August 5, 2020

Group project?  Work with the A students.

the_letter_A

There was a near-truism in high school: Straight-A kids hang out together … as do the straight-D kids.

(Don’t overthink this. Yes, plenty of straight-D high school kids went on to find their way to successful adulthoods.)

That old bromide came to mind upon reading a proposal that suggests the U.S. Department of Health and Human Services (HHS) team up with another government agency in an effort to improve patient matching, which is persistently at the heart of what stands in the way of increased, meaningful interoperability.

Patient matching is an issue that regular readers will recognize as a topic we write about quite a bit because of its importance. And we also lament the healthcare IT community's reluctance in modeling its patient-matching plans on those that have been successful in other industries (e.g., financial services).

So why, then, the hesitation about this HHS proposal? Two things:

  1. The best-case estimate for patient-matching improvement is 3 percent. That’s not a typo. Sure, any improvement is better than no improvement but I shudder to think of the costs (money and opportunity) that might be involved in this endeavor.
  2. The partner for this endeavor? The U.S. Postal Service (USPS). That’s not a typo either.

The proposal involves HHS encouraging the adoption of the postal service’s standardized address system into electronic health records. The USPS makes the system available for free to internet retailers. (You’ve encountered it if you’ve had to pick an address – it wants you to select the one with “ST” instead of the one with Street – in the delivery step of an online purchase.)

The idea is that forcing EHRs to use the USPS system would help eliminate some level of patient-identification errors that occur when their addresses are entered differently at various caregivers’ offices. Improved address formats would be beneficial now, plan advocates say, as various places use trackers to stay abreast of the COVID virus’s movements.

We're sure standardized addresses have improved overall mail delivery (via the use of optical sorting machines, primarily) but it cannot overcome those with indecipherable handwriting – sound familiar? – or the letter carrier who puts a letter in the wrong house’s box.

This idea may have some merit but we think the patient-matching issue is bigger than just addresses and we would hate for bigger, more comprehensive solutions to be put on the back burner in the pursuit of this.

Also, we can’t help but point out that the A students (the financial-services industry) likely didn’t seek out the post office for its acumen when they looked to create a near-universal patient-matching system that works across institutions, here and abroad.

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