{"id":998,"date":"2019-09-18T17:31:00","date_gmt":"2019-09-18T17:31:00","guid":{"rendered":"https:\/\/www.hln.com\/?p=998"},"modified":"2024-04-05T05:59:57","modified_gmt":"2024-04-05T05:59:57","slug":"onc-pmal-project-creeping-forward-on-patient-matching","status":"publish","type":"post","link":"https:\/\/www.hln.com\/onc-pmal-project-creeping-forward-on-patient-matching\/","title":{"rendered":"ONC PMAL Project: Creeping Forward on Patient Matching"},"content":{"rendered":"<div id=\"themify_builder_content-998\" data-postid=\"998\" class=\"themify_builder_content themify_builder_content-998 themify_builder\">\n \t<!-- module_row -->\n\t<div class=\"themify_builder_row module_row clearfix module_row_0 themify_builder_998_row module_row_998-0 tb_fzky614\">\n\t \t <div class=\"row_inner col_align_top\" >\n\t\t\t<div class=\"module_column tb-column col-full first tb_998_column module_column_0 module_column_998-0-0 tb_tu41614\">\n\t \t \t <div class=\"tb-column-inner\">\n\t\t <!-- module text -->\n<div class=\"module module-text tb_30u441 \">\n <div class=\"tb_text_wrap\">\n <p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1722 alignright\" src=\"https:\/\/dev-new-hln-site.pantheonsite.io\/wp-content\/uploads\/2020\/08\/ONC-Petient-Matching.png\" alt=\"\" width=\"207\" height=\"223\" srcset=\"https:\/\/www.hln.com\/wp-content\/uploads\/2020\/08\/ONC-Petient-Matching.png 469w, https:\/\/www.hln.com\/wp-content\/uploads\/2020\/08\/ONC-Petient-Matching-278x300.png 278w\" sizes=\"auto, (max-width: 207px) 100vw, 207px\" \/><br \/>Last week, the Office of the National Coordinator for Health Information Technology (<a href=\"https:\/\/www.healthit.gov\/topic\/about-onc\" target=\"_blank\" rel=\"noopener noreferrer\">ONC<\/a>) released the <a href=\"https:\/\/www.healthit.gov\/sites\/default\/files\/page\/2019-09\/PMAL%20Final%20Report-08162019v2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">final report<\/a> from its Patient Matching, Aggregation, and Linking (<a href=\"https:\/\/www.healthit.gov\/topic\/scientific-initiatives\/pcor\/patient-matching-aggregating-and-linking-pmal\" target=\"_blank\" rel=\"noopener noreferrer\">PMAL<\/a>) Project, as well as an <a href=\"https:\/\/www.healthit.gov\/sites\/default\/files\/page\/2019-09\/PMAL_PDDQ_Paper_08292019.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">additional report<\/a> describing a pilot project to test the <a href=\"https:\/\/www.healthit.gov\/playbook\/pddq-framework\/\" target=\"_blank\" rel=\"noopener noreferrer\">Patient Demographic Data Quality Framework<\/a>\u00a0(PDDQ) to Support Patient Matching that was released several years ago. Funded from June 2015 through September 2018 by the HHS\u00a0Office of the Assistant Secretary for Planning and Evaluation (ASPE) through the\u00a0Patient-Centered Outcomes Research (PCOR) Trust Fund, PMAL was one of the activities I described in an <a href=\"https:\/\/live-new-hln-site.pantheonsite.io\/update-on-patient-matching-activities\/\" rel=\"noopener noreferrer\">earlier blog entry<\/a>.<\/p>\n<p>The Final Report reviews the four challenged of patient matching and linking that the PMAL project attempted to address:<\/p>\n<ul>\n<li><strong>Improvements to Matching Algorithms:\u00a0<\/strong>This section primarily addresses work that was done to support the ONC\u00a0<a href=\"https:\/\/www.healthit.gov\/buzz-blog\/interoperability\/demystifying-patient-matching-algorithms\" target=\"_blank\" rel=\"noopener noreferrer\">Patient Matching Algorithm Challenge<\/a>, including development of test data and an open source<strong>\u00a0<\/strong><a href=\"https:\/\/mitre.github.io\/test-harness-interface\/\" target=\"_blank\" rel=\"noopener noreferrer\">test harness<\/a>. I have previously raised my own concerns about the challenge participants “tuning” their algorithms for the test data set, and ONC also seemed to indicate at the time that the “gold standard” data set was not actually used for the challenge. With regard to the test harness, I am not aware of anyone\u00a0leveraging this tool for algorithm evaluation but it very well may be in use.<\/li>\n<li><strong>Improvements to Data Quality:\u00a0<\/strong>The main activity here seems to be regarding\u00a0PDDQ, an evaluation tool for organizations to use to assess the standardization of their policies, procedures, and practices\u00a0with respect to patient matching. The more <a href=\"https:\/\/www.healthit.gov\/sites\/default\/files\/page\/2019-09\/PMAL_PDDQ_Paper_08292019.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">detailed report<\/a> describes a pilot project using PDDQ done in conjunction with a set of community health centers affiliated with <a href=\"https:\/\/ochin.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OCHIN<\/a>. Once again, I am not aware of any organizations who have used this tool, and the results from the pilot study were mixed at best.<\/li>\n<li><strong>Expanded Data Sharing:\u00a0<\/strong>In many ways, this section described projects I was least aware of and which I found most interesting. It describes a number of efforts within the standards development world to create specifications and tools related to security and trust which are prerequisites to effective matching and linking. The project built upon standards like <a href=\"https:\/\/oauth.net\/\" target=\"_blank\" rel=\"noopener noreferrer\">OAuth<\/a> and <a href=\"https:\/\/www.hl7.org\/fhir\/\" target=\"_blank\" rel=\"noopener noreferrer\">FHIR <\/a>and worked with the <a href=\"https:\/\/openid.net\/foundation\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenID Foundation<\/a> to create the\u00a0<a href=\"https:\/\/openid.net\/wg\/heart\/\" target=\"_blank\" rel=\"noopener noreferrer\">Health Relationship Trust (HEART) Working Group<\/a>. They also experimented with innovative technologies like <a href=\"https:\/\/en.wikipedia.org\/wiki\/Blockchain\" target=\"_blank\" rel=\"noopener noreferrer\">blockchain <\/a>to explore its relevance to this domain.<\/li>\n<li><strong>Data Standardization:\u00a0<\/strong>Activities in this arena focused on tools to evaluate record completion (necessary for good matching or linking), data provenance (necessary for better reliability, supported by an ONC <a href=\"https:\/\/www.cccinnovationcenter.com\/challenges\/provenance-challenge\/\" target=\"_blank\" rel=\"noopener noreferrer\">Data Provenance challenge<\/a>), and work on provider identity and provider directory (again, to help ensure better reliability and accuracy).<\/li>\n<\/ul>\n<p>This project helped ONC and the PCORS community “go deep” on a number of important technical and policy issues. It is less clear how widely these tools are being used or even how useful they are given some of the limitations described in their own studies. We still do not have a unified approach to patient matching and linking in healthcare, but perhaps we might make more progress if Congress proceeds to lift its ban on a national patient identifier. As care becomes more patient-centered, and the need for data sharing and integration extends beyond just healthcare (see the Stewards of Change National Interoperability Collaborative’s Person Matching Workgroup), better person matching and linking become even more important.<\/p>\n<p><br \/><i><\/i><\/p> <\/div>\n<\/div>\n<!-- \/module text -->\n\t <\/div>\n\t \t<\/div>\n\t\t <\/div>\n\t <!-- \/row_inner -->\n\t<\/div>\n\t<!-- \/module_row -->\n\t\t<!-- module_row -->\n\t<div class=\"themify_builder_row module_row clearfix module_row_1 themify_builder_998_row module_row_998-1 tb_a08y359\">\n\t \t <div class=\"row_inner col_align_top\" >\n\t\t\t<div class=\"module_column tb-column col-full first tb_998_column module_column_0 module_column_998-1-0 tb_5efg361\">\n\t \t \t <div class=\"tb-column-inner\">\n\t\t <!-- module text -->\n<div class=\"module module-text tb_ocxr793 \">\n <div class=\"tb_text_wrap\">\n <p><strong>Send us feedback about this blog<\/strong><\/p> <\/div>\n<\/div>\n<!-- \/module text -->\n<!-- module text -->\n<div class=\"module module-text tb_rset364 \">\n <div class=\"tb_text_wrap\">\n \n<div class=\"wpcf7 no-js\" id=\"wpcf7-f616-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"616\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"> <ul><\/ul><\/div>\n<form action=\"\/wp-json\/wp\/v2\/posts\/998?utm_source=PANTHEON_STRIPPED&utm_medium=PANTHEON_STRIPPED&utm_campaign=PANTHEON_STRIPPED&utm_term=PANTHEON_STRIPPED#wpcf7-f616-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"616\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f616-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p><label><span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Name*\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span> <\/label>\n<\/p>\n<p><label><span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email*\" value=\"\" type=\"email\" name=\"email\" \/><\/span> <\/label>\n<\/p>\n<p><label><span class=\"wpcf7-form-control-wrap\" data-name=\"company\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Company\/Website\" value=\"\" type=\"text\" name=\"company\" \/><\/span> <\/label>\n<\/p>\n<p><label><span class=\"wpcf7-form-control-wrap\" data-name=\"comment\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Comment\" name=\"comment\"><\/textarea><\/span><\/label>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap g-recaptcha-response\"><span class=\"wpcf7-form-control\"> <\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" id=\"submitcomment\" type=\"submit\" value=\"Submit Comment\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n <\/div>\n<\/div>\n<!-- \/module text -->\n\t <\/div>\n\t \t<\/div>\n\t\t <\/div>\n\t <!-- \/row_inner -->\n\t<\/div>\n\t<!-- \/module_row -->\n\t<\/div>\n\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Last week, the Office of the National Coordinator for Health Information Technology (ONC) released the final report from its Patient Matching, Aggregation, and Linking (PMAL) Project, as well as an additional report describing a pilot project to test the Patient Demographic Data Quality Framework (PDDQ) to Support Patient Matching that was released several years ago. This project was funded from June 2015 through September 2018 by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) through the Patient-Centered Outcomes Research (PCOR) Trust Fund.<\/p>\n","protected":false},"author":4,"featured_media":1722,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[17,20],"tags":[36],"class_list":["post-998","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-matching","category-onc","tag-blog","has-post-title","has-post-date","has-post-category","has-post-tag","has-post-comment","has-post-author",""],"acf":[],"builder_content":"<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dev-new-hln-site.pantheonsite.io\/wp-content\/uploads\/2020\/08\/ONC-Petient-Matching.png\" alt=\"\" width=\"207\" height=\"223\" srcset=\"https:\/\/www.hln.com\/wp-content\/uploads\/2020\/08\/ONC-Petient-Matching.png 469w, https:\/\/www.hln.com\/wp-content\/uploads\/2020\/08\/ONC-Petient-Matching-278x300.png 278w\" sizes=\"auto, (max-width: 207px) 100vw, 207px\" \/><br \/>Last week, the Office of the National Coordinator for Health Information Technology (<a href=\"https:\/\/www.healthit.gov\/topic\/about-onc\" target=\"_blank\" rel=\"noopener noreferrer\">ONC<\/a>) released the <a href=\"https:\/\/www.healthit.gov\/sites\/default\/files\/page\/2019-09\/PMAL%20Final%20Report-08162019v2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">final report<\/a> from its Patient Matching, Aggregation, and Linking (<a href=\"https:\/\/www.healthit.gov\/topic\/scientific-initiatives\/pcor\/patient-matching-aggregating-and-linking-pmal\" target=\"_blank\" rel=\"noopener noreferrer\">PMAL<\/a>) Project, as well as an <a href=\"https:\/\/www.healthit.gov\/sites\/default\/files\/page\/2019-09\/PMAL_PDDQ_Paper_08292019.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">additional report<\/a> describing a pilot project to test the <a href=\"https:\/\/www.healthit.gov\/playbook\/pddq-framework\/\" target=\"_blank\" rel=\"noopener noreferrer\">Patient Demographic Data Quality Framework<\/a>\u00a0(PDDQ) to Support Patient Matching that was released several years ago. Funded from June 2015 through September 2018 by the HHS\u00a0Office of the Assistant Secretary for Planning and Evaluation (ASPE) through the\u00a0Patient-Centered Outcomes Research (PCOR) Trust Fund, PMAL was one of the activities I described in an <a href=\"https:\/\/live-new-hln-site.pantheonsite.io\/update-on-patient-matching-activities\/\" rel=\"noopener noreferrer\">earlier blog entry<\/a>.<\/p> <p>The Final Report reviews the four challenged of patient matching and linking that the PMAL project attempted to address:<\/p> <ul> <li><strong>Improvements to Matching Algorithms:\u00a0<\/strong>This section primarily addresses work that was done to support the ONC\u00a0<a href=\"https:\/\/www.healthit.gov\/buzz-blog\/interoperability\/demystifying-patient-matching-algorithms\" target=\"_blank\" rel=\"noopener noreferrer\">Patient Matching Algorithm Challenge<\/a>, including development of test data and an open source<strong>\u00a0<\/strong><a href=\"https:\/\/mitre.github.io\/test-harness-interface\/\" target=\"_blank\" rel=\"noopener noreferrer\">test harness<\/a>. I have previously raised my own concerns about the challenge participants \"tuning\" their algorithms for the test data set, and ONC also seemed to indicate at the time that the \"gold standard\" data set was not actually used for the challenge. With regard to the test harness, I am not aware of anyone\u00a0leveraging this tool for algorithm evaluation but it very well may be in use.<\/li> <li><strong>Improvements to Data Quality:\u00a0<\/strong>The main activity here seems to be regarding\u00a0PDDQ, an evaluation tool for organizations to use to assess the standardization of their policies, procedures, and practices\u00a0with respect to patient matching. The more <a href=\"https:\/\/www.healthit.gov\/sites\/default\/files\/page\/2019-09\/PMAL_PDDQ_Paper_08292019.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">detailed report<\/a> describes a pilot project using PDDQ done in conjunction with a set of community health centers affiliated with <a href=\"https:\/\/ochin.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OCHIN<\/a>. Once again, I am not aware of any organizations who have used this tool, and the results from the pilot study were mixed at best.<\/li> <li><strong>Expanded Data Sharing:\u00a0<\/strong>In many ways, this section described projects I was least aware of and which I found most interesting. It describes a number of efforts within the standards development world to create specifications and tools related to security and trust which are prerequisites to effective matching and linking. The project built upon standards like <a href=\"https:\/\/oauth.net\/\" target=\"_blank\" rel=\"noopener noreferrer\">OAuth<\/a> and <a href=\"https:\/\/www.hl7.org\/fhir\/\" target=\"_blank\" rel=\"noopener noreferrer\">FHIR <\/a>and worked with the <a href=\"https:\/\/openid.net\/foundation\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenID Foundation<\/a> to create the\u00a0<a href=\"https:\/\/openid.net\/wg\/heart\/\" target=\"_blank\" rel=\"noopener noreferrer\">Health Relationship Trust (HEART) Working Group<\/a>. They also experimented with innovative technologies like <a href=\"https:\/\/en.wikipedia.org\/wiki\/Blockchain\" target=\"_blank\" rel=\"noopener noreferrer\">blockchain <\/a>to explore its relevance to this domain.<\/li> <li><strong>Data Standardization:\u00a0<\/strong>Activities in this arena focused on tools to evaluate record completion (necessary for good matching or linking), data provenance (necessary for better reliability, supported by an ONC <a href=\"https:\/\/www.cccinnovationcenter.com\/challenges\/provenance-challenge\/\" target=\"_blank\" rel=\"noopener noreferrer\">Data Provenance challenge<\/a>), and work on provider identity and provider directory (again, to help ensure better reliability and accuracy).<\/li> <\/ul> <p>This project helped ONC and the PCORS community \"go deep\" on a number of important technical and policy issues. It is less clear how widely these tools are being used or even how useful they are given some of the limitations described in their own studies. We still do not have a unified approach to patient matching and linking in healthcare, but perhaps we might make more progress if Congress proceeds to lift its ban on a national patient identifier. As care becomes more patient-centered, and the need for data sharing and integration extends beyond just healthcare (see the Stewards of Change National Interoperability Collaborative's Person Matching Workgroup), better person matching and linking become even more important.<\/p> <p><br \/><i><\/i><\/p>\n<p><strong>Send us feedback about this blog<\/strong><\/p>\n<p>[contact-form-7 id=\"616\" title=\"Post Comment\"]<\/p>","_links":{"self":[{"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/posts\/998","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/comments?post=998"}],"version-history":[{"count":15,"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/posts\/998\/revisions"}],"predecessor-version":[{"id":5743,"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/posts\/998\/revisions\/5743"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/media\/1722"}],"wp:attachment":[{"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/media?parent=998"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/categories?post=998"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hln.com\/wp-json\/wp\/v2\/tags?post=998"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}