient name, hit enter, and presto!  Right? 

It’s not that easy.  While each of us would love to think that a combination of the data points that make up our everyday lives make us unique, that is not always the case.  Names are the most commonly used unique identifier in everyday life.  However, just ask someone with the last name of “Smith Jones” if she feels safe having her records combined amongst all the other Smiths and Joneses out there (she doesn’t).  Also many Asian children do not receive a name until their 100th day.  How do we track those important 100 days of infant care?  How about the commonly used social security number?  Not everyone has one.  Every other piece of information in your life (e.g., address) is likely to change over time.  Every organization will have their own patient number for the same patient.  Even a concatenated key that combines several pieces of information will not do the trick since it is best practice to create a unique identifier that is specific to the database in question. 

The Master Patient Index

So what are healthcare organizations to do?  The answer can be found in a Master Patient Index (MPI).  MPI technology can be used to match and merge duplicate patient data to create a unique patient identifier for each patient and map the identifiers used across record systems.  By correctly matching these records, a full view of each patient becomes a reality.  Healthcare providers become empowered by this complete view.  Doctors can view historic data from a single patient from a trip into the emergency room all the way through to rehabilitative treatment.  There are many benefits to MPI systems.  They include: 

• Improving the quality of care for patients:  A cleaner view of patient data enables quality outcomes around selected disease states as well as specific geographic, ethnic and gender factors to better target and deliver specific healthcare education and associated services.
• Enable clinicians in their care processes:  Physicians will be able to see all healthcare-related services that have been provided, even if that physician was not the individual that delivered the care. In addition, physicians can review healthcare results including laboratory results and prescribed medications.
• Reduce costs associated with providing quality care:  While improving quality of care is the most important consideration, controlling and being aware of the cost of the care is just as important. By including costs in the exchange of clinical information, providers can begin to understand the correlation between the quality of care and the costs associated with that care across the continuum. 
• Promoting preventive medicine: Preventive medical services traditionally occur within a conglomerate of divergent clinical care settings.  Integrated data can drive disease-management programs to 1) promote preventive medicine services and 2) reduce the costs associated with these critical health care services overall. 
• Empowered emergency care: Emergency staff are enabled with information related to medical conditions, prescription medication, or other information they need in order to provide care quickly. 
• Time involved in recovering missing patient information:  Physicians treating a patient may not have recent test results, medical notes or observations from other physician specialists.  One physician is good; a community of physicians working together is better.