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Health IT End of Year Loose Ends

Posted on December 13, 2016 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manager doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst, a role he recently repeated for a Council member.

In that random scrap heap I refer to as my memory, I’ve compiled several items not worthy of a full post, but that keep nagging me for a mention. Here are the ones that’ve surfaced:

Patient Matching. Ideally, your doc should be able to pull your records from another system like pulling cash from an ATM. The hang up is doing patient matching, which is record sharing’s last mile problem. Patients don’t have a unique identifier, which means to make sure your records are really yours your doctor’s practice has to use several cumbersome workarounds.

The 21st Century Cures Act calls for GAO to study ONC’s approach to patient matching and determine if there’s a need for a standard set of data elements, etc. With luck, GAO will cut to the chase and address the need for a national patient ID.

fEMR. In 2014, I noted Team fEMR, which developed an open source EHR for medical teams working on short term – often crises — projects. I’m pleased to report the project and its leaders Sarah Diane Draugelis and Kevin Zurek are going strong and recently got a grant from the Pollination Project. Bravo.

What’s What. I live in DC, read the Washington Post daily etc., but if I want to know what’s up with HIT in Congress, etc., my first source is Politico’s Morning EHealth. Recommended.

Practice Fusion. Five years ago, I wrote a post that was my note to PF about why I couldn’t be one of their consultants anymore. Since then the post has garnered almost 30,000 hits and just keeps going. As pleased as I am at its longevity, I think it’s only fair to say that it’s pretty long in the tooth, so read it with that in mind.

Ancestry Health. A year ago September, I wrote about’s beta site Ancestry Health. It lets families document your parents, grandparents, etc., and your medical histories, which can be quite helpful. It also promised to use your family’s depersonalized data for medical research. As an example, I set up King Agamemnon family’s tree. The site is still in beta, which I assume means it’s not going anywhere. Too bad. It’s a thoughtful and useful idea. I also do enjoy getting their occasional “Dear Agamemnon” emails.

Jibo. I’d love to see an AI personal assistant for PCPs, etc., to bring up related information during exams, capture new data, make appointments and prepare scripts. One AI solution that looked promising was Jibo. The bad news is that it keeps missing its beta ship date. However, investors are closing in on $100 million. Stay tuned.


7% of Medical Records are Mismatched or Duplicates

Posted on January 15, 2016 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Patient Matching Problem

Anyone that’s worked in healthcare knows that patient matching is a major problem. It’s interesting to see that ONC has quantified the problem as 7 out of 100 medical records having issues. It’s not hard to see how this can, will and does lead to medical errors. Doctors need the right information at the right time. If they are missing information or have the wrong information, then it can lead to deadly consequences.

One challenge I have with this problem is that I’ve heard many suggest that the reason this is such a problem is that we don’t have a national patient identifier. Next week CHIME is going to announce the details of their $1 million National Patient ID Challenge. We should have Anne Zieger onsite to report on the event, but here’s the challenge:

Ensure 100% accuracy of every patient’s health info to reduce preventable medical errors and eliminate unnecessary hospital costs/resources.

While I applaud CHIME’s efforts to push the national patient id forward, the issue of patient matching won’t just be solved by having a national patient ID. We’ll see what the challenge produces, but the challenge is so complex that I don’t think anyone will be able to achieve 100% accuracy. While I don’t think we’ll ever be perfect when it comes to patient matching in healthcare, I do think we can do better. Maybe CHIME’s efforts will help inspire organizations to do better.

HIMSS Pushes For National Patient Identifier System

Posted on October 2, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Well, here’s some trade organization efforts that aren’t just a lot of smoke and mirrors and self-interest. Apparently, HIMSS is pushing Congress hard to establish a national patient identifier system usable for sharing digital records between facilities.

HIMSS execs estimate that as many as 14 percent of all medical records include wrong, potentially dangerous information due to patient misidentification, a problem which is likely to get worse as more systems transition data from paper to EMRs, according to a story in InformationWeek magazine.

As if that wasn’t bad enough, HIMSS says, when organizations begin to share data under Meaningful Use Stage 2, the problem is likely to get much worse. (And doesn’t a system that makes mismatches and lost data likely more or less completely defeat the purpose of setting up HIEs in the first place?)

In reality, a single patient identifier won’t do the job on its own. In fact, it could contribute to errors of its own, HIMSS notes, so adding biometrics and probabilistic matching records will be necessary to really get things right. But getting moving on the identifier is a start.

To get things standardized, HIMSS would like to see Congress request a report from the Government Accountability Office on the subject to help legislators better understand the issues. (They got so far as getting the House to file a resolution in support of the concept last year, but no further.)  HIMSS has since been working with other associations, think tanks, CMS and ONC to raise awareness of the issue.

To get what it wants, HIMSS will have to convince Congress to change existing law, reports InformationWeek. Since 1999, it’s been illegal to establish such an identifier, as Congress apparently felt the public would view it as a privacy risk.

Would National Patient Identifiers Work?

Posted on January 25, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Right now,  healthcare organizations have to go through some pretty tricky maneuvers to link patient data across varied systems and settings.  It’s possible to connect patient info electronically through database hacks, but more often than not, matching patients to clinical data gets done by hand.

Given the insane complexity of the existing system, would it make sense to create a national patient identification number for every U.S. patient?  The question is worth revisiting, given the immense level of error and wasted time generated by the existing system. After all, not only would putting an NPI in place make it easier to track patients within a hospital or health system, it would simplify the rollout of HIEs dramatically, wouldn’t it?

Dr. Robert Rowley of EMR vendor Practice Fusion notes that the biggest enemies of establishing a National Patient Identifier are privacy advocates who feel that an NPI would expose patients to greater risk of breaches or misuse of data.

But is that a realistic concern? Probably not. I agree with Dr. Rowley, who asserts that it’s hard to imagine that PHI would be at greater risk simply because of how it’s indexed.  As he notes, PHI breaches are nearly always often haphazard affairs in which a laptop is stolen than Big Government or corporate conspiracies. (If you’re afraid the government is covertly siphoning your health data off to study it, not having an NPI won’t protect you, anyway.)

No, the real barrier to this kind of administrative simplification measure is time, money and resources, the same barriers that hold back any other proposed HIT project.  It’s hard to imagine the resources that would be involved in instituting such a system — the idea makes my head hurt — and I have to assume it’d be several years before it was anything like mature.

Still, it’s good to bear in mind that at least some members of the public are afraid that creating an NPI would compromise their privacy. If the only barrier to improving patient matching in our EMRs is technical, that’s one thing — but if it’s patient fears, that’s another thing entirely. Sometimes, it’s good to remember that most of the world doesn’t think like a health IT exec.