Early on in EMR implementation it was all about getting up and running to realize the incentive payments offered by the government. How could legacy information be cost-effectively uploaded into the new EMR system? What data should be captured in fixed field format and who would be responsible for capturing it? Through what means would employees and physicians be trained on EMR functionality? And then, of course, how would usage be monitored and enforced? As HIM professionals focused on building this foundational framework, the EMR market continued to evolve. The once saturated market began to consolidate, an emergence of a few strong vendors bubbled up and system functionality and capabilities advanced. This market evolution triggered a wave of EMR upgrades and system migrations which, by extension, are today creating an opportunity for HIM to accelerate data integrity efforts.
EMR vendors recommend, if not often require, healthcare providers to address data integrity challenges, more specifically to resolve MPI duplicates and errors, prior to migration. As a common practice, providers will license some form of analytic software that leverages probabilistic algorithms to identify and segment duplicates and errors in the system. This helps define the scope of the problem and build the business case required to secure the tools and resources necessary to support clean-up efforts. As part of the clean-up project duplicate records are merged, errors are remediated and, assuming all is well managed, an acceptable duplicate rate is achieved. This process itself improves the state of data integrity and, historically, this is where the engagement would end.
Today, however, HIM professionals are increasingly leveraging migration-related clean-up projects as “trigger events”, or a means by which they can drive change back into the organization. Keep in mind, a single project does not prevent the entry of new errors into the system nor does it ensure that the acceptable duplicate rate can be maintained. Forward thinking HIM professionals understand this and are challenging their organizations to advance towards a proactive data integrity management program.
The shift in strategy requires a top-down and bottom-up commitment. The organization must be prepared to
1) define and implement the process and system changes required to address the deficiencies that are deemed largely responsible for the creation of duplicates and errors and
2) license and leverage the software required to identify and resolve errors on a consistent and ongoing basis.
Though cost constraints in the healthcare industry are rampant, HIM professionals are able to justify this investment by articulating the long term value. Not only does a proactive strategy mitigate the risks associated with high MPI duplication rates – including those directly related to the quality of patient care – but it also prevents recurring cycles of resource-intense, highly expensive, point-in-time clean-up projects. With the pain and expense of a reactive clean-up so fresh in leadership’s mind, these concepts become more tangible and the value more explicit. As a result, HIM professionals are able to secure the resources required to implement a proactive data integrity management program that will ultimately mitigate cost, reduce risk and support improved patient care across the broader organization thereby reaffirming the value of their expertise in today’s increasingly electronic industry.