The central interoperability challenge in transitions of care across different organizations is patient matching —ensuring that incoming clinical information is accurately linked to the correct individual. This is best captured by patient identity integrity , which refers to the correctness, completeness, and consistency of a patient’s identity data across systems so records are not mismatched (overlay) or split/duplicated. When identity integrity is weak, care teams may receive incomplete histories, allergies, medications, or problem lists—or, worse, information for the wrong person—creating direct patient-safety risk and undermining continuity of care.

While patient demographic data (name, DOB, address, phone) is used as input for matching, demographics alone are not the “challenge”—the challenge is maintaining integrity and reliably matching across systems with variations, missing fields, typos, name changes, and differing registration workflows. A unique patient identifier could help, but in real-world cross-provider exchange it is often not universally available or consistently used across all participants. An enterprise master patient index (EMPI) is a tool that supports matching within an enterprise or network, but the broader interoperability problem remains the integrity and accuracy of identity across boundaries. Therefore, overcoming patient identity integrity issues is essential to ensure the right patient receives the right care.