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Person Matching: Navigating Health Care Mergers and Acquisitions

By Megan Pruente, MPH, RHIA

Hospital merger and acquisition (M&A) activity has risen significantly during the past decade as health care leaders seek to increase value, achieve economies of scale, and improve patient care and outcomes. The challenges for HIM leadership are the complexities M&A creates in terms of managing and maintaining the master person/patient index (MPI).

The key to successfully navigating the complexities of MPI management before, during, and after a merger is the implementation of best practices for data conversion planning, employing effective person matching strategies, and leveraging cutting-edge artificial intelligence technology to resolve duplicate records.

Protecting the MPI
Effective planning is paramount for maintaining postmerger data integrity. Bringing together multiple MPIs, often from multiple EHR and enterprise master patient index systems, creates a host of issues including skyrocketing duplicate and cross-over rates. That’s why, in the realm of M&A, the adage “it’s never too early to start planning” holds true for protecting the MPI.

Rigorous planning processes can identify potential data integrity issues early, allowing for implementation of prompt corrective measures to ensure that patient information remains accurate, reliable, and accessible. It also ensures compliance with regulatory standards and mitigates the risk of penalties and legal implications that may arise from noncompliance, thereby protecting the organization's reputation and safeguarding its financial stability.

Furthermore, strategic planning minimizes risks and errors associated with data conversion, reducing the likelihood of costly mistakes that could compromise patient safety and erode trust. It preserves the continuity of care by safeguarding critical medical histories, treatment plans, and other essential information throughout the conversion process, ensuring seamless transitions and uninterrupted care delivery.

Additionally, proper planning enhances efficiency and productivity by streamlining the data conversion process, minimizing downtime, and enabling health care providers to focus on delivering quality care rather than grappling with data discrepancies and inefficiencies. By facilitating interoperability between disparate systems, planning fosters seamless data exchange and collaboration across health care networks and organizations.

MPI Conversion Planning
Effectively navigating postmerger MPI management requires meticulous analysis and documentation of both the “current state” and the envisioned “future state.” This involves a thorough review of database structures for both existing and forthcoming systems, as well as the assessment of current and future medical record numbers (MRNs).

Engaging key stakeholders, especially those downstream in the system, is vital for developing a comprehensive strategy that addresses the diverse needs of the organization. Finally, determining the appropriate tools for duplicate and crossover remediation is crucial for ensuring data accuracy and integrity throughout the MPI management process.

Preconversion, create MPI data extract specifications to ensure a comprehensive approach that captures all available identifiers for each patient from the system. If transitioning from a “person” to a “patient” centric database (or vice versa), devise a detailed plan to facilitate a smooth conversion process. Additionally, if MRNs begin with leading zeros, take measures to prevent their inadvertent removal. Careful consideration should also be given to leaving behind certain record types in accordance with internal and external policies and regulations, including those older than a specified number of years, as well as deceased, shell, and test records.

Before initiating the data conversion process, conduct frequency analyses on key demographic data fields to identify patterns and outliers and comprehensively examine the structure of MRNs from each facility to anticipate any required structural changes for the new system.

For testing and validation, verify the accuracy of the extract by cross-referencing patient information and conducting spot checks for errors. Pay special attention to ensuring accounts marked for retirement are excluded from the extract to avoid creating duplicates during subsequent analysis. This reduces the workload for health information teams and maintains data integrity throughout the extraction process.

Finally, develop strategies for managing duplicate records to ensure data accuracy and integrity. Establish protocols and clear guidelines for resolving duplicates and reconciling crossovers. Define a threshold for acceptable error rates and allow sufficient time to rectify errors before reaching that threshold.

MPI Management Best Practices
Change is never easy, but taking small steps can make a big difference. This includes implementing best practices including the following:

• Prioritization: Use tools like weights to allocate resources for duplicate pair resolution.

• Algorithm optimization: Reach out to the technical team to better understand how potential duplicates are identified and if any changes can be made to improve reports.

• Audit MPI data: Ascertain the MPI’s current health and where improvement efforts should be focused, whether retraining or implementing enterprisewide standards.

• Identify external resources: There are many tools that can help design improvement strategies, including resources from state AHIMA chapters, Project US@ and its companion guide, and AHIMA’s naming policy.

Finally, involve the registration team. It’s the first stop for patient data, so their buy-in is incredibly important to ongoing MPI health and provision of quality care. Establish feedback loops and improve training materials to help boost their understanding of just how important they are to the organization and MPI management.

A Synergistic Approach
Just as no two M&A strategies are alike, managing the MPI isn't a one-size-fits-all process. It requires a tailored approach that synergizes people, processes, and technology for optimal outcomes. Successful MPI management hinges on the collaborative efforts of individuals, streamlined processes, and leveraging advanced technology.

There's no magic wand to solve the complexities of MPI management; instead, it's about harnessing the collective power of this trio working in tandem to ensure accurate patient identification, streamlined operations, and data integrity. By recognizing the unique challenges and opportunities within their organization and effectively aligning people, processes, and technology, health care entities can navigate the intricacies of MPI management with confidence and effectiveness.

— Megan Pruente, MPH, RHIA, is vice president of industry relations and strategy with Harris Data Integrity Solutions, the leading provider of best-in-class patient data integrity services and software.