Question

Describe the difference between a Master Patient Index and Enterprise Master Patient Index (EMPI).  

How will an EMPI improve data integrity, patient safety.  

Consider how this will impact Health Information Exchange.   

Answer 1

DIFFERENCE BETWEEN MPI AND EMPI

MPI	EMPI
The Master Patient Index (MPI) refers to a database that is maintained by a health care organization for identifying a patient and their medical record.	An enterprise master patient index (EMPI) is a database that can maintain consistent and accurate information about each patient registered by a healthcare organization. It may link several smaller MPIs together, such as those from outpatient clinics and rehabilitation facilities and also it can aggregate patient data contained in separate systems within one facility.
Duplication of records is common:while comparing records coming from different sources, the MPI creates duplicate records and splits up a patient’s information which cause even more problems when sent to downstream systems and make it harder for a care provider to find the right information.	More efficient matching methods done to avoid duplication:The enterprise master patient index (EMPI) is designed to correlate patient identifiers from different systems and settings, like EMRs,insurers and HIEs.It uses both probabilistic and deterministic matching algorithms to account for slight variations in data content, increasing the likelihood of finding a match.
Poor data stewardship capabilities:a lack of standardized procedures to enter data in the MPI system have resulted in an inaccurate and incomplete MPI.	Better data stewardship capabilities: An EMPI provides consistent and accurate information about each patient registered by a healthcare organization.It offers many tools for managing data integrity and defining transaction workflows. Other features include the user interfaces to merge, unmerge, and edit records .

HOW EMPI ENSURES DATA INTEGRITY AND PATIENT SAFETY

• For ensuring data integrity, an EMPI must contain only one complete, consistent and accurate record for each patient registered within the healthcare organization.
• One of the first steps to ensuring the integrity of patient data is to know what is in the EMPI by analyzing the data so as to find duplicate records or other errors.This is done by making use of algorithms to constantly look for duplicate records in a healthcare organization's registration system. The algorithms scan for data elements within the patient's information; for example, their name, address, medical record number, Social Security number, insurance company or healthcare provider.

• The two algorithms used by EMPI to match patient records are: deterministic and probabilistic.
  Deterministic matching, also called exact match logic, looks for an exact match of the data elements in a patient record. For example, two records will match if they agree on elements such as the patient's first and last name and phone number. Elements that do not match exactly, such as a nickname, will likely cause a rejection.

  Probabilistic matching assigns a rank to different data elements based on a preset acceptable level of certainty and scores the likelihood that two or more records belong to the same patient. The higher the score, the higher the probability that there is a match between two records.

• Since improper matching causes caregivers to unknowingly make treatment decisions based on incomplete or inaccurate data, posing a serious risk to patient safety,EMPI is considred to be safe in this regard.

IMPACT ON HEALTH INFORMATION EXCHANGE:

• Health Information Exchange allows health care professionals and patients to appropriately access and securely share a patient’s medical information electronically. EMPI determines whether records belong to the same patient or if more research is needed.

• The use of the EMPI helps the health information exchange to better match and link patient records across its participating providers and correctly matching patient records from disparate systems and different organizations provides a more complete view of a patient. Additional benefits include:

1. Better patient care

2. Improved customer service

3. In emergency or other critical care situations, medical staff can be more confident that they know medical conditions or other information that would be critical to providing proper care

4. Historical care related information can be obtained from across organizations