1. M2SYS Technology Free Online Learning PodcastsPatient Identity and the Role of Modern CIOs with Sharon Canner, Director of Public Policy, College of Healthcare Information Management Executives (CHIME) recorded at 2013 HIMSS Conference Podcast length 42:53

2. Topics Covered in Podcast:Who is CHIME, and what is their mission?What technologies are emerging as viable solutions to helpaddress patient identification and data matching?What are the pros and cons of establishing a National PatientIdentifier (NPI) and is CHIME in favor of this initiative?How has healthcare IT succeeded and fallen short to implementelectronic medical records and what changes or adjustmentsshould be made to foster more innovation?What impact do successful healthcare IT implementations haveon the economic vitality of the industry and the economy?What are the top health IT initiatives that healthcare CIOsare currently most consumed with?

3. Topics Covered in Podcast (continued): Do CHIME members use a best practice approach when testing new methodologies or does the forum foster an environment of innovation? How much of the burden of accurate patient ID typically fall on the IT department?

4. Who is CHIME, and what is their mission? The College of Healthcare Information Management Executives (CHIME) is the only organization that serves the educational and development needs of senior healthcare IT leaders Positions on issues are all member-driven CHIME works with Capitol Hill to educate and encourage and are not lobbyists Encourage continued support for health IT initiatives Engage with federal agencies on regulatory proposals Established a State network of CIOs called CIOStatenet - http://ciostatenet.org/ - collaborate on consent and patient matching

5. Emerging Technologies to Help Address Patient Identification and Data Matching There are a variety of technologies in use across the country, which is essentially the crux of the problem Patient identity systems that work well internally may not work as well across health information exchanges (HIEs) or Integrated Delivery Networks (IDNs) Lack of healthcare industry standards or required data elements causes patient identification problems throughout industry error rates are 5% 8%Types: Algorithms: mathematical formulas to combine weighted data elements could be name, DOB, even email addresses

6. Emerging Technologies to Help Address Patient Identification and Data Matching Biometrics: Using human physiological characteristics for identification (Example iris, palm vein, fingerprint) Patient identity systems that work well internally may not work as well across health information exchanges (HIEs) or Integrated Delivery Networks (IDNs) Did you know? In a 2011 study, Harris County, TX researched a number of years of data and determined that they had over 2,400 patients named Maria Garcia. Of those, 231 had the same birth date.

7. National Patient Identifiers (NPI) Pros and ConsPros: Efficient way to connect patients with their medical data Facilitates efficient information exchange between physicians Guards against needless medical errors Promotes safety, improves care, and lowers costs Improves privacyCons: May facilitate more collection and sale of patient data Patients may lose trust in the system and withhold information that may compromise their privacy

8. National Patient Identifiers (NPI) Pros and Cons CHIME has been working closely with HIMSS and Capitol Hill on the issue including the political feasibility of a NPI CHIME feels that there really is no consensus on the issue NPI doesnt resolve all of the problems, additional data is needed to ensure accurate patient matching What to do in the absence of a NPI? There could be agreement on a standard set of matching methodologies Work with ONC and NIST to provide an environment for crafting parameters of a common matching algorithm Best practices study

9. National Patient Identifiers (NPI) Pros and Cons Establish non-punitive safeguards available for providers and HIEs adopting the resolving methodologies Leverage the work of the National Strategy for Trust and Identities in Cyberspace (NSTIC) shows promise in dealing with direct patient encounters More effective training of front end staff Use of a voluntary patient identifier

10. Healthcare ITs Success with HITECH Implementation Percentage of use for tools of clinical decision support has gone up and is much more widely used Accurate reporting of electronic clinical quality measures is proving to be one of the most daunting challenges faced by providers Although EHR products were able to automatically reduce CQM reports, the data was inaccurate and not comparable across different providers CHIME feels that current patient safety initiatives across the government should be leveraged instead of creating something new Still work to be done on establishing more effective means of patient matching Overall, HITECH has had a positive impact on using the tools of Health IT to improve care

11. Impact of Healthcare IT on Industry and Economy Creation of Accountable Care Organizatons (ACOs) , bundled payments, and other reimbursement models are encouraging greater efficiency all fueled by healthcare IT Healthcare IT data collection portends even greater savings when organizations analyze and leverage HITECH act sparked need for Health IT staff, trained at Community Colleges, but was it too soon? A lot of graduates still looking for work Congressional schedule may have been out of sync with needs of hospital IT systems Health IT jobs are high value and add to the economic growth of the country

12. Top Health IT Concerns for CIOs1. Meaningful Use Stage 1 and Stage 2 implementation, and planning for Stage 32. The evolution of health information exchange and interoperability we wont realize the gains of Meaningful Use until we achieve true interoperability3. Patient matching4. Clinical quality measurement across value based programs5. Accountable Care Organizations6. Stark Exemption (sunsets at end of 2013)7. Patient portal patent disputes8. ICD 10

13. Testing New Methodologies at CHIME A great deal of variety in how CHIME encourages and innovation CHME members seek out best practices through formal settings like CHIMEs annual forum and multiple networking, online communication venues (example My CHIME, a place for CIOs to share and raise questions) Conversations CIOs have with their vendors, EHR developers - many of which have put together informal networks to share best practices CHIME holds periodic webinars to encourage discussion

14. How Much of the Burden of Accurate Patient ID Falls on an IT Department? IT department has responsibility to select and implement software that performs patient matching IT is the lead in taking interdisciplinary effort of client and vendor teams IT maintains close relationship with vendors to facilitate smooth operation of internal systems IT is asked to identify, devise, and implement technology to help positively identify patient at point of care

15. Sharons #1 Takeaway from 2013 HIMSS Conference In a number of sessions with ONC and CMS, Sharon observed a lot of note taking, and genuine listening to the concerns of CIOs. There was an air of palpable concern and authenticity, something that struck her as a step forward in further opening the lines of communication and dialogue between the entities. Sharon also enjoyed walking the exhibit floor and interacting with vendors to learn how the products work and what value they add to health IT. What does the product do for patients? What does the product do on the network?

16. Thank you to Sharon Canner for her time and knowledge for this podcast!

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