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Enterprise Master Patient Index

FOX Systems, Inc. (FOX) knows that most healthcare organizations are experiencing a patient identity crisis.

Information Technology
For example, the typical hospital has an error in at least five percent of the records in the Enterprise Master Patient Index (EMPI) -one of every twenty patient record has an error!

The types of patient identification problems that compromise the integrity of the EMPI typically fall into three major categories:
  • Duplicates: Two or more medical record numbers for a single patient.
  • Overlays: One medical record number has two or more patients assigned.
  • Overlaps: Patients seen at multiple facilities have medical record numbers at each facility within an enterprise or integrated delivery network.

FOX helps its clients define requirements for an EMPI, procure a Commercial-Off-the-Shelf (COTS) EMPI software solution or assist them in building one, and then provide support during implementation and installation, either through our technical development support or Independent Verification and Validation (IV&V) services. FOX offers end-to-end services to help our clients develop EMPIs that meet all of their needs.

Example EMPI services include:

  • Assisting our clients to develop a statement of work
  • Building data and process models
  • Developing a requirements document
  • Developing a Request for Proposal (RFP) and proposal evaluation process and manual
  • Conducting analysis of proposals and providing recommendations
  • Supporting contract negotiations (for COTS or outsourced development)
  • Providing configuration, development and testing resources (for internal development option)
  • Performing IV&V during implementation

FOX employs a robust, top-down methodology to support the entire process, from requirements and design to development, configuration, testing, and implementation. We begin by defining business objectives and developing graphical models to depict data and process requirements and maintain traceability of business objectives and requirements throughout the entire process. This ensures that no requirements are dropped or missed and that the resulting system will satisfy the enterprise’s EMPI business needs.

The EMPI is a crucial link in the growing network of interrelated computer systems. Accurate patient identification and unique identifiers are the prerequisites to successful data linkage and communication between different computer systems within the healthcare enterprise. The EMPI is one of the most important components of successful longitudinal data exchange across the enterprise because it provides the unique key to identifying the recipient of healthcare services.

Organizations that serve large geographic areas must be able to identify and track their clients to determine the programs and services that they provide, develop unduplicated client counts on demand, and administer resources efficiently and effectively. FOX has the knowledge and experience to help such organizations develop enterprise master patient indexes (EMPI) to accomplish these important tasks.

EMPI errors dramatically impact the quality and accuracy of an organization’s information infrastructure, and are key determinants of effectiveness services.

Duplicate records and other EMPI data integrity problems impact organizations in a number of ways:

  • Quality of patient care can be compromised if a patient’s information is not readily available to caregivers. There are risks of misdiagnosis, treatment errors, and patient inconvenience or patient harm.
  • Duplication of services can occur when all records for a patient are not available. Tests and services may be repeated unnecessarily. This is costly for the facility, and risky for the patient.
  • High costs arise from duplicate tests, operational inefficiency, supplies, and rework associated with duplicate records. These costs can range from $25 to $400 per duplicate set.
  • Longitudinal records and repositories are dependent on the ability to accurately identify a patient and interface and link data correctly.
  • Operational effectiveness is affected in multiple departments. Delays in registration occur when there are multiple EMPI records for a patient. Registration staff is presented with ambiguous choices, and errors compound.
  • Privacy and confidentiality can be jeopardized unknowingly. Incorrect patient identification, especially overlays, can result in bills and other information being sent to the wrong address or the wrong insurance company.
  • Regulatory compliance with CMS billing rules and HIPAA regulations can be undermined. Duplicate records can put the facility at risk for billing errors that can lead to substantial fines for noncompliance, fraud, and abuse. Confidentiality breaches in violation of HIPAA rules can result in litigation, and significant financial penalties.

 

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