A new study finds that consistent use of standards for demographic data would help link patients’ records from various providers, no matter where they seek care. Many of the standards, such as the address format used by the U.S. Postal Service, are already in use in other settings, but not consistently when it comes to matching in health care.
The research, led by experts at Indiana University and supported by The Pew Charitable Trusts, was published March 8 in the Journal of the American Medical Informatics Association. The research team assessed whether, and to what extent, the use of consistent formats for address, name, date of birth, and other demographic data yield improvements to patient matching rates. As medical providers make greater use of electronic health records (EHRs), improved matching will give them better access to the most complete and current health information on their patients.
For example, the study found that standardizing addresses using the Postal Service’s format—such as how to list street names and abbreviate certain words—can improve match rates by up to 3 percent. That figure can jump to as much as 8 percent when standard formats are used for both addresses and last names. If both of those details were standardized, an organization with a match rate of 84 percent, for example, could see the number of unlinked records halved.
Unlike many other assessments of patient matching, this study drew on tens of thousands of real-world records that had previously been matched through human review. This made it possible for investigators to confirm when standardizing certain information improved the success of a matching algorithm. They found that standardizing addresses showed the most promise for improving matching, while standard formats for telephone numbers, birth dates, and Social Security numbers made no significant difference.
These findings should inform federal government actions to improve interoperability, which is the ability of EHR systems to effectively exchange information—a priority for the Trump administration and Congress. Specifically, the Office of the National Coordinator for Health Information Technology (ONC) should advance the standardization of addresses. One step could be to update policies that govern how digital systems exchange information to support use of the Postal Service format. To further improve match rates, ONC should also encourage the use of additional data routinely captured in EHRs—such as email addresses—for matching.
Through those steps, the government can help ensure that different systems are using the same information in the same way. Progress on this front will help patients get the care they need, wherever they seek it.
Ben Moscovitch directs The Pew Charitable Trusts’ health information technology initiative.