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Universal Patient Identifier Can Improve Care, Save Lives

By Karly Rowe, Vice President New Product Development and Identity Management, Experian

We’ve all heard in the news, and are certainly disheartened, about the opioid crisis. According to the Centers for Disease Control and Prevention (CDC), on average, 115 Americans die daily from an opiate overdose.

There are many solutions being discussed, rightly so, such as cutting back on prescriptions to patients and providing alternate pain management plans; as well as increasing the number of addiction programs. There is certainly a role on the clinical side to addressing the crisis. But we should also consider how using technology – specifically the power of data and analytics – can help. What if we armed medical professionals on the front lines with up-to-date information about their patients’ histories with narcotics and amount of prescriptions they have received most recently?

This can be accomplished through a universal patient identifier (UPI) – a concept that is not new. Unfortunately, it hasn’t been very “universal,” despite the many reasons it should be. One reason, in particular, makes a strong case.

Beyond the opioid crisis, drug overdoses in general are the leading cause of death among Americans under 50, according to the CDC. Prescription drugs are often the culprit as they are being prescribed to individuals from multiple providers without any way for medical professionals to cross-reference the patient’s past and current drug prescriptions.

Those who are leading the charge successfully

The concept has been embraced at the local levels. According to a University of Michigan study released this year, the prescription drug monitoring programs in Kentucky, New Mexico, Tennessee and New York have significantly reduced opioid prescriptions and the dosages of those prescriptions.

But while this has proved successful at the local level, patients very often move to a different state or city or need a specialization not offered by their current medical group, requiring them to start all over with a new doctor. However, using UPI technology, patient data—and supporting patient demographic data—can be used for the common good to improve patient safety, increase quality of care and reduce mistaken identity risks.

The creation of a UPI will allow the healthcare industry to facilitate accurate information exchange to stop problems before they start. For example, the National Council for Prescription Drug Programs (NCPDP) has already started using this vendor-neutral technology to establish a cost-effective solution for national patient safety. This technology can link patient data at scale efficiently and accurately to improve patient safety and care coordination.

There are many more clinical, administrative benefits

The benefits of a UPI extend across the entire healthcare system as well, as it improves the quality of patient identities, which can have duplicate, overlapping and incomplete records. Additionally, a UPI can help eliminate incorrect medical treatments; deliver current and accurate patient data; and prevent identity fraud, HIPAA breaches and incidental disclosures of protected health information (PHI).

As consolidation within healthcare continues, data management suffers and the interoperability issues become more evident; thus managing records becomes even more of a challenge. While organizations complete the conversion to electronic health records and increase information sharing through Health Information Exchanges (HIEs) and Integrated Delivery Networks, accuracy emerges as a primary concern, as overlapping and incomplete records become commonplace.

There is no doubt a UPI will lead to more informed clinical decision-making

A UPI prevents duplicate, overlapping and incomplete records from impacting continuity of care, delaying treatment, increasing the risk of medical errors, delaying billing and opening the door to fraud, all of which costs healthcare organizations millions of dollars each year. It is estimated that the average hospital has around 800,000 records, of which 8 to 12 percent are duplicates. With duplicates costing up to $50 per record pair to reconcile, this could add up costing the industry billions. UPIs could eliminate this issue.

It doesn’t stop there. UPIs benefit patients directly too. Consumer demand – and they are consumers – for access to their own health information could be satisfied, as they begin to compile health histories through apps from different health organizations, UPIs can help ensure the right person is connected with the right information. Gone would be the daunting task of assembling one’s healthcare history by relying on memory or spending an inordinate amount of time requesting records from individual providers through fax or mail and piecing together a history. Patients are demanding more ease, options and control over their care experience and providers need to start to view their patients as “customers” who can shop elsewhere, in order to improve satisfaction and maintain loyalty. This is a key step in embracing the consumerism environment that healthcare providers face today.

There is no doubt a UPI will lead to more informed clinical decision-making, allow open communication among providers, enable more integrated and coordinated care, enhance quality of care, and result in more prudent use of valuable healthcare resources. Ultimately, this approach would improve customers’ health and save lives – which we can all agree is benefit No. 1.


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