Understanding a person’s full health journey is critical to making the best possible decisions for their health and well-being. Yet, inherent in knowing the person’s journey is ensuring you have the right person’s information.
Not only do mismatched records impact patient safety and quality care, but they also cost hospitals and health systems millions of dollars. Eighty-six percent of nurses, physicians, and IT practitioners say they’ve witnessed or know of a medical error that was the result of patient misidentification.2 Each duplicate record costs healthcare organizations over $1,950 per inpatient stay because of redundant medical tests and procedures.1
Healthcare organizations are dedicated to managing and resolving these patient identity challenges, but that also comes at a cost. They spend over 109 hours per week resolving patient identity issues, time that is not spent on higher-value or innovative work. 3
Investing in a robust, flexible, and highly performant Enterprise Master Person Index (EMPI) solution has become a top priority for healthcare organizations worldwide. We sat down with our Chief Architect Kevin Schmidt to talk response times, volume of transactions, and the breadth and depth of our API offerings within Rhapsody EMPI.
1. Let’s start by understanding how Rhapsody EMPI uses application programming interfaces (APIs).
Kevin: We view APIs as table stakes for an EMPI solution. With the varied data sources that an EMPI uses to match person identity data, it’s vital that the systems can talk to each other. The most modern – and future-proof – way to do so is through API integration. APIs are how data gets in and out of the EMPI so they must be secure and performant.
Over 15 years ago, early versions of Rhapsody EMPI used SOAP Web Service APIs, and, for the past seven years, RESTful APIs have become the preferred approach. We continue to enhance our APIs in backward-compatible ways – so those using SOAP APIs can still access their data even if they begin using REST APIs. This allows us to continue innovating with new features and capabilities that our customers want.
Our breadth and depth of APIs is unmatched across EMPI vendors. Through these protocols, customers can add, update, retrieve, and search records. We also have public APIs available to address data quality issues and task management, mapping codes between systems, monitoring and checking the system’s health, and more that other vendors don’t have.
To this day, we continue to track and display metadata like create or modify date, function, system, and user. We have full history APIs that allow customers to know what changed, when, and who made the change.
2. What types of customers and organizations use Rhapsody EMPI today? What’s the volume of data they ingest?
Kevin: Our customers range from hospitals and regional, statewide, and nationwide health systems to health information exchanges. We have retail healthcare organizations and full-service specialty laboratories. In total, we have over 100 customers in nine different countries who, together, account for billions of records.
We have customers who complete 80 million record retrievals per month. Our customers also have millions of records in their systems. They’re not operating with an empty system with these very large transaction volumes. They have 10 million, 40 million, and even over 150 million records in their systems.
3. What does that mean for system performance?
Kevin: Our system performance remains incredibly high and reliable. When talking performance, it’s important to make note of the API grouping or the type of transaction taking place. For example, record adds and updates are the most expensive APIs because of the effort it takes to find matches, determine if it’s an automatic match or a potential duplicate, and, if it’s a duplicate, update all the information related to that record.
It takes longer for the system to process record adds and updates. Yet, our average response time for these and searches is under 300 milliseconds – three times faster than our competitors. The record retrieval and cross reference APIs are not as intricate, and our average response time is well under 100 milliseconds with those – also three times faster than our competitors.
The customer I mentioned with 40 million records and 80 million record retrievals per month – that customer’s data is included in our average response times. They still experience exceptional performance with the high data volume. These numbers reflect the real volume that our customers transact, which is incredible and emphasizes the importance of a highly performant EMPI solution.
4. Can you put the system performance into perspective for us? What does that mean for the integration team and for end users?
Kevin: From an integration standpoint, the team has trust that the system can scale with bursts of activity. These bursts of activity could come from onboarding a new system, connecting to another data source, and uploading new records. Or they could be natural throughout the course of a day if an organization sees higher frequency or volume at some point.
Daily operations need to continue smoothly without interruption even when these bursts of activity happen. The average performance our customers experience provides them with confidence that their system can handle an increase in the number of transactions at a given point in time.
5. From an end-user standpoint?
Kevin: The value in our fast transaction times is when we talk about synchronization. Records across a system – in one hospital, across hospitals in a system, with payers and outside data sources – need to stay in sync. That’s the only way a clinician treating a patient can trust the data they’re viewing. And trust that it is for the right person with all updates made being reflected in their view.
If there is latency or slowness, the analytics, portals, and dashboards that end users rely on will not be current. Out-of-sync systems lead to bad information, and, ultimately, mistakes, errors, and poor health outcomes for patients.
6. What is Rhapsody’s approach to synchronization?
Kevin: Our EMPI solution sends push notifications. When something changes, it immediately pushes that change out to any subscribers. It’s not waiting on a downstream system to query or poll for new information, which causes latency and leads to records being out of sync.
In fact, for customers who have our EMPI solution and the Rhapsody Integration Engine, the notification is pushed to the integration engine to push out to all the systems that need the change. This aids in message flow, increasing efficiency and effectiveness.
7. Rhapsody is an expert in data integration. How does this experience and proven track record give an advantage when selecting Rhapsody EMPI?
Kevin: First, having our Rhapsody or Corepoint integration engine broadens the reach of EMPI APIs by translating from other formats or handling message routing. When you have our integration engine and select our EMPI as part of the full interoperability suite we offer, you end up with one vendor, streamlining the number of vendors to manage. We can also simplify the onboarding process.
Rhapsody integration engines can take data in whatever format it’s available and translate that into our APIs. There is no custom work needed to transform the data source format to be read by an existing API. Our integration does that heavy lifting. Additionally, if there’s a repeating element within an organization or across several sources, we have and can develop templates to support the integration.
Further, we can complete the integration work for customers as part of their EMPI implementation, reducing the cost and burden on their integration teams.
For further reading, check out these resources:
- 2016 National Patient Misidentification Report, Ponemon Institute
- 2018 Mid-Year EHR Consumer Satisfaction Survey, Black Book Market Research
- Patient ID Now Survey, 2023