Comprehensive patient information is one of the top factors that impacts treatment for patients in government healthcare systems and programs. Incomplete and inaccurate profiles can lead to slow service, impede quality of care and waste resources.

Though promising, the appropriate adoption and success of electronic health records (EHRs) is yet to be realized in many government agencies, including the Veterans Health Administration (VHA) and the Centers for Medicare and Medicaid Service (CMS). With EHRs, interoperability issues and regulatory requirements can hinder record sharing from provider to provider and program to program, even within an agency. When it comes to healthcare, consistency and clarity are key to ensure the best patient treatment and outcomes. 

The understanding of a patient goes far beyond what an EHR can provide. Providers must think beyond current EHR solutions because they offer only a narrow, clinical view of each patient. Additional data – such as societal and social influences – collected from non-traditional sources should be incorporated to provide a complete picture of the patient.

More Effective Patient Matching Requires More Complete Patient Data

Today, some crucial treatment programs require trial and error.

Dr. Ron Kessler, McNeil Family Professor, Health Care Policy at Harvard Medical School, explained during a recent LexisNexis®️ Risk Solutions webinar, Transforming Government Healthcare: Non-Traditional Data as an Enabler, that no single post-traumatic stress disorder (PTSD) treatment is optimal for every patient. In fact, there are seven different classifications of PTSD and 20 different approved medications within the VHA system. 

Many PTSD patients drop out of the VHA’s care while still trying to identify the best treatment options despite the risk of severe ongoing problems. Dr. Kessler relayed that access to factors such as employment status and where a veteran lives may enable the VHA to more readily identify those most at risk for suicide so it can deliver faster intervention services. He added that pulling in outside data can build on what is already in the EHRs to help researchers see trends more accurately.

Matching Patient Data from Every Source

Patients need to be identified clearly and consistently to make use of non-traditional data that Dr. Kessler referred to in the PTSD example. The lack of standardization of patient information across health systems and programs is a major issue. It can be difficult to know that “Jane Smith,” “J. Smith,” and “Jane Margaret Smith” are the same person. The solution has multiple facets, including creating unique identifiers for each patient and a nationwide health information exchange that gives patients control of how and when their data is shared.

In the webinar, Mark Scrimshire, Entrepreneur-In-Residence for NewWave Telecoms and Technologies and CMS Blue Button Innovator, said that CMS’s Blue Button 2.0 can enable Medicare beneficiaries to give permission (or not) to connect their data to applications, services and research programs.

Providers tend to get data from other providers, Scrimshire explained, but BlueButton 2.0 supports a non-traditional source for data: the patients themselves. If patients are also connecting electronically to their health plan and then to another application, they have self-identified, matching their profiles in two data sets.

The Privacy Challenge and the Path Forward

Healthcare data is some of the most sensitive personal information that exists today. It is also one of the most sought after – and most frequently breached – data types.

Personally identifiable information (PII) must be kept private and secure and, according to Kessler, healthcare organizations are coming together to develop a trust framework and a code of conduct for consumer-mediated applications. Strict governance and compliance with HIPAA and other regulations are the baseline for protecting patient data.

A More Patient-centered Future

A comprehensive view of identities can help to improve the quality of care and services provided to public-assistance program beneficiaries and veterans. A consistent identifier can also help providers verify if patients are receiving benefits, under which programs the benefits are administered, and which services qualify for care. It can even spot stolen identities.   

With all of that in mind, how can government provider organizations begin to improve patient matching by linking records across systems and ensure they have the most up-to-date information on a patient as a person? Start by assessing current processes and data hygiene to improve the accuracy and completeness of the data already in-house. Next, launch pilot programs using trusted outside sources to build more complete profiles of patients and corroborate identities.  

Learn more about using non-traditional data for improved patient matching and better care. Click the link to view the webinar, Transforming Government Healthcare: Non-Traditional Data as an Enabler and read this white paper, Referential Matching Could Be the Answer to Better Patient and Member Identification.