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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