Posted on behalf of Jeff Ford, Director, Client Services
In an ideal world, all your vendor systems are communicating in the same protocols and using the same patient identifier. Patient A1234 in your HCIS would be patient A1234 in your affiliated physician practice systems, telehealth platforms, and any other integrated solution used outside the walls of your hospital. But of course, in the healthcare technology industry, we are far from an ideal world. There has yet to be a globally accepted EMR system. The same patient is entered separately into your HCIS and any other systems feeding it. This not only creates multiple identifiers, but multiple points to enter erroneous data, misspell names, create dummy social security numbers, and generate any other number of combinations of incorrect data and duplicates.
Enter the eMPI
An eMPI (Enterprise Master Patient Index) is a centralized patient database used within a healthcare organization to maintain one system of accurate data that all your systems contribute to. Patients are given one unique eMPI patient identifier so they are represented only once across all the hospital’s vendor systems. Typically, the eMPI is setup as your one trusted source, with admissions completed through it or your admissions team checking the eMPI whenever a patient presents.
A full-scale eMPI is a large solution to an even larger problem. But let’s be honest, a comprehensive solution of this measure is not always feasible, especially for smaller organizations. It takes a lot of resources to build and maintain. More than that, it requires system wide buy-in and adherence to a completely new workflow. Your staff will need to work out of the eMPI and constantly keep all downstream systems updated. This beefy solution and tremendous workflow doesn’t always make sense for a healthcare system, especially smaller ones.
A potential hurdle with an eMPI solution is that, if not done right, you are just adding in yet another patient ID that your systems need to handle. Unless you make the eMPI patient ID your source of truth across all environments, it won’t work. Most hospitals want their main HCIS to be the source of truth, the main ID referenced across systems. So how can you keep your current setup intact while solving the problem of unique identifiers across your systems?
A Simpler Solution
The goal here is to still have your HCIS be your anchor system while allowing all your disparate vendor systems to still communicate while not creating duplicate or incorrect data anywhere. You have staff admitting and processing patients in many different applications. How are all those applications talking to each other? Through your interfaces. You can use the highway of information that is your interfacing system to your advantage by sitting an eMPI in the middle of it.
A solution we have worked on at Summit Healthcare uses the eMPI not as an admission entry tool, but as a highly sophisticated crosswalk table. An API on your integration engine feeds the eMPI real-time. The highly accurate matching system of the eMPI combines identical patients, adding to their list of identifiers. This creates one entry in the eMPI for each of your patients with all their outside identifiers attached.
Now that we have a real-time updated eMPI with one record for each patient, the final step is to allow each system to communicate in its own language. Each message that comes through will check first with the eMPI and grab the correct patient ID. If it is a message from our HCIS going out to NextGen, we’ll put the NextGen patient ID in the message before it is sent. If it is going from NextGen back, we’ll return the HCIS Patient ID. We can query for all systems we have in the eMPI, returning the one patient ID they expect.
This solution provides the strong patient matching technology of a full eMPI with the behind-the-scenes working of an integration engine. We’ve found it to be a much less resource intensive way to get the value of an eMPI without uprooting your technology infrastructure. If you’re interested in learning more about it, reach out to me: firstname.lastname@example.org