Rhapsody EMPI helps KeyHIE establish integrated network of accurate, accessible health records

As one of the oldest and largest Health Information Exchanges, Pennsylvania’s Keystone Health Information Exchange (KeyHIE) is a national model of success for fully connected care, serving more than 5.8 million patients through a diverse network of 29 hospitals, 369 physician practices, 35 home health locations, 90 long term care facilities, 18 pharmacies, and 19 urgent care clinics. Founded by Geisinger Health System in 2005, KeyHIE prides itself on interoperability, offering patient-consented access to over 10 million electronic health records across 59 counties in Pennsylvania and New Jersey through a secure, single online login.

Creating an integrated network of accurate and accessible patient data was fundamental to KeyHIE’s commitment to coordinated patientcentered care. For health information exchanges, the goals of expanding network participation and driving effective collaboration between members hinge on the ability to provide timely, accurate, and up-to-date patient data. Like many evolving HIEs, KeyHIE’s need for an enterprise-level patient matching partner grew, in part, due to the scores of EHR applications, and the resulting number of duplicate and incomplete patient records. According to Kim Chaundy, senior director of operations at KeyHIE, the network not only needed to improve patient identification and record matching accuracy, but also to enhance its ability to share data among participants. “True interoperability is making sure we can transition a patient into the community, that the succeeding care team has access to their data with a full understanding of that individual’s care history, and effectively complete the cycle of treatment,” she said. “It’s critically important to integrate these EHR systems so that all of the community data comes together.”

“It not only reduces costs,” she continued, “but more importantly improves the overall care provided to the patient because the clinician or care team member is presented with a timely, accurate and complete view of everything that happened previously with that individual.”

To realize its vision of a sustainable, connected network, KeyHIE needed an enterprise data integration and identity management partner to reconcile patient records across its growing number of participants and to provide on-demand access to millions of patient records. KeyHIE chose Rhapsody EMPI as their enterprise master person index (EMPI) solution.

EMPI automatically links the right patient to the right record by assigning each individual a global unique person identifier. The solution provides a centralized location of trusted patient demographics with capabilities that include:

• A single source of reference for patient identity management across all EHR systems.
• Automated, real-time patient record matching across disparate systems and settings of care.
• Seamless integration of new and existing legacy applications to provide fluid data exchange without sacrificing clinical or administrative workflow.
• De-identification processes for population-based analytics and quality reporting.

The ability of the EMPI to provide a centralized and reliable index of patient health data and enable vendor-neutral cross-platform interoperability allows KeyHIE to provide real-time delivery of information.

“That means faster service and improved customer satisfaction,” said Chaundy.

Uniquely identifying patient data from multiple providers and sources gives KeyHIE participants an enterprise level view of a patient’s care record at the time it matters most, resulting in improved clinical decision-making, quality and safety, and patient-provider experience.

“It was important for us that the EMPI be a foundational tool in supporting the downstream benefits of population health management and accountable care,” said Chaundy. “With Rhapsody, we are able to match patient data at an enterprise level and connect the dots from various stakeholders across the community to support value-based care delivery and positively influence the health of our citizens.”

Using the Rhapsody EMPI solution to map one’s entire care history, KeyHIE is now able to identify at-risk patients and trends and close care gaps. For example, the HIE can send information on a diabetic patient seen by a foot specialist over to the individual’s primary caregiver for streamlined coordination and more cohesive, person-centered care.

“For a small family practice doctor, it can be incredibly difficult to know what’s going on with the patient throughout the community. The HIE is leveraging the EMPI to communicate that a patient received care elsewhere for highly collaborative care and better decision-making,” Chaundy said.

Since implementing EMPI, KeyHIE has been able to save 743 hours of manual remediation labor per month and has reduced its duplicate record rate down to less than one percent. “Each one of those is a potential risk,” said Chaundy, “so the impact on care quality and an organization’s reputation is significant.”

During the initial record clean-up for KeyHIE, over 12 million disparate records were resolved into single enterprise unique identifiers (EUIDs). “We were amazed how many possible duplicates there were,” said Chaundy. “We knew we had issues, but it was quite an eye-opening experience to discover that our data wasn’t as clean as we thought it was.”

Now whenever a patient receives services in the community, KeyHIE matches that up with the patient and the medical record of the ordering site. The EMPI performs this function automatically, adding the information to the metadata header and transferring it across via HL7 messaging directly into the patient’s chart, along with a notice to the provider. Previously the information would be faxed, where five to six people worked to pull it up, read it, match it, and put it into the patient’s record, taking about one minute per document.

“It’s the responsibility of any organization collecting patient data from multiple systems and sites of care to have an EMPI in place, and it’s extremely important to have one that has market maturity behind it,” Chaundy said. “Experience and market longevity allow you to collaborate your lessons learned and make a stronger platform, and that’s exactly what Rhapsody has done.”

Chaundy added that Rhapsody has been an effective and dynamic partner in working with KeyHIE to maximize the extent of the platform. “Our strong partnership with Rhapsody has allowed us to support our vision of a totally digital healthcare system environment,” said Chaundy. “They have a very robust tool. They’re experienced and innovative, and they’re good at what they do.”

Having a longitudinal view of patient records improves nearly every aspect of care delivery for KeyHIE and the more than 4,000 healthcare providers across its 500+ member organizations.

“The EMPI is really the foundation of the HIE, “said Chaundy. “It’s making sure we’re doing all of the little things right to make the big things happen.”