Patient Matching in the Patient Matching in the Indiana Network for Indiana Network for
Patient CarePatient Care
Shaun Grannis, M.D. M.S.Shaun Grannis, M.D. M.S.The Regenstrief Institute andThe Regenstrief Institute andIndiana University School of Indiana University School of
MedicineMedicine
Regenstrief BeginningsRegenstrief Beginnings Endowed by Sam Regenstrief - Endowed by Sam Regenstrief -
inventor of the low cost dishwasherinventor of the low cost dishwasher Obsessed with process Obsessed with process
improvementimprovement Supported the creation of the Supported the creation of the
Institute in 1972 to apply process Institute in 1972 to apply process improvement to medicineimprovement to medicine
Regenstrief Institute Regenstrief Institute Regenstrief tasked in 1972 to “stitch” Regenstrief tasked in 1972 to “stitch”
silos of medical information together -> silos of medical information together -> the Regenstrief Medical Record System the Regenstrief Medical Record System (RMRS/Wishard Memorial Hospital) (RMRS/Wishard Memorial Hospital)
In 1994, began stitching together In 1994, began stitching together information across institutions information across institutions (INPC/Indianapolis)(INPC/Indianapolis)
In 2003, working towards stitching the In 2003, working towards stitching the state together (INPC/Indiana)state together (INPC/Indiana)
A “Big” Repository by US A “Big” Repository by US StandardsStandards
In the system:In the system:- 1.3 million patients, 5 million 1.3 million patients, 5 million
registration entitiesregistration entities- 24 million orders24 million orders- 660 million coded results660 million coded results- 12 million dictated reports12 million dictated reports- 8.8 million radiology reports8.8 million radiology reports- 25 million prescriptions25 million prescriptions- 480,000 EKG tracings480,000 EKG tracings- 45 million radiology images45 million radiology images
Added Per Year:Added Per Year:- 600,000 ambulatory encounters600,000 ambulatory encounters- 50,000 inpatient encounters50,000 inpatient encounters
Consolidating the SilosConsolidating the Silos
ImmunizatioImmunization Registryn Registry
Electronic Electronic Medical Record Medical Record
SystemSystem
Patient ID: 123LMNOPPatient ID: 123LMNOPName: Jane Doe Name: Jane Doe DOB: 01/01/04DOB: 01/01/04SSN: N/A SSN: N/A Address: 555 Johnson RoadAddress: 555 Johnson RoadCity: IndianapolisCity: IndianapolisState: IndianaState: IndianaZIP: 46202ZIP: 46202
Patient ID: 6789XYZPatient ID: 6789XYZName: Jane Ellen DoeName: Jane Ellen DoeDOB: 01/01/04DOB: 01/01/04SSN:123-45-6789SSN:123-45-6789Address: 555 Johnson Address: 555 Johnson RoadRoadCity: IndianapolisCity: IndianapolisState: IndianaState: IndianaZIP: 46202ZIP: 46202
Global Global Patient Patient IndexIndex
Concept Concept DictionaryDictionary
Global ID:Global ID: 4567845678Name: Name: Jane Ellen Doe Jane Ellen Doe Demographics..Demographics..MRF1 ID: MRF1 ID: OU81247OU81247MRF2 ID: MRF2 ID: 45643564564356PH MRF ID: PH MRF ID: 123LMNOP123LMNOPMRF3 ID:MRF3 ID: 6789XYZ6789XYZ
Consolidating the SilosConsolidating the Silos
ImmunizatioImmunization Registryn Registry
Electronic Electronic Medical Record Medical Record
SystemSystem
Global Global Patient Patient IndexIndex
Concept Concept DictionaryDictionary
St. St. Vincent Vincent
MRFMRF
Clarian Clarian MRFMRF
Wishard Wishard MRFMRF
Community MRFCommunity MRF
Public Public Health MRFHealth MRF
Global Global Patient Patient IndexIndex
IUMG MRFIUMG MRF
Concept Concept DictionaryDictionary
The Indiana Network for Patient The Indiana Network for Patient CareCare
Record LinkageRecord Linkage DeterministicDeterministic
- ““All-or-None”All-or-None”- Rules based on exact agreement or disagreementRules based on exact agreement or disagreement
ProbabilisticProbabilistic- Each identifier (Name, DOB, etc.) is associated Each identifier (Name, DOB, etc.) is associated
with customized weights based on identifier with customized weights based on identifier agreement ratesagreement rates
Fuzzy MatchingFuzzy Matching- Middle groundMiddle ground- Increases flexibilityIncreases flexibility- Pragmatic approachPragmatic approach
Global Patient Registry Linkage Global Patient Registry Linkage Algorithm FeaturesAlgorithm Features
One record per assigned patient number per One record per assigned patient number per institutioninstitution
Create logical links between each of these Create logical links between each of these recordsrecords
Match using social security number, patient Match using social security number, patient name, birth date and gendername, birth date and gender
Use string comparator algorithm and phonetic Use string comparator algorithm and phonetic transformations for near name matchestransformations for near name matches
Implements the concept of a “patient group”Implements the concept of a “patient group”
Global Patient RegistryGlobal Patient Registry
AssigningAssigningAuthority Authority Global #Global # Local Pat #Local Pat # Patient NamePatient Name Birth dateBirth date SexSexHospital AHospital A 99-199-1 231456231456 Sinkwell, Ralph JSinkwell, Ralph J 12-2-5912-2-59 MMHospital BHospital B 123-0123-0 A47239A47239 Sinkwell, RJSinkwell, RJ 2-12-592-12-59 MMHospital AHospital A 99-199-1 10321151032115 Sinkweil, RalphSinkweil, Ralph 12-2-5912-2-59Hospital CHospital C 101-0101-0 A3276A3276 Fredrick, AliceFredrick, Alice 4-14-784-14-78 FFHospital AHospital A 101-0101-0 23145902314590 Fredrick, AlyceFredrick, Alyce 4-14-784-14-78 FF
Global ID is for internal indexing onlyGlobal ID is for internal indexing only – – not publicly exposednot publicly exposed
Results Results Retrieval: Retrieval:
Patient Patient Selection Selection
DialogDialog
Results Results Retrieval: Retrieval:
Patient Patient Selection Selection
DialogDialog
Results Results Retrieval: Retrieval:
Patient Patient Selection Selection
DialogDialog
Results Results Retrieval: Retrieval:
Global Global Patient Patient GroupGroupDisplayDisplay
Results Retrieval InterfaceResults Retrieval Interface
Thank You!Thank You!
Shaun Grannis, M.D. M.S.Shaun Grannis, M.D. M.S.The Regenstrief Institute The Regenstrief Institute [email protected]@regenstrief.org