Solving the patient identity problem with universal identifiers

Published: March 2, 2022 by Experian Health


Solving the patient identity problem and ensuring that each patient record is accurate and airtight is a top priority. Healthcare providers want to be 100% confident in answering “yes” to the following questions:

  • Is the patient who they say they are?
  • Is the right medication being administered to the right person?
  • Is the correct bill being sent to the patient’s current address?

By validating patient identities, providers can secure patient trust, deliver high-quality care, and avoid losing revenue to identity errors and fraud. Unfortunately, patient identity management is only becoming more complex. While telehealth and remote patient access are opening healthcare’s digital front door to meet changing consumer needs and expectations, a mountain of sensitive patient data is piling up.

This data is a gold mine for fraudsters who steal and sell patients’ personal information or use it to access services and prescriptions without paying. It’s distressing for patients and creates a major financial and administrative burden for healthcare staff.

A nationwide patient identification system may still be some way off. However, providers can optimize patient matching in their own health systems by working to reduce vulnerabilities and adopting cutting-edge interoperable patient matching technology.

Better patient matching means better patient care and protected profits

The human cost of incorrect, incomplete or outdated patient medical records is significant. Patients could be given the wrong medication or diagnostic procedures. Allergy information can be missed. Patient test results can be mislabeled or mixed up. In Experian Health’s State of Patient Access 2.0 survey, almost half of providers said inaccurate and incomplete patient data was an obstacle to proactive follow-up, which could cause gaps in care and avoidable complications – which are critical to value-based care compensation.

Duplicate and mismatched patient records also create massive inefficiencies that can threaten an organization’s financial health too. With telehealth claim lines climbing by 2817% between December 2019 and December 2020, reliably authenticating patient identities in both existing and new services will be critical to future financial performance.

Resolve, protect and enrich patient identities with universal identifiers

Having the right technology to resolve and secure a patient’s information when they log on to patient portals and telehealth systems is the first step. Automating patient enrollment with Experian Health’s PreciseID® ensures the patient is who they say they are. This solution utilizes best practices in identity-proofing, fraud management and device recognition.

But this system only works if the records being matched are accurate. A universal patient identifier provides a single, accurate, 360° view of each patient throughout their healthcare journey. An interoperable format allows systems to talk to each other and protects against duplicates, errors, inefficiencies and fraudulent activity.

Universal identifiers aren’t available nationwide yet, though there has been some encouraging movement. Congress is working to remove the ban on funding for such measures, while the Centers for Medicare and Medicaid Services are taking steps to promote data standardization. For health systems that want to maintain a golden record for each patient within the bounds of their own operations, Experian Health’s Universal Patient Identifier allows staff to connect, verify and protect patient information.

Choosing the right patient matching technology

Traditional matching technology relies on demographic data and uses deterministic or probabilistic methods to link records with identical identification information. However, relying on a single source of data means that previous errors are inherited by new versions of a patient’s record. Demographic data isn’t unique to individual patients, which can lead to mismatched records and create extra manual work to fix.

Experian Health uses referential matching technology to build a complete view of patients from reliable health, credit, and consumer data sources. The universal patient identifier connects disparate datasets and instantly updates the master index of patient records with new data points.

Referential matching can only ever be as good as the data that is being matched and Experian is a global leader in data accuracy, across numerous sources, and is continually updated.

Victoria Dames, VP of Product Management at Experian Health, says, “With Experian’s reference data, we’re able to create a longitudinal record of each individual and reconcile their data as they change names, addresses and see different providers. You need to know that it’s the same person, especially with the pandemic acting as a catalyst for digital technologies such as telehealth. It also helps organizations bring data together and ensure data integrity through mergers and acquisitions. Dealing with large volumes of data is a big hill to climb, but with the right technologies it can be that much faster.”

As telehealth and digital patient access services gain traction, solving the patient identity problem becomes increasingly urgent. Universal Identity Manager combines industry-leading consumer demographic information with the highest quality reference data and powerful unique patient identifiers to create a single view of each patient. With better patient identity management, providers can protect against errors and fraud, and reassure patients that their personal information is safe.

Find out more about Experian Health’s identity management solutions.

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