Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use

Abstract

Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

• Computer communication networks
• controlled
• health care reform
• health facilities
• health information exchange
• vocabulary

Acknowledgements

The authors thank Amanda Smiley, Lincoln Carr and Andrew Martin of the Regenstrief Institute for their help in extracting service location information from real-world clinical information systems. We also thank Lacy E. Boyd, Jr. and Masoud Hosseini, graduate students at the Indiana University School of Informatics and Computing, for their assistance with mapping and data analysis. The authors also thank the Indiana Health Information Exchange and health information exchange organizations that provided insight on their local strategies for managing service location information. Further, the authors thank Eduardo Jezierski of InSTEDD as well as Shaun Grannis and Dan Vreeman of the Regenstrief Institute for providing feedback on drafts of the manuscript.

Declaration of Interest

This publication is derived from work supported under a contract with the U.S. Social Security Administration (Contract No. SS00-10-60031). The views expressed in this publication are those of the authors and do not necessarily reflect the position or policy of the Social Security Administration, Department of Veterans Affairs or the United States government.