Learning Centre: Ideas

Active Registration: A Case Study

“Dad, I can’t find my shoes!” is a constant refrain heard in my household. “Well, did you actually look for them?” is my usual reply. In the lost-and-found world of our home lives we get annoyed with these kinds of antics, but when it comes to registering patients, sometimes we are in such a rush that we don’t take the time to carefully look for patients either. Instead we just say “I can’t find your medical record” and create a new one (or some hospitals have a “Stat Reg” policy where new records are created every visit). Regardless of how duplicates are created, they only lead to a headache for someone else downstream.

Duplicate medical records create problems, from fragmenting a patient’s medical history to re-ordering “missing” tests and procedures. Across the US and Canada, it is estimated that between 8-12% (AHIMA) of the records in EMRs are duplicates. The cost to resolve a duplicate averages around $60 (healthit.gov) per incident; so resolving the duplicates in a patient set of 500,000 could cost close to $35,000 – which adds up. The clinical implications of a Physician or Caregiver not seeing the complete medical history or full set of test results and can easily create a patient safety emergency.

To be fair… there are a ton of awesome registrars working in the emergency rooms, ambulatory care centers, and clinics across the healthcare universe. But, the tools at their disposal for finding patients rarely offer helpful features to make their jobs easier.

Look first… then tell me you can’t find it

That’s where Active Registration comes into play. It’s like having a parent who has mapped the contents of the house in their photographic memory and who is willing to help you look for your juice box (instead of issuing snarky remarks from the couch). Only if you have looked first, can you move on the more advanced step of getting another one.

Active Registration is the process of:

  • Looking up a patient’s record at the point of registration
  • Confirming the patient’s demographics while they are present
  • Making any updates to the patient record (while the patient is still there)
  • Creating a new patient record only if we are certain the patient is new

This is nothing new. But the thing that impedes effective Active Registration is the lack of insight into all of the different systems that store patient data across the healthcare enterprise. Which is precisely why Active Registration needs a trustworthy Enterprise Master Person Index (EMPI) behind the scenes to keep track of the records in your systems.

EMPI + Active Registration = Big Results

Michelle Majerus, HIM Director and Privacy Officer at Olmsted Medical Center in Rochester, MN recently shared her experience with deploying Active Registration at an IMT and IBM co-sponsored event (download the presentation). Olmsted was able to show the measurable impact that Active Registration made, not only in data quality but also in time spent resolving issues. Michelle was joined by Lorraine Fernandes, Global Health Care Ambassador at IBM, and IMT’s own Corinne Blair, who offered industry context and offered additional solutions.

Here are some of the highlights:

Olmsted began their project by deploying a “Passive Registration” style, where duplicate records and overlays were corrected “after the fact” if a patient was not found in the local registration system.

During the passive phase, a baseline was established over a 5-day period:

Baseline, EMPI Passive
Data Quality Issues 60
Duplicates 22
Overlays 3
Staff Time (hours) 11:28

Phase two included the implementation of IMT Resolve:ID™ to perform a seamless lookup of records across systems in IBM® MDM at the point of registration. Leveraging IBM® MDM allows a more sophisticated search (i.e., Nicknames, Phonetics, etc.) of any known patient across the enterprise.

Data Quality Issues Duplicates Overlays Staff Time (hours)
Baseline, EMPI Passive 60 22 3 11:28
One Month post Active 32 14 2 4:32
Six Months post Active 19 7 0 2:12

One month after switching to Active Registration, a huge impact was noticed. But six months later, once Active Registration lookups had become ingrained in the process, it became clear that the investment in IMT Resolve:ID™ was having a significant long-term impact:

  • 66% reduction in new Data Quality issues over the course of a 6 month window, showing that staff were able to leverage Resolve:ID™ more effectively.
  • 68% reduction in Duplicates being created during registration and a total elimination of Overlays.
  • 80% reduction in the time required by staff to manually resolve Data Quality issues.

Beyond the Numbers

Deploying the IBM® MDM platform for an EMPI gave Olmsted the confidence of knowing a single, complete and trusted view of their patients. Physicians, Staff, Registration, and Billing were all able to see the positive effects of the EMPI. The addition of IMT Resolve:ID™ further accelerated the benefits by avoiding data quality errors at the point of registration – doing it right, from the start.

Here are some additional benefits Olmsted was able to see:

  • Reduced potential for misdiagnosis with a more complete view of the patient’s medical history, including radiology and lab results.
  • Lowered the amount of time it took to register a patient by confirming data instead of entering data.
  • Reduction in duplicate tests meant less money spent supporting accountable care mandates.
  • Elimination of duplicate billing, which increased customer satisfaction by giving the patient their information in one place.

Finding Solutions

While I still dream of the day when my living room won’t be littered with the “missing” shoes my kids can’t find; Olmsted is already reaping the benefits of Active Registration with their EMPI today. IBM® MDM and IMT Resolve:ID™ have combined to make a cleaner, more complete set of Patient data that all of Olmsted’s staff can trust.

Visit the IMT Resolve:ID™ page to learn more, download the presentation, a fact sheet, or watch a video demo of IMT Resolve:ID™ in action.

Photo credit: Mark Quintanilla via photopin (license)