Simple Workflow Changes Enable Effective Patient Identity Matching in Poison ControlFunding This study was supported by the U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, grant 5R01HS021472, and the Office of the National Coordinator for Health Information Technology (901 × 003). The authors wish to acknowledge the assistance of the Utah Poison Control Center, Intermountain Healthcare, the Utah Health Information Network, and Dr. Tom H. Greene. Additional assistance was provided by the Center for Clinical and Translational Sciences of the National Institutes of Health under Award Number UL1TR001067. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH). Support and resources were also provided from the Center for High Performance Computing at The University of Utah, partially funded by the NIH Shared Instrumentation Grant 1S10OD021644–01A1.
30 January 2018
02 June 2018
25 July 2018 (online)
Background U.S. poison control centers pose a special case for patient identity matching because they collect only minimal patient identifying information.
Methods In early 2017, the Utah Poison Control Center (Utah PCC) initiated participation in regional health information exchange by sending Health Level Seven Consolidated Clinical Document Architecture (C-CDA) documents to the Utah Health Information Network and Intermountain Healthcare. To increase the documentation of patient identifiers by the Utah PCC, we (1) adapted documentation practices to enable more complete and consistent documentation, and (2) implemented staff training to improve collection of identifiers.
Results Compared with the same time period in 2016, the Utah PCC showed an increase of 27% (p < 0.001) in collection of birth date for cases referred to a health care facility, while improvements in the collection of other identifiers ranged from 0 to 8%. Automated patient identity matching was successful for 77% (100 of 130) of the C-CDAs.
Conclusion Historical processes and procedures for matching patient identities require adaptation or added functionality to adequately support the PCC use case.
Keywordshealth information exchange - toxicology - delivery of health care - electronic health records
Protection of Human and Animals Subjects
This study was reviewed and approved by the University of Utah Institutional Review Board.
- 1 National Center for Health Statistics. NCHS Data on Drug-poisoning Deaths. NCHS Fact Sheet. August, 2017. Available at: https://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.pdf . Accessed July 12, 2018
- 2 Mowry JB, Spyker DA, Brooks DE, Zimmerman A, Schauben JL. 2015 annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 33rd annual report. Clin Toxicol (Phila) 2016; 54 (10) 924-1109
- 3 Cummins MR, Crouch B, Gesteland P. , et al. Inefficiencies and vulnerabilities of telephone-based communication between U. S. poison control centers and emergency departments. Clin Toxicol (Phila) 2013; 51 (05) 435-443
- 4 Caravati EM, Latimer S, Reblin M. , et al. High call volume at poison control centers: identification and implications for communication. Clin Toxicol (Phila) 2012; 50 (08) 781-787
- 5 Cummins MR, Crouch BI, Del Fiol G, Mateos B, Muthukutty A, Wyckoff A. Information requirements for health information exchange supported communication between emergency departments and poison control centers. AMIA Annu Symp Proc 2014; 2014: 449-456
- 6 Morris GFG, Afzal S, Robinson C, Greene J, Coughlin C. Patient identification and matching final report. Final Report ed: Office of the National Coordinator for Health Information Technology; 2014: 1-93
- 7 Godlove T, Ball AW. Patient matching within a health information exchange. Perspect Health Inf Manag 2015; 12: 1g
- 8 Davidson PJ, Ochoa KC, Hahn JA, Evans JL, Moss AR. Witnessing heroin-related overdoses: the experiences of young injectors in San Francisco. Addiction 2002; 97 (12) 1511-1516
- 9 Del Fiol G, Crouch BI, Cummins MR. Data standards to support health information exchange between poison control centers and emergency departments. J Am Med Inform Assoc 2015; 22 (03) 519-528
- 10 Nelson SD, Del Fiol G, Hanseler H, Crouch BI, Cummins MR. Software prototyping: a case report of refining user requirements for a health information exchange dashboard. Appl Clin Inform 2016; 7 (01) 22-32
- 11 Khalifa A, Del Fiol G, Cummins MR. Public health data for individual patient care: mapping poison control center data to the C-CDA consultation note. AMIA Annu Symp Proc 2017; 2016: 1850-1859
- 12 Fellegi IP, Sunter AB. A theory for record linkage. J Am Stat Assoc 1969; 64 (328) 1183-1210