Overview

The system must allow a user to distinguish information about patients with similar sounding names or identifying information in order to select the right patient from the provider’s EHR or other clinical software. This information allows the provider to correctly identify and select the correct patient. For example, twins living in the same household will have similar dates of birth, addresses, and may have similar sounding names. Specifically for matching patients with those in the immunization registry, the EHR or other clinical software should have the ability to record the mother’s maiden name, whether the patient was part of a multiple birth, and if so, the order of birth, when such information is available.

Example

Joanna Gonzales Morales, age 32, presents at the office with her twin daughters, Juana Maria Gonzales Morales and Mariela Gonzales Morales, age 3 years and 4 months. Neither child has received any MMR vaccine. The provider (e.g., doctor, nurse, etc.) must administer the vaccine to each child and then record the immunization information in each child’s record in the EHR or other clinical software system.

To accomplish this, the intake clerk enters the name “Juana Maria Morales” into the system to locate her record. The system returns three potential matches: 1) Juana Maria Gonzales Morales (multiple birth indicator = yes, birth order = 1); 2) Mariela Gonzales Morales (multiple birth indicator = yes, birth order =2); and 3) Juana Mariana Gonzales (multiple birth order = no). In this instance, the multiple birth indicator and birth order information provides sufficient information for the intake clerk to quickly determine which patient to select.

Guidance

The HL7 2.5.1 Implementation Guide lists data elements usable for patient identification. Click here for the full set of demographic data elements. When provided with such information, systems should store and submit it. The fields most likely to be absent in existing software the project evaluated include multiple birth indicator and birth order. These fields are helpful in immunization registries to differentiate children from multiple births, especially when other differentiating data are not available from the birth facility. Capturing complete data (e.g., a full middle name rather than a middle initial) is preferable to differentiate patients with similar names.

• Vendor Perspective. Products with the ability to store all elements listed as required (R), required if exist (RE), and conditional (C) may more commonly match patients with those in public health registries by allowing capture of a superset of demographic elements to manage the variation in statutory requirements.
• Provider and Implementer Perspectives. Capturing more demographic data elements for each patient helps match patients within the practice and especially when communicating with immunization registries. Better matching increases the likelihood that queries sent to the registry for information will identify unique patients and return data to the practice.

Test

Click here for a test script scenario that includes the capability Select New Patients. The script also indicates successful performance for each of the test sections. When provided in the script with a patient’s full middle name, a mother’s maiden name, multiple birth data and birth order, the system will be able to distinguish among test patients with similar sounding names and twins.

Data Elements

Click here for data elements associated with the capability Select New Patients.