I am frequently asked whether an EMPI or Identity component from a EHR vendor can sufficiently handle the complex needs of patient identification. There’s never a simple answer. Rather, organizations should ask several questions, including:
Are you addressing person or patient data?
First and foremost, organizations must ponder what type of data they need in a single view. Is it exclusively patient data? Or do strategic and operational goals demand a broader perspective of members, guarantors, next of kin, employees, consumers, enrollees, or citizens? If the organization is thinking broader than a patient, they must question how the chosen EMPI will integrate, use, and manage all the data essential for the broader perspective.
Can the EMPI handle all data and business needs?
Choosing the right EMPI entails far more than just reviewing technical specifications. Organizations must also consider how robustly the entire solution actually operates – and its full operational impact. Can it support complex workflows, with auditability and communication? In particular, business process management software should be readily available to ensure centralized or federated work processes that enhance collaboration and create maximum efficiency between Lines of Business. Organizations should also test the relative strength, performance, and accuracy of multiple EMPI vendors’ matching algorithms by comparing the results of analysis on at least 500k records, not just 50K records. With the IoT movement, devices will be sending more updates, more often, thus higher volume testing is essential.
Is the organization’s technology ecosystem “bigger than the EHR vendor?”
Data ecosystems can quickly grow much more complex than a typical EHR can handle. For example, if the organization is involved in a HIE, all parties must do the governance work that establishes how data will be shared, integrated, and audited. Organizations are looking beyond the purely clinical use of data – seeking to support consumer engagement, community initiatives, wellness, and marketing – and need to assess whether the EMPI can facilitate these goals. HIPAA limitations must be front and center in the discussion, particularly around marketing and community initiatives.
How much does it actually cost?
Many EHR vendors will say their EMPI functionality is “free,” but nothing in life is truly free. A detailed cost analysis will naturally consider the implementation fee and expenses for servers, license and maintenance, or the annual cloud service fees. Organizations will also want to consider the lost opportunity cost if the EHR vendor approach can’t address today’s strategic and operational needs, but perhaps more importantly, tomorrow’s. If algorithm accuracy is found to be lacking in the EHR EMPI, an organization will have to face the cost of finding only 60-80% of the records that should have been linked or merged. Furthermore, the costs of correcting high volumes of duplicate records created during registration must be considered. Looking ahead, has the EHR vendor architected a future-proof solution that can adapt to an organization’s changing technology portfolio? With the increase in M&A activity, development of IoT devices, and an uptick in cloud-based solutions – flexibility and adaptability are key.
When I work with clients the outcome is not predetermined. Through careful analysis, many clients end up choosing an agnostic EMPI/MDM vendor that meets their organization’s “bigger picture” strategic needs. That being said, many make the decision to use the EHR vendor EMPI, as it’s “good enough.”
I challenge organizations not to simply take the path of least resistance and go with the EHR EMPI, but to do the hard analysis and fact finding to ensure they are comfortable with the final decision. Only through due diligence can organizations be confident that their chosen solution will deliver a trusted, complete view of person/patient/member/enrollee data that the organization needs, and that consumers expect.