Montefiore CIO on patient ID, pop health

December 11, 2014 in Medical Technology

One of the “basic challenges that we face,” says Jack Wolf, Montefiore Medical Center’s chief information officer, “is the lack of a unique patient identifier.”

Montefiore delivers care to some 2 million people in the Bronx and beyond, in its hospitals and some 100 ambulatory sites, including more than 20 Montefiore Medical Group locations.

It has long taken a keen interest in spurring better population health, seeking novel ways to tackle chronic disease, through various public health programs, including community-based health fairs, informational workshops and more.

Partnering with various agencies and community groups is an essential component of Montefiore’s education and outreach. But when it comes to the brass tacks of care delivery, there are hurdles, says Wolf – specifically when it comes to tracking patients.?as they move among various care settings beyond the Montefiore system.

“When you start to talk about population health, and start to talk about the population in the Bronx, our patients make their decisions about where they want to go for their own healthcare, and it’s not always to the same provider each time,” he says.

“An individual might show up to an emergency room that’s not part of our system, but we might be at risk for their healthcare,” he adds. “Or it might just be that they decide that they want to go to a different provider or a different specialist, outside or inside of our network. And when they move from one location to another, it’s difficult to say that Jack Wolf is the same Jack Wolf in the Montefiore system, now presenting in the emergency room of a Bronx-Lebanon or a Saint Barnabas.

“When you get into population health, tracking these patients is very dependent on being able to uniquely identify that it is the same patient,” says Wolf. “Obviously when you get into certain areas it’s critical you’re certain you have the right person for allergies and medications.”

The argument over the establishment of universal patient identifiers is a long and passionate one, of course. And Wolf recognizes this: “One person could say its more important to have access to your health record in a critical situation because it could save your life. Another might say, ‘Well that’s my decision, not your decision.’”

Still, despite that lack of a UPI, and the fact that New York is an opt-in state with regard to health information exchanges and regional health information organizations, Montefiore has been looking toward novel ways to solve the challenges of keeping patients identified as they move through different provider sites, locally and statewide.

“There are ways that you can identify the patient and still meet all the concerns (about) privacy,” he says. “That’s where I believe – and this is Jack Wolf’s personal opinion – that the power of the HIEs and the RHIOs comes into play.

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