All about patient IDs

March 30, 2017
Nick John Head of Compliance and Risk Management

Sometimes when talking to people, the engineer in me wants to blurt out “just get to the point.”

That’s what this blog is about—getting past the details and minutiae of healthcare integration and focusing on the important stuff that makes these projects both possible and successful.

So, what really matters when it comes to integration? Well, before any of the “meat” of integration can take place—before you can exchange orders, file notes, or pull CCDs—you have to get in sync with the EHR. To do this, you have to lay some fundamental groundwork comprised of one essential data element: patient identifiers.

The power of the patient identifier

To push any data into an EHR, you must know the patient ID; to query for a chart summary, you must know the patient ID; to make an appointment or post a result or add a charge to a patient account, you must know the patient ID.

Until a universal patient identifier is adopted, we must deal with the fact that each health system uses its own identifier for patients. In fact, some health systems use many more than that:

All this being said, here’s some practical advice for app developers: code your system with the assumption that there will be just one patient ID for you to work with. When you begin integrating with a new health system, always have the discussion early regarding whether this assumption is true, and work from there.

Learning the patient ID

As we’ve established, before you can send any data into a health system, you must know the patient ID. Depending on your workflow, there are a few different ways to get your hands on it:


Patient Management and Merging Duplicates

In 2013, a survey of hospitals found the rate of duplicate patient records to be between 8% and 12%. Health systems work hard to ensure their patient database is as clean as possible because not only does this give patients the best chance of their doctors having access to their full patient record when delivering care, but it’s required in Meaningful Use. To do this, health systems run tools that analyze their master person index (MPI) and identify potential duplicates. They then review the list of duplicates and perform chart merges for each confirmed duplicate in their system.

When merges happen, downstream systems need to begin using the new patient identifier to ensure your data is filed to the correct place in the EHR. Merges are communicated on the Patient Admin data model with the event type of “Patient Merge”.

We hope this gives you a clear rundown of what patient IDs are, how to obtain them, and how they are the fundamental building blocks that truly power integration. If you have any questions, feel free to reach out!

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