Assertion-Based Record Linkage in Distributed Healthcare
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Solution Overview
Problem
Current systems face challenges in reconciling and linking patient records across multiple healthcare providers due to inconsistent patient identifiers and demographic information, especially in decentralized environments where manual review is time-consuming and prone to errors.
Innovation Solution
A method and apparatus that assign a unique record number, compare demographic information against a collection of records, derive a likelihood ratio, and use accept and reject thresholds to determine record linkage, with assertions allowing sites to independently review and manage matches and mismatches, ensuring autonomy and accuracy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual review is used to reconcile patient records across multiple healthcare providers, then accuracy of record linkage can be maintained, but time consumption and operational burden increase significantly
Solution Approach 1:
The patent introduces an intermediary automated system that acts as a mediator between multiple healthcare provider systems. This intermediary computes likelihood ratios and generates assertions about record matches, reducing the need for direct manual review while maintaining accuracy through systematic comparison and statistical analysis of demographic data across distributed systems.
Solution Approach 2:
The patent replaces the mechanical manual review process with an automated computational system that uses algorithms to compare demographic information, calculate likelihood ratios, and generate assertions. This substitution eliminates the time-consuming manual aspect while preserving accuracy through systematic automated analysis of patient records.
2Productivity
If automated systems are used to link patient records, then processing speed increases, but accuracy may deteriorate due to inconsistent patient identifiers and demographic information
Solution Approach 1:
The patent transforms the record linkage problem by changing parameters from simple exact matching to probabilistic likelihood ratio computation. By converting demographic data into comparable parameters and calculating likelihood ratios, the system can process records automatically while maintaining accuracy even with inconsistent identifiers and demographic information across different healthcare providers.
Solution Approach 2:
The patent performs preliminary actions by standardizing and normalizing demographic data before comparison. The system pre-processes patient information by extracting, cleaning, and formatting demographic fields, which enables subsequent automated processing to achieve both high speed and accuracy by eliminating data quality issues before they affect matching results.
3Stability of the object's composition
If centralized control is used to manage patient record linkage, then consistency across systems can be maintained, but autonomy of individual healthcare providers is reduced
Solution Approach 1:
The patent segments the record linkage system into autonomous modules that can operate independently at each healthcare provider site. Each system can generate its own assertions based on local data while maintaining compatibility with the overall federation through standardized interfaces and assertion formats, allowing both consistency and provider autonomy to coexist.
Solution Approach 2:
The patent creates a universal assertion format and standardized interface that enables different autonomous healthcare provider systems to interoperate. The multi-functional assertion mechanism allows each provider to maintain independence while participating in the federated network, achieving both consistency through standardization and autonomy through decentralized operation.
4Adaptability or versatility
If multiple patient identifiers are used across different healthcare providers, then each provider can maintain its own record system, but reconciling and linking these identifiers becomes complex and error-prone
Solution Approach 1:
The patent creates virtual copies of patient records with standardized demographic information that can be compared across systems without requiring actual identifier reconciliation. By copying and standardizing key demographic fields, the system enables matching across multiple identifier systems while maintaining the independence of each provider's original record system, reducing the complexity of identifier reconciliation.
Data Source
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AI summary
A method is provided for using assertions to reconcile records in a healthcare environment. Records are input, compared to a collection of previously input records and likelihood ratios indicating a probability of each input record match each of the collected records are calculated. The ratio is compared against two separate accept and reject criteria. Based on the comparison result it is decided whether a pair of records should be accepted as matching, rejected, or placed on a global exception list for manual review. The global exception list is split among the sites that are part of the federation, so that each site receives a local exception list referring to patients records at that site. Each site evaluates each pair of records in its local exception list and makes an assertion stating for each pair of records whether they are a match or a mis-match. This assertions derived during the manual review is placed in a global exception list and are accessible by other members in a federation of users. An assertion becomes the truth for the site making that assertion.