An enterprise master patient index to improve identity accuracy across state health and human services agencies

Objective: Describe how Washington state implemented a comprehensive identity management system and key lessons enabling highly accurate unique person identification across a complex multi-agency digital health information and patient identity ecosystem. Methods: Ensuring accuracy of patient identity is critical to patient engagement and in converging diverse streams of patient data across agencies. To improve identity accuracy, the state of Washington deployed an enterprise master patient index (EMPI). A qualitative study was conducted through interviews with agency technology leadership, and observations and insights were organized thematically into key areas of impact and value delivery, implementation challenges, and expectations for ongoing continuous improvement. Results: Issues encountered included: identity interoperability challenges in converging patient data from multiple agencies and data systems; critical needs for effective and efficient data governance; technological infrastructure required to establish identity management and integration strategies; and ongoing maintenance and advancement of the identity management solution. Building an advanced person-patient identity management system through the EMPI initiative conveyed benefits beyond an initial COVID-19 disease surveillance/contact tracing use case. It accelerated a pan-organizational effort by the State of Washington to address identity accuracy needs and gaps, and to improve identity accuracy performance. Conclusions: EMPI implementation in the state of Washington resolved duplication errors and reduced the inaccuracy of person-patient records, while enabling improved coordination of health and human services delivery, increased staff productivity, and decreased service delivery costs. In state disease control efforts, the EMPI enabled accelerated, more efficient and effective communicable disease contact tracing and disease control, thereby reducing infection transmission risk within the community.