Increases in patient volume have made it difficult for medical staff to collect accurate contact details from patients, and with low levels of interoperability across health entities, professionals risk more errors occurring at every point in the care continuum. These types of mistakes can lead to a plethora of costly effects for patients across the care continuum: administrative errors, incorrect diagnoses, duplicate procedures, wrong medication, etc.
In an effort to remedy this long-standing affliction, health organizations like the Office of the National Coordinator for Health Information Technology (ONC) and Health Level 7 (HL7) have drawn new light to the concept of location as a cornerstone of the health system, and address standardization as an effective cure.
Why Address Standardization?
The global health agenda aims to ensure that all people obtain the health services they need. But in the age of digital transformation, delivering excellence in patient service doesn’t come easy.
Improved health care quality demands at the very least better data on the location of both services and populations they are intended to serve. However, in the age where patient data is entering health systems in different formats, this knowledge does not always come in the most organized, digestible format. Outcomes like duplicate patient records, incomplete profiles, and incorrect diagnosis, become the very basis behind some of the more costly data-driven health care errors.
Conscious of the need for a unique patient identifier, experts are leaning on location data as the latest method to advance patient identification efforts. Organizations such as the ONC and HL7 have outlined the need for a universal standard for interoperability of health systems, but there are still many obstacles to overcome.
Project US@ was launched in December 2020 to help health officials and experts establish a universal criterion for patient address data, aims to make United States Postal Service (USPS) address-formatting tools available for use by health providers.
However, the 21st Century Cures Act outlines several limitations with using the USPS standard, stating: “While the US Postal Service Postal Addressing Standards include a single representation for certain data elements (such as rendering apartment as apt, building as bldg, floor as fl, etc), they also allow variations for other data elements, such as ‘acceptable’ and ‘preferred’ spellings and abbreviations for street and city names. This may result in multiple ‘valid’ addresses. … Because of the variation, the required use of reference files, and the manual reconciliation necessary for implementation, we have not adopted the US Postal Service Postal Addressing Standards as a required standard for the address Data Elements within the USCDI.”
The Postal Service’s database has generally been plagued by poor data quality due to inconsistent updates and misconducted street reviews. Addressing is complex, relying on incomplete or inaccurate location data is not enough to end the patient matching crisis. In times like these, trusting an address verification specialist to reduce variation in data formatting and completion is the best path forward toward universal address standardization.
Addressing is complex
Across the 249 countries and territories, there are approximately 6,500 spoken languages, 139 character scripts, and more than 130 different address formats that are continuously changing.
Variations in address structure, complex address formatting/order and data decay (the percentage of people that move every year equates to 14% of the population or roughly 40 million), are a few of the obstacles hindering our effort to fully understand the complex nature of verifying addresses.
The extent of usefulness of address data is critically dependent on the quality of the data. This implies the requirement for all data to be verified, enhanced, and formatted to one single standard but variations in the methods used to collect and patient data in EHR systems makes it challenging. For example, some might record “Avenue” while others use “Ave.” While this distinction may seem like a harmless nuance, the damage can be detrimental when applied to patient care.
Consider a street address, one of the most commonly used geographic identifiers for a patient. This address information can be used to communicate with past and current patients, validate patient identify for treatment, or can be converted into locations on a map through geocoding to direct patients to further care. If an address is recorded incorrectly during the point of capture or is not maintained consistently across health systems, it limits the ability to share information across systems, which in turn limits opportunities for proper care coordination.
The ultimate goal: Interoperability
To date, interoperability has remained more of a distant promise than a reality. Limitations of USPS forced sharing of data filled with data gaps globally and internally mean that a golden record is far from reach without new innovation.
One innovation that is making headway is address intelligence technology. Address enhancement, standardization and normalization procedures are critical components of the address validation process. Linking electronic health record (EHR) or Enterprise Master Patient Index (EMPI) systems to address verification APIs holds great promise for addressing some of the location-based obstacles standing in the way of developing a universal standard.
Using this technology, health entities can ensure that the correct address is recorded at the point of entry before entering any database and reliably formatted to a single standard to eliminate data quality issues. During the data enrichment part of the process, health professionals can gain another key variable for pinpointing location via geographical latitude and longitude coordinates that can be automatically generated and appended to any address. These coordinates can also be used as reverse geocoding, allowing patients to identify providers in their neighborhood in the case of in-network physician searches and referrals.
Address verification standardizes each captured address, detecting validity of the address while correcting spelling errors, adjusting abbreviations, and adding missing information (such as ZIP code), so that each address is converted to the appropriate format. This means addresses are always accurate, standardized, and up to date.
Enhancing provider relations
Beyond supporting the connection between providers and patients, location data can also enhance the communication and processes between providers. In a single year, providers can receive approximately two million referrals for outpatient services. This volume was too often accompanied by incomplete referrals, long waiting times for specialist outpatients, and delays in patient care. General practitioners (GPS) and clinicians depend on provider data—which includes such information as a physician’s name, services, specialty, address, phone number, hours of operation, etc.— for referrals, test orders, outpatient appointments, diagnostic procedures, and surgeries.
By collecting and standardizing patient data at the point of capture, providers can improve referral tracking and referrer’s visibility, giving reliable access to provider information, enabling informed decision-making, and enhancing workflow processes. Additionally, with the help of a geocoding API, providers can calculate the distance from the patient’s address to the healthcare service location and provide this information to the GP so they can make an informed decision on where to refer the patient.
The path forward
By validating and standardizing mailing addresses according to a global reference dataset that is curated from some of the most trusted data sources across the globe, health entities can deliver an even higher degree of patient data and matching accuracy to customers.
But first we must seek to improve the quality of our matching through the construction of a single best address format and best record.
Integrating Loqate's solutions into an existing infrastructure is seamless. Our APIs can be implemented or embedded depending on the final solution, but the outcome is always the same: easily accessible, accurate global address data.
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