The report cites the need for more work by providers.

The Government Accountability Office (GAO) report on patient matching dropped last Wednesday. The industry had been waiting for the report since the 2016 passage of the 21st Century Cures Act, which included a provision for the GAO to report on the Office of the National Coordinator’s (ONC’s) patient record matching policies and related activities. 

The report concluded that more work is needed to ensure that patient health records are consistently and accurately matched. The GAO interviewed a total of 37 stakeholders, including ONC officials, provider and industry associations, representatives from physician practices, hospitals, health systems, health information exchanges (HIEs), and information technology vendors. 

The interviewed parties reported the following challenges:

  • Inaccurate, incomplete, or inconsistently formatted demographic information (i.e. patient first name, last name, middle name, date of birth, address, cell phone contact, etc.)
  • Patients’ records don’t always contain correct information, and health information technology systems and providers use different formats for key information such as names that contain hyphens.

These findings are very well-known to those who manage the master patient index in their healthcare facilities. Most health information management (HIM) professionals struggle daily with the management and resolution of these data discrepancies.

Stakeholders relayed that more could be done to improve patient matching, identifying several suggestions:

  • Establishing common standards for demographic data
  • Developing a data set to test the accuracy of matching methods
  • Sharing best practices and other resources
  • Implementing a national unique patient identifier
  • Developing a public-private collaboration effort
  • Instituting an ONC requirement of demographic data standards as part of the electronic health record (EHR) certification process; others suggested ONC facilitate the voluntary adoption of such standards

Finally, the report noted that many stakeholders emphasized that no single effort would solve the challenge of patient matching. This is an important finding since patient matching is not a one-and-done, technology-only solution. The people, processes, and technology approach used by many healthcare organizations incorporates staff education and training, daily maintenance of the master patient index by a data integrity team, and ensuring that the technology used to sometimes auto-match records are monitored for quality.

The healthcare industry has long recognized the need for accurate patient matching. As our systems become larger through mergers and acquisitions, technology disruption, and ingesting data from multiple sources, the patient’s demographic data will grow in complexity without data standards.


Program Note:

Listen to Julie Dooling report this story today on Talk Ten Tuesday, 10 a.m. Eastern. 

Comment on this article

Facebook
Twitter
LinkedIn

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Proactive Denial Management: Data-Driven Strategies to Prevent Revenue Loss

Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.

November 19, 2025
Sepsis: Bridging the Clinical Documentation and Coding Gap to Reduce Denials

Sepsis: Bridging the Clinical Documentation and Coding Gap to Reduce Denials

Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.

September 24, 2025
2026 IPPS Masterclass 3: Master MS-DRG Shifts and NTAPs

2026 IPPS Masterclass Day 3: MS-DRG Shifts and NTAPs

This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.

August 14, 2025

Trending News

Featured Webcasts

Surviving Federal Audits for Inpatient Rehab Facility Services

Surviving Federal Audits for Inpatient Rehab Facility Services

Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.

November 13, 2025
E/M Services Under Intensive Federal Scrutiny: Navigating Split/Shared, Incident-to & Critical Care Compliance in 2025-2026

E/M Services Under Intensive Federal Scrutiny: Navigating Split/Shared, Incident-to & Critical Care Compliance in 2025-2026

During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.

August 26, 2025
The Two-Midnight Rule: New Challenges, Proven Strategies

The Two-Midnight Rule: New Challenges, Proven Strategies

RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.

June 19, 2025

Trending News

Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more

Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24