Patient-matching issues cost hospitals $1.5M a year

A physician's stethoscope
Patient matching issues are a $6 billion annual strain on the healthcare industry. (Getty/millionsjoker)

Improving patient record-matching could save the healthcare industry billions of dollars each year.

Approximately 33% of all denied claims are associated with inaccurate patient identification, which costs the average hospital $1.5 million and the U.S. healthcare system over $6 billion annually, according to a survey from Black Book Research. 

Even more specifically, inaccurate patient identification or information leads to an extra $2,000 per patient per inpatient stay and an extra $800 per emergency department visit, according to the survey. 

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The poll of 1,392 health technology managers shows that before implementing an enterprise master patient index (EMPI) tool to keep track of patient identity, duplicate records accounted for 18% of a hospital’s patient records. On average, hospitals that had EMPI tools in place correctly identified patients with 93% of registrations and 85% for records shared with non-networked providers.

RELATED: Health informatics leaders say it’s time for Congress to lift its ban on a unique patient identifier

Meanwhile, the match rate for hospitals without EMPI tools was just 24% when organizations exchanged records.

“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,” Doug Brown, managing partner of Black Book, said in a statement.

RELATED: As data exchange matures, leaders find ways to use it to their advantage

Incorrect or missing information about a patient and their treatment can lead to deadly mistakes. That’s why the ECRI Institute listed patient identification errors among the top 10 patient safety dangers in 2017. To avoid such mistakes, the ECRI recommends that healthcare providers standardize electronic identification tools and wristbands or utilize barcode systems.

As hospitals deal with hundreds of thousands, and sometimes millions, of electronic patient records, a combination of technology and outside data sources such as credit bureaus or loan servicing organizations could also help improve patient identification.

Late last year, the Office of the National Coordinator for Health IT launched a new patient demographic tool aimed at helping providers match records. And a bipartisan group of senators has asked the Government Accountability Office to expand a planned study on patient matching. 

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