Tell us a little bit about yourself and NextGate.
NextGate is a leading EMPI provider for patient identification. We are a private company based in Monrovia, Calif. and our identity intelligence solutions are used in six countries across the globe. As co-founder and CTO, I’ve been committed to helping healthcare overcome the clinical, operational and financial challenges of patient identification for over twenty years. Today, more than 200 organizations worldwide have implemented our EMPI to integrate, cleanse, and de-duplicate medical records for improvements in cost, safety, and efficiency, as well as a better healthcare experience for providers and patients.
What has COVID-19 taught us about patient identification?
The COVID-19 pandemic has exposed the longstanding challenge of patient matching and identification. Lack of accurate or complete demographic data on COVID-19 patients hampers nearly every aspect of tracking and managing the virus, including testing, contact tracing and immunizations. For example, a coronavirus test missing the patient’s phone number perpetuates delays in communicating results, inhibiting the individual’s ability to self-isolate before potentially spreading the virus to others. Insufficient patient identification also limits healthcare stakeholders’ abilities to detect trends in the community and react accordingly. The ability to exchange and synchronize demographics across multiple systems and sites of care is a key element in supporting public health responsiveness at local, state and national levels.
Which is the most exciting thing in patient identification or EMPI that you see happening right now?
The ability to tie an individual’s digital identity to their legacy identifiers across the healthcare enterprise will be a game changer in terms of automation and accuracy. Rapid progress has been made in the last few years with decentralized identity standards and this will undoubtedly affect the healthcare industry just as it has affected other industries that are ahead in using this technology such as in finance. The Enterprise Master Patient, or Person, Index (EMPI) will play an important role as a bridge between legacy identifiers such as medical record numbers, and a patient’s digital ID.
What does a progressive identity management solution look like?
A progressive approach to identity management is to recognize that no EHR, or single application, should sit at the center of identity. Rather, all applications in the healthcare enterprise need to reference a single master repository and tie the local identifiers generated in the applications to the master. This requires what we call “active integration,” where the local applications query the EMPI during the registration process as opposed to relying on their individual silos to identify the patient. When this type of integration is implemented, it is far more likely that the patient will be correctly identified and that his or her demographics will be recorded accurately. It is not an easy path since each application must be pointed to actively query the EMPI, but once the integration is in place, it reduces the misidentification rate drastically.
Where are we at with using biometrics in identity management? What does the future look like for biometrics?
Biometrics as another matching field in the record comparison process presents serious privacy implications. Once a patient’s data has been associated with those biometrics, the impact of a breach is much higher, as well as the chances of the data being used in unintended ways (for example exposing healthcare data in a way that affects eligibility for employment or insurance). I believe that biometrics should be used to authenticate an individual into their smartphone and grant access to a digital wallet that would drive decentralized identity exchange.
What do you think of ONC’s efforts to create Project US, a unified specification for addresses in healthcare? What problems could this solve and what doesn’t it solve?
NextGate applauds ONC for recognizing the importance of address standardization as it pertains to patient matching. We integrated address verification and geocoding into our EMPI three years ago. This ensures address data is verified and standardized against such official mailing databases as the U.S. Postal Service (USPS), Royal Mail or Canada Post. How the Unified Specification for addresses in health care will differ from the USPS standards is something we will actively monitor.
What can the health IT community do to help you and NextGate?
Raising awareness over the importance of managing patient identity is key given the criticality of the problem and the fact that many organizations fail to appreciate the impact it has to the patient experience. In addition, a lack of adoption of standards has made things like active integration of systems needlessly difficult. This affects the ability of an EMPI to deliver its maximum value to an organization. Finally, the importance of safeguarding patient privacy cannot be overstated. Organizations continue to gather more and more sensitive information, but their ability to give patients control over the exchange of data between parties has not been keeping up. We believe this will only be solved through the adoption of decentralized identity standards.
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