Why Your EMPI Needs Address Verification Technology

By Daniel Cidon, CTO of NextGate
Twitter: @NextGate
Twitter: @dcidon
At HIMSS20: Visit NextGate in booth #3128 in Orlando FL

Discussion around unique patient identifiers took center stage during the 2020 ONC annual meeting in Washington D.C. recently. Consensus among panelists, which included a diverse range of industry stakeholders, was that while a national patient identifier would undoubtedly be beneficial in reducing medical errors, it’s “not a panacea,” for solving America’s patient matching crisis.

According to the ECRI Institute, errors occur at every point in the care process, from registration and order entry to diagnostics and surgery. Across the care continuum, these types of mistakes can lead to “never events” for patients: serious, costly, or even deadly occurrences such as wrong-site surgeries, major medication administration errors, and incorrect diagnoses.

Unfortunately, the federal government’s ban on national patient identifiers remains intact. Therefore, we must continue to build upon proven processes and tools, while carefully considering other innovations that can help advance patient identification efforts.

One innovation that is making headway is address intelligence. Address intelligence refers to the validation and standardization of a mailing address according to postal standards such as the U.S Postal Service (USPS). NextGate began utilizing this technology as part of our flagship EMPI platform two years ago, which has helped us to deliver an even higher degree of patient data and matching accuracy to our customers. As we look to construct a Single Best Record across the enterprise, address intelligence allows us to improve the quality of our matching.

In short, the technology ensures the correct address is entered and consistently formatted to help healthcare organizations proactively manage, detect and eliminate data quality issues. This means addresses are always accurate, standardized, and up to date for a trusted, reliable patient record. With the right address format, providers can be sure they are not unnecessarily creating duplicate patient records. In fact, a study published in the May 2019 issue of the Journal of the American Medical Informatics Association (JAMIA) found that standardizing patient addresses using the USPS format in EHRs improved match rates by up to 3 percent.

Standardization of the address corrects spelling errors, adjusts abbreviations, adds missing information (such as zip code or suffix), and resolves appropriate capitalization so that the address is converted to the appropriate format. To combat fraud, the technology can even verify if USPS in fact delivers mail to a particular address. Additionally, it can geocode any address location.

Geocoding of the address refers to the geographical latitude and longitude coordinate that is automatically generated during the data enhancement process. It can even identify locations nearest to a latitude and longitude coordinate, called reverse geocoding, to perform location-based services. This could significantly benefit providers and patients in cases of in-network physician searches and referrals. Using location as key variable can help to identify providers in the patient’s neighborhood with the requisite knowledge, skills, experience to address their condition.

Using address data to tackle SDOH
As an individual’s precise location becomes more important in helping organizations tackle social determinants of health (SDOH), address intelligence can be useful for identifying populations at risk for disease, natural disaster, poverty, or poor water purity. Operational efficiencies including a reduction in claim denials, lower administrative burdens and improved patient communication and outreach (mail gets to the correct address) can also benefit from this technology.

For providers looking to enhance the integrity of their analytic projects with “where,” address intelligence adds a new dimension to EMPI capabilities. Insight into a patient’s location can determine the geographical and social risk factors of a population, aid care interventions, and identify access to healthcare facilities.

I invite you to learn more about how address intelligence can make an impact on your organization by downloading our new white paper.

This article was originally published on the NextGate Blog and is republished here with permission.