Contexture HIE Partners with Verato to Support Patient Matching 

Contexture, a health information exchange (HIE) for Arizona and Colorado, is integrating Verato's healthcare master data management (hMDM) solution to aid in patient matching across its network of 28 million patients. 

“The ability to track patient identities and understand who patients are across services and geographies is an essential component of a successful HIE,” Deanna Towne, chief information officer of contexture,” said in a press release. 

Specifically, the HIE plans to leverage Verato's Referential Matching, a technology that aims to automate and simplify data management. The tool draws upon a database containing over 300 million identity records and three decades of historical data. By being the first point of contact for incoming data, it is expected to reduce data duplication and enhance overall data quality. 

“Better healthcare data integrity supports better decisions at both the individual patient level and the broader community level,” said Clay Ritchey, CEO of Verato.  

Patient matching, a process crucial to patient safety and care quality, is the linchpin of healthcare interoperability, yet it presents a significant challenge in the US. This process, which ties together a patient's data across multiple health systems, often stumbles on discrepancies. 

In fact, one in five patient records within the same healthcare system are duplicates, and a staggering 50 percent of records are mismatched during transfers. From data entry errors to poor technology to unforeseen issues such as individuals moving or divorcing, there are many factors that lead to poor patient matching. 

It's been found that such misidentifications, leading to mismatched or incorrect patient records, are responsible for about 33 percent of payer-rejected medical claims. According to a 2018 Black Book survey, duplicate patient EHRs cost hospitals an average of $1,950 per patient. In 2017, claim denials due to these issues cost the average hospital $1.5 million. 

Beyond the financial burden, patient misidentification significantly affects patient outcomes, which can lead to grave safety issues. 

John Lee, MD, CMIO of Allegheny Health Network, noted that he gave a patient the inappropriate antibiotic because the allergy information attributed to the patient was actually from a patient with a similar name. 

"I also know of a patient who couldn't get their COVID vaccine because, according to records, that patient had already received a COVID vaccine because their record had been overlaid with another patient's record," Lee, said at a Patient ID Now Coalition press briefing. "That sort of thing happens at scale on a repeated basis throughout our healthcare system." 

Such systemic errors occur repeatedly across the healthcare sector, sparking concerns among healthcare executives and federal agencies. This has stirred interest in solutions to address patient matching deficiencies, one of them being the concept of a National Patient Identifier (NPI). This controversial yet frequently sough after idea involves assigning each American citizen a unique number. This number would be used across the healthcare system, greatly reducing the chance of overlapping patient health records when individuals share the same name or birthdate.