The COVID-19 crisis has exposed a painful number of deficiencies in our nation’s healthcare system, from shortages of protective personal equipment to insufficient emergency and intensive care capacity.
However, in the frantic rush to treat patients, a number of shortcomings in how patient demographic data is collected has weakened response efforts. While it’s difficult to think about prioritizing patient identification during a public health crisis, the collection of case information, and how it is preserved and managed, plays a crucial role in effectively meeting the data demands of pandemic preparedness and prevention.
In crisis situations such as the one our nation’s providers are experiencing, basic data elements needed to track and manage patients effectively are not being captured. Approximately 40 percent of patient demographic data has been missing from commercial laboratory test feeds for COVID-19, according to Janet Hamilton, MPH, Executive Director of the Council of State and Territorial Epidemiologists (CSTE). The lack of such demographics as phone numbers and addresses has resulted in significant care delays.
Furthermore, access to a patient’s full medical history during an emergency is dire when treating patients who have comorbidities or other serious prior medical conditions. A new study released by the Journal of the American Medical Association found that of the 5,700 patients hospitalized for the virus in 12 hospitals operated by Northwell Health in the New York metropolitan area, 57 percent also had hypertension, 34 percent had diabetes and 42 percent were obese. In all, 94 percent of the patients had a chronic health problem, while 88 percent had two or more such conditions. That kind of knowledge is important for front-line clinicians to know as they make emergency treatment decisions.
Lack of interoperability continues to make front-page news. A recent investigation by Nature, illustrates just how severe poor system interoperability is harming efforts to address the outbreak. While a number of laboratories have ramped up efforts to provide free widespread testing, many have been stalled due to fragmented and disparate electronic systems. According to the report, “even as testing backlogs mounted for hospitals in California, for example, clinics were turning away offers of testing from certified academic labs because they didn’t use compatible health record software, or didn’t have existing contracts with the hospital.” Bogged down by software integration and administrative issues for exchanging data and handling billing, several hospitals rejected free tests. Even when one of the labs was able to use its free COVID-19 testing in Berkeley to test the city workers and homeless individuals, data had to be entered manually because the city and the lab’s systems didn’t “align.”
The need for robust data governance and seamless information exchange demonstrates how unique patient identifiers could bring some degree of order. While calls for a universal patient identifier have fallen on deaf ears for over two decades, the challenges of responding to this pandemic will likely move the discussion to the forefront yet again.
While it’s clear that the nation needs to see improved tracking to identify hotspots, conduct contact tracing, track patterns in illness severity and recovery, and ensure that patients receive the most appropriate follow-up care, it’s exceedingly difficult to do without an accurate identity management system underpinning the continuum.
Some organizations using our patient identity management solutions are doing so to deal with the pandemic. For example, Alaska’s health information exchange has been working with NextGate to be able to disseminate reports of patients who have tested positive for COVID-19 who are leaving the state to go elsewhere in the U.S. In Nebraska, NEHII is using our EMPI as critical piece of their COVID-19 data dashboard to provide matching and cross reference services across the population.
It’s important for healthcare systems that identify gaps in their patient management processes address them as soon as possible, particularly if they intend to share information with public health, disease registries or other entities and deploy intelligent proven matching technologies to attempt to bridge the gaps as they exist in all current legacy systems to enable them to interoperate.
As an anticipated second wave hits, this data sharing capability will only grow in importance. Even post-pandemic, much is unknown about the long-term clinical effects of COVID-19, and it will be crucial to ensure patients remain connected to appropriate primary care or other healthcare resources for the long haul.
Information sharing between hospitals and primary care providers has been a long-standing problem, and strong patient identification protocols are necessary to serve as the connective tissue that binds diverse organizations’ efforts.
Many in the healthcare industry are coming to this realization, among many of the lessons learned from this crisis. The challenges posed by influxes of patients during a pandemic – for healthcare organizations, private sector companies and regulatory agencies – underscore the importance of ensuring patient identities are uniquely tied to those who are being treated for COVID-19.
This article was originally published on the NextGate Blog and is republished here with permission.