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Just Associates, Inc., a nationally recognized leader in patient matching and health information data integrity, is an official exhibitor at the AHIMA20 Virtual Conference. To learn more about Just Associates, its MPI data analysis and clean-up services, or arrange a meeting with representatives during AHIMA20, please contact Robin Gates, RHIA, vice president, sales.

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By Karen Proffitt, MHIIM, RHIA, CHP, and Rachel Podczervinski, MS, RHIA


From COVID-19 mitigation to legislative moves in support of a national unique patient identifier (UPI) and data standardization, patient matching has been front and center throughout 2020. And rightfully so. A recent study found that 18 percent of patient records are duplicates—up significantly from a decade ago when AHIMA put the rate at 8 percent to 12 percent and a long way off the 1 percent the association has established as the recommended maximum.

As a result, approximately one in five records are incomplete. This includes an estimated 40 percent of demographic data missing from commercial laboratory test feeds for COVID-19, which can lead to delayed, excessive, or unnecessary care and hamper efforts to gain control over the pandemic.

A Long-Term Problem

While critical to eradicating the duplicate problem, a standardized national approach to patient identification is a long way off. Thus, the ongoing lack of data standards and naming conventions will continue to negatively impact duplicate rates. Indeed, an internal examination of just five reconciliation projects completed by Just Associates found a rate of discrepancy in data captured in the middle name field of 45 percent for confirmed duplicate pairs and in the Social Security Number (SSN) field of 64 percent.

While some problems are created by system limitations, the root of the problem can typically be traced back to policies and procedures. Those include inconsistent capitalization and naming conventions, failure to capture all 10 SSN digits, if and how the year of birth is captured, and appropriate capture of sexual orientation and gender identity information. There are also often inconsistencies in how street abbreviations and apartment numbers are captured and how alias names are managed.

Immediate Solutions

There is no magic bullet that can fix everything that ails the patient matching process, but there are things healthcare organizations can be doing now to chip away at duplicate rates. The first is to gain a clear understanding of just how serious the problem is by conducting a cleanup of the master patient index (MPI) to deal with any duplicates, overlays, and shell records lurking in the system.

An audit of standards should also be conducted in conjunction with patient access to determine what policies are in place to ensure the MPI remains clean. Employees must also be trained on the standards and ongoing quality assurance conducted to identify problem areas and intervene with education and training when necessary.

The next action an organization can take to reduce duplicate rates is to leverage existing tools to help standardize data as much as possible in lieu of national guidelines. These include the United States Postal Service (USPS) address formatting tool, the focus of the bipartisan Patient Matching Improvement Act of 2020 to ensure healthcare organizations can access the tool to improve record linkages.

Doing so will correct and standardize address formats, so when a patient matching algorithm analyzes those fields it looks the same across all health data systems, including those in hospitals and labs. In fact, a 2019 study found that standardizing address fields is independently associated with improved matching sensitivities for public health (0.6 percent) and HIE (4.5 percent) datasets and can increase matching by up to 3 percent, which equates to tens of thousands of correct matches.

Work Remains

While use of the USPS tools can help address inadequate patient matching, it unfortunately is not enough to fully resolve what has become one of healthcare’s most intractable problems. That is because it cannot address the plethora of other issues that contribute to the nation’s dismal match rate.

For example, technology cannot fix human errors such as transposed numbers, misspelled names, and blank demographic fields—all of which contribute significantly to the current state of mismatched patient records. An internal analysis of 25 million patient records from 18 different Just Associates client MPIs found that, on average, 10 percent of all address fields were blank or contained invalid or default data elements.

This does not mean USPS tools and other technologies are not impactful; even a 3 percent improvement in duplication rates moves us in the right direction toward accuracy and patient safety. However, truly moving the needle on eliminating duplicate and incomplete patient records requires a multifaceted solution that brings together USPS tools, third-party data, expert analysis and intervention, and industry-wide standardization.

When hospitals arm themselves with all the resources available today, the 1 percent duplication rate becomes far more realistic, far faster, than sitting on the sidelines and waiting for a national solution.

Register for AHIMA20

The AHIMA20 Virtual Conference is the premier educational, exhibition, and networking event for health information professionals. Whether you are seeking cutting-edge education, evaluating the latest market innovations, or are seeking new professional connections, the AHIMA20 Virtual Conference is the place to be. Register today.


Karen Proffitt, MHIIM, RHIA, CHP is vice president, industry relations/CPO, and Rachel Podczervinski, MS, RHIA, is director of identity solutions for Just Associates, Inc., a nationally recognized leader in patient matching and health information data integrity, providing expert services such as MPI data analyses and full scale MPI clean-ups.


Just Associates, Inc. leaders are members of the national Patient ID Now Coalition and AHIMA’s Patient ID Policy Workgroup.

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