Patient Identification

Patient identification is key to interoperability. The failure to find a patient's medical records may result in suboptimal care, while an incorrect patient match may expose information about the wrong patient, lead to incorrect clinical care decisions, and create a mix of patient records that are actually for different patients.

Patient identification is particularly challenging in the EMS environment:

• EMS incidents are usually time-sensitive emergencies.
• Most EMS calls are unscheduled.
• EMS providers encounter patients anywhere, usually not in healthcare facilities.
• EMS providers usually have limited time in contact with the patient.

Post-encounter Patient Matching

One commonly used method of patient matching is for EMS providers to obtain a "face sheet" from the hospital receiving the patient at the end of the EMS call. The face sheet is available after the patient has been registered at the hospital, and it contains the identifiers used by the hospital for the patient and the encounter. EMS providers can record the hospital-issued identifiers in their own software, and then their software can query for hospital outcomes using those identifiers.

The advantage of post-encounter patient matching is that it gets the specific identifiers for the hospital's patient encounter, which are available even if the true identity of the patient has not been established yet. The disadvantage is that the information is only available after EMS providers have already cared for the patient. It can only be used for post-encounter operational purposes, such as billing and quality improvement.

Real-time Patient Matching

Real-time, software-assisted patient matching utilizes the capabilities of health information networks to query for patients using whatever demographic data is known to EMS providers at the time of the patient encounter. For patients frequently encountered by EMS, it may be possible for EMS providers to pre-identify the patient while responding to the scene. In most cases, EMS cannot identify the patient until they have arrived at the scene and obtained some form of identification from the patient. Driver licenses are a commonly used and reliable source of patient identification.

The advantage of real-time patient matching is that it can happen earlier in an EMS encounter and enable EMS providers to query for the patient's medical history, which they can use to inform the care they provide. The challenges of real-time patient matching are that EMS providers often have very little time to identify the patient and retrieve and review the patient's medical history, and EMS providers may not have access to enough high-quality identifying information to conclusively determine the patient's identity.

The American Health Information Management Association (AHIMA) Naming Policy Framework 2023: Enhancing Person Matching with Essential Demographic Data Elements offers policies for standardizing how patients' (and providers') names are recorded, with the goal of improving patient matching.