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Customer Experience and Design

Master Patient Index: A Foundational Component to Excellence

An enterprise master patient index (EMPI) is the glue that holds together all things patient related. It provides the foundation for improved patient safety and outcomes, as well as a positive patient experience. The issue I’ve seen is that a lot of healthcare organizations don’t havea comprehensive, consistent, EMPI.

So why are organizations in this situation? There are a number of reasons, including:

Growth through Acquisition

Many healthcare organizations have grown through the mergers with, or acquisitions of, other healthcare facilities. However, in many cases, they haven’t fully integrated the clinical, administrative or operational transaction systems to a common platform. This often results in patients having different identifiers for different facilities of the same overall healthcare organization.

Silo’d Nature of Healthcare Organizations

I’m sure the following statement will cause some controversy. Many healthcare organizations are highly silo’d in nature and the silos often don’t collaborate well. Agreeing on a common, EMPI definition requires strong collaboration between all the major players across the organization. A strong governance function facilitates this, but most organizations don’t have such a group driving this type of enterprise view.

Best of Breed Application Strategy

Historically, a lot of healthcare organizations have purchased their core transaction systems taking a best of breed vs. an integrated platform approach. I’m not expressing an opinion that one approach is better than the other, but additional care needs to be taken to ensure system inter-operability when implementing applications from different vendors.

Lack of Priority or Resources to Implement an Enterprise Patient Identifier

In many cases, the implementation of an EMPI just hasn’t reached a higher enough priority level. Over the past several years, healthcare organizations havebeen under a number of competitive, regulatory and cost pressures that they perceive to require focus elsewhere. Ironically, an EMPI would benefit in each of these areas.

The impact of not having a common EMPI can be significant. As noted above, healthcare organizations are under pressure to reduce costs, attract patients and comply with new (and often ambiguous) government regulations. Not having an EMPI can make addressing these pressure much more complicated. The lack of an EMPI can potentially result in:

Reduced Patient Safety and Less Optimal Outcomes

Not having all the pertinent information on a patient (or even worse, having conflicting information) can result in inefficient treatment or even treatments that can result in negative consequences. Often patients are not in a position to fully inform the clinician of their medical backgrounds and the clinicians must rely on the information they have, which can be incomplete if all the patient information isn’t tied together.

Increases Administrative/Operational Costs

When patient information isn’t well integrated, it often takes significant time and effort to manually collect and organize the data into a usable form. This can result in significant cost for the resources to perform this activity.

Decreased Patient Satisfaction
When patients visit a healthcare facility, they are usually concerned with a specific health related issue that they are facing. Having to deal with providing personal information they have repeated given in the past or correcting information in the systems can be frustrating and stressful. The reduced patient satisfaction that can result may cause some patients to consider healthcare provider alternatives.

The good news is that most healthcare organizations have realized the criticality of having fully integrated patient information and the importance an EMPI plays in doing so. Some have either implemented an EMPI or are well on the way. However, there are still many that have not begun the journey or are stuck in the implementation. There are a number of things healthcare organizations can do to help ensure the success in implementing an EMPI:

Make Sure All the Key Players Are On-Board

The “E” in EMPI stands for Enterprise. While this might seem like a silly statement, organizations often still take a silo’d view when implementing an EMPI. Clinical, financial, administrative, operational and research groups all have a vested interest in ensuring the EMPI will meet their needs.

Consider Implementing a Governance Function

When you bring together the diverse groups necessary to implement an effective EMPI, there are going to be conflicting opinions. A governance function can provide the structure, direction and decision making authority to help breakthrough roadblocks that arise. Any governance function created needs to have representation for the all impacted parties.

Have a Strategy (a.k.a. Do the Necessary Upfront Planning and Analysis)

Implementing an EMPI is not a task for the faint of heart. Years of silo’d applications, conflicting opinions of how the EMPI should be defined and dealing with poor data quality can lead to frustration and failure. Trying to go directly into implementation without doing the proper due diligence will significantly increase costs and the chances for less optimal results. Fully understanding the current environment, having a clear vision of the end game and creating a realistic and pragmatic roadmap will make the journey much easier.

Take a Phased Approach

Implementing an EMPI is not an overnight activity. It can take significant time and resources to do properly. Issues will arise, business priorities will change, resources will be pulled in multiple directions. Short implementation cycles with clear goals and deliverables will allow for the flexibility to deal with the challenges that arise.

An EMPI offers substantial benefits. Having the right approach and framework in place is critical to success. It’s not an easy journey, but the payoff will justify the trip.

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