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ONC publication guides EHR use in patient identification

October 5, 2014

Patient and Doctor Consultation

In recent years, the federal government has been encouraging the adoption of electronic health records (EHRs) by health care workers across the U.S. Electronic communication facilitates the coordination of care among disparate clinicians who share the same patients. In addition to coordination of care, other benefits emerge from the use of EHRs. Errors such as those attributable to illegible writing are virtually eliminated. Digitized information on patients' diseases can easily be forwarded to public health registries for surveillance as well as for easy centralization and access to researchers.

However, the glut of information liberated from paper records into cyberspace raises several concerns about the security and privacy of patient data, as well as the accuracy and integrity of the data. In response, the Office of the National Coordinator (ONC) for Health Information Technology published several documents to help guide the adoption and use of EHRs by medical providers.

Technology configurations are not enough
The ONC published a series known as the SAFER Guides, which act as self-assessments for health care professionals who adopt EHRs. They cover topics such as the accuracy of patient identification, contingency planning, clinician communication, system configuration, system interfaces, test-results reporting, computerized provider order entry, organizational responsibilities and high-priority practices.

One SAFER Guide focuses specifically on the topic of patient identification.

"Processes related to patient identification are complex and require careful planning and attention to avoid errors," the introduction to the Patient Identification SAFER Guide reads. "In the EHR enabled health care environment, providers rely on technology to help support and manage these complex identification processes. Technology configurations alone cannot ensure accurate patient identification. Staff also must be supported with adequate training and reliable procedures."

Organizational leaders and staff members who conduct self-assessments with this guide can identify failures or shortcomings in the patient identification process while using EHRs. Altogether, the Patient Identification SAFER Guide contains fourteen individual worksheets and assessments that can be filled out by a multidisciplinary organizational team. Dimensions of EHR use that are addressed by these worksheets include utilization of an enterprise-wide master patient index (EMPI) as a common patient record number across systems, standardization of patient registration, verification of patient identity and regular monitoring for errors.

Each worksheet explains the rationale of the pertinent practice and provides hypothetical scenarios in which the practice would be useful.

EHR adoption rates continue to rise
According to Health IT Buzz, the official blog of the ONC, adoption of EHRs in the U.S. has increased significantly since 2008, when only 9 percent of hospitals were using this technology. As of February 2014, that rate had jumped to more than 80 percent. And as of February 2014, more than 50 percent of physicians' offices were able to demonstrate meaningful use of EHR technology.

Impact on research
With the adoption of EHRs, researchers now have the ability to tap into vast data stores in order to analyze patient data across populations of interest. The guidelines set out by the OHC for patient identification will help ensure that medical information is appropriately assigned to the right patient, yielding more accurate data and better research results. This benefit will likewise apply to research done using remnant biospecimens that are accompanied by large amounts of clinical data.