By David Bennett and Dr. Brian Frohna

Fragmented patient information continues to be a significant barrier to tackling rising health care costs and improving the quality, safety and efficiency of care.

As data proliferates, a longitudinal view of an individual’s medical record sets the foundation for enhanced care coordination, informed clinical decision-making and improved patient experiences.



Despite intense efforts and significant investments to implement EHRs, duplicate and incomplete records continue to plague providers. Patient data matching functionalities within EHRs often lack the complexities to unify information from disparate and external systems. The resulting number of duplicate and disjointed records lead to patient safety errors, skewed reporting and analytics, administrative burdens and lost revenue.

To align records for 4.5 million patients across its multiple hospitals, imaging centers and radiology practice locations, and to provide on-demand access to scads of imaging exams, Phoenix-based Southwest Diagnostic Imaging (SDI) – one of the nation's largest radiology specialty corporations – looked to implement an enterprise-wide solution that would consolidate patient data and imaging files into a single record.

Defining the challenge
Integrating patient records with medical imaging is a challenge for many of today's radiology practices. Lack of real-time access to X-rays, MRIs and other imaging files caused by siloed health care data across various systems and settings leads to suboptimal outcomes and avoidable costs of care.

Providing diagnostic imaging services to the entire Phoenix metropolitan area, SDI is comprised of three radiology practices – Valley Radiologists, Scottsdale Medical Imaging and East Valley Diagnostic Imaging. Annually, SDI performs 900,000 outpatient exams and interprets 2.6 million exams across its 35 full-service imaging centers and 12 regional hospitals.

Like many growing health care institutions, SDI struggled to reconcile and exchange patient data and imaging files from multiple systems and locations. For years, radiologists spent much of their day performing addendums because information at the point of care was missing or incomplete. At times, radiologists could not access patient studies from hospitals just 150 yards away.

When radiologists received newly acquired patient imaging studies, previous medical histories, X-rays, laboratory and test results were not readily available, hindering the ability to accurately interpret radiologic examinations.

From a revenue and operational standpoint, duplicate and disconnected records at SDI put a strain on billing, which faced inefficiencies processing claims, collections and payments.

Duplicate patient records frequently occur as a result of complex spellings or multiple name variations, data entry errors and a lack of standardized admissions processes. A typo or absence of a single digit in one’s Social Security number, birth date or address only compounds the potential for creating duplicates. This can lead to diagnosis errors, redundant medical tests, gaps in treatment and billing inaccuracies.

The solution
Managing and sharing patient information across multiple systems and sites of care requires a holistic approach, free of data silos and disjointed records that hinder patient care and optimal clinical workflows. As health information exchange proliferates, organizations must be able to quickly reconcile the exorbitant amount of patient data within the network.

To give their providers an enterprise view of any given patient, and enable greater clinical and operational efficiency, SDI implemented a vendor-agnostic enterprise master patient index (EMPI) to facilitate medical record reconciliation and link imaging files to the same individual in real time. The patient matching technology enabled integration and clean-up of more than 5.2 million records within 18 source systems across SDI’s 35 imaging centers, 12 regional hospitals and third-party sources, and prevented the creation of 100,000 duplicate records in the first six months.

Additionally, SDI was able to:

• Move its patient master file out of the billing system and institute a stand-alone network for cross-platform patient identification.
• Provide an automated, centralized interface to integrate, resolve and unify patient records across all clinical and financial systems.
• Bring accuracy and consistency to the complex patient data environment by creating a single source of truth for every individual.
• Establish SDI as a fully integrated entity for seamless health information exchange and a longitudinal view of a patient’s medical imaging history regardless of where the exam was performed.

Patient identity management has made a big difference in the efficiency and effectiveness of SDI’s clinicians and staff, and has reduced wait times for patients and their families.

Automation and data standardization provided by the EMPI have streamlined workflow and productivity, affording downstream benefits to SDI’s operational and financial outcomes. The enterprise implementation allows radiologists, technicians and other staff members to provide improved patient services via portals and online billing tools, delivery of electronic reports and electronic image linking with added ease and security.

Prior to implementing the EMPI technology, radiologists at SDI had a limited view of their patient’s historic data, which led to continuous disruptions throughout each phase of the workflow, and delayed turnaround time of reports. Since the patient matching implementation in January 2017, the number of addendums has reduced by 75 percent on average. That means clinicians spend less time performing repeated documentation tasks and more time assessing, treating and engaging with patients.


About the authors: David Bennett is vice president of partnerships and alliances for NextGate, a global health care leader in identity management. Dr. Brian Frohna is a Phoenix-based, board-certified radiologist specializing in diagnostic radiology and neuroradiology and chief technology officer of SDI.