Mastering Data Management

More in Healthcare

• Response: A Universal Identifier Isn’t a Silver Bullet
• Transforming Healthcare through Analytics
• Getting Your Healthcare House in Order in 2012
• 3 Best Practices in Identity Management

More from Penny Schlyer

• Is Protecting Patient Privacy a Thing of the Past?
• Sharing eHealth Lessons Across Borders
• Accurate Identification: A Universal Requirement for eHealth!
• Ditch the Clipboard: Strategies for HIE Success

Share this Post

Recent Comments

• Lorraine Fernandes on Response: A Universal Identifier Isn’t a Silver Bullet
• Henrik Liliendahl Sørensen on Response: A Universal Identifier Isn’t a Silver Bullet
• Response: A Universal Identifier Isn’t a Silver Bullet | Mastering Data Management on 3 Best Practices in Identity Management

With all the discussion around “meaningful use” and ARRA funding, there are multiple, competing definitions. As it applies to an electronic health record (EHR), though, “meaningful use” is usually characterized in several different ways including:

1) The capabilities of the EHR itself – Access to information, e-Prescribing, information exchange.
2) The number of users – Wide spread use is required for a meaningful amount of information sharing to take place.
3) The quality of data – Information is degraded if records are incomplete or not matched properly. This impacts quality of care and user adoption.

For the purpose of this post, I will focus on the quality of data since it impacts the effectiveness of the EHR itself and impacts user adoption, but doesn’t get a lot of time and attention in the news.

Regardless of the capabilities of the EHR, the EHR alone is not interoperable and cannot deliver meaningful results. An interoperability infrastructure with a patient registry is required to facilitate information exchange and accurately link patient records across disparate systems and organizations.

A patient registry integrates patient information from different sources and in different formats to create a view of all available patient records and their location. The EHR and other clinical applications leverage this registry to access and share records across organizations. This technology enables coordinated care and improved quality by providing the clinician with information at the point of care regardless of where the patient presents, ie; meaningful use.

User adoption of the EHR increases as the quality and quantity of information available about a patient increases. Accurately linking records across systems and presenting a comprehensive view increases the value of the EHR to the user and patient, which is critical to achieve meaningful use.

A patient registry has been part of the National Health Information Network (NHIN) architecture since its inception. It is part of the current recommended CONNECT architecture and is in use in hundreds of HIEs and IDNs, and for good reason. Although not directly stated in the requirements, it is logical to assert that if you can’t accurately connect records across systems to deliver a comprehensive view of the patient and all available information, the value of EHR is meaningless and could trigger some significant privacy and liability issues.

Consider the preliminary recommendations for “meaningful use” and the impact of accurate patient identification:
• Improve Quality, Safety and Efficiency: Reporting on quality will require timely and accurate aggregation of patient data across systems
• Engage Patients and Families: Providing patients with electronic access to medical records requires the ability to accurately identify the right patient and link all records about a patient correctly
• Improve Care Coordination: Exchanging key clinical data across providers requires the ability to accurately link records across disparate systems to create a comprehensive view for the EHR, portal or EMR
• Improve Population and Public Health: Reporting chronic illnesses and immunization status requires the ability to accurately identify patients over time and across many geographically dispersed systems
• Ensure Privacy and Security Protections: Allowing users to access medical records requires strict security and access controls and an ability to accurately identify the patient to protect patient privacy

Data quality is imperative to meaningful use of an EHR. With poor quality data that has incorrect or insufficient information, patient care can suffer. Adoption can be hampered if users believe that the data is unreliable or incomplete. Hence, ensuring data quality should be one of the first steps you take towards attaining meaningful use.