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unique patient identifier in healthcare

Why should the Senate choose biometrics as a unique patient identifier?

Unique patient identifiers have been talked about several times, not only in this space but also everywhere else in the US- especially quite recently. This is because there have been positive signs which might finally grant the health systems and hospitals alike with the mythical unique patient identifier, which is sorely needed in the healthcare industry for positive patient identification. But why is it so badly needed? What are the problems faced due to patient misidentification? What will be the benefits? What can be a viable unique patient identifier in healthcare? Let’s explore these questions.

unique patient identifier in healthcare

One does not need even to imagine losing someone close and dear due to patient misidentification- these stories have been all over the news for years, and there’s no stopping them, unfortunately. Whenever you turn on the television or watch healthcare-related news on your smartphone or tablet, you’ll see at least one problem which has been caused by patient misidentification. It might be medical ID theft, insurance fraud, patient mix-up, a denied claim, or in extreme cases, death. These are just some of the real-life examples which have occurred over the years and are also very valid reasons why a proper patient identification system should be in place for health systems all over the US. For instance, there was once a case where a patient was misidentified and was denied care due to the wrong medical record being pulled. Or, take the opioid crisis- an addictive medication can inadvertently be suggested to patients who are addicts. 

These are scenarios that could have easily been avoided if only the patients were identified accurately and matched with their appropriate records. Over one hundred health systems are already doing that, but more on that later. Thanks to the recent talks regarding UPIs, the US Senate has a unique chance to do something about it and save lives as well as healthcare costs. It has the opportunity to do that when the members get to vote on Senate Fiscal Year 2020 Labor, Health & Human Services, & Education & Related Agencies Appropriations bill. Back in June, positive news spread throughout the news portals that the House of Representatives passed an amendment regarding the removal of the old ban on the creation of an effective UPI that can be used across the health systems of the US. However, everything now rests on the US Senate to make this a reality by creating a UPI or adopting something across the lines which have been helping to identify patients accurately.

What happened previously?

It has been around twenty years since the previous talks regarding unique patient identifiers occurred, which have resulted in zero progress. This has caused major problems regarding patient misidentification like medical errors, as well as insurance fraud, medical ID theft, and in extreme cases, and deaths of unfortunate patients. Earlier, patient misidentifications were overlooked, but recently, everyone recognizes it as a serious threat to patient safety- even a prominent entity like the ECRI institute has listed patient misidentification as one of the biggest impediments to effective patient safety.

Why should the Senate choose biometrics as a unique patient identifier?
Why should the Senate choose biometrics as a unique patient identifier?

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However, that’s not all. The absence of a proper patient identification system also causes problems for healthcare providers, as well. As previously mentioned, insurance frauds, as well as denied claims, and increased losses are quite common issues for health systems, hospitals, and physician practices, as well as ACOs. Conventional EHRs have also shown an absence of interoperability, due to which the healthcare providers cannot share the same information regarding the same patient who may need to go to different health systems for various ailments.

Some statistics

A study conducted in 2016 states that patient misidentification costs any given healthcare provider approximately $17.4 million yearly, as a result of denied claims, thus cutting down their revenue. According to the study, the more pressing issue is that these misidentifications not only cause losses but also hamper patient safety. The same survey states that 26% of the sample had witnessed a medical error firsthand or at least have known about it, which were generated by misidentifications.

What should be the unique patient identifier in healthcare?

Thus, it is seen how vital an effective patient identification system is for the healthcare industry. But what should the Senate choose as a unique patient identifier in healthcare and why? RightPatient is the answer. It is a biometric patient identification system that over one hundred respectable health systems are using, such as Novant Health, Duke Health, UMC, and TGMC. All of them are providing the same feedback- better patient experience, enhanced patient safety, and improved patient matching, all of which lead to reduced duplicate medical records as well as reduced insurance fraud. A patient only needs to register into RightPatient using their biometric data like their fingerprints or irises- afterward, they are identified within seconds, and their appropriate medical record is pulled from the EHR system. Thus, RightPatient seems like the perfect candidate to be a unique patient identifier in healthcare since it has the capability as well as the experience and proven track record to be one.

unique-patient-identifier

Why a Unique Patient Identifier is so important in the healthcare industry?

Not a day goes by when we do not hear of patient identification errors– this has been plaguing the healthcare industry for a prolonged period of time; since the dawn of healthcare, patient misidentification has been present, and it still is, even to this very day. Accurate patient identification is of paramount importance – so much so, that it has forced the Joint Commission to prioritize patient identification as the first patient safety goal during 2014, and this has continued ever since. However, a unique patient identifier is yet to be found, funded, and determined due to privacy issues when it was first proposed.

unique-patient-identifier

Back when a unique patient identifier was initially proposed, it was thought to be integral for valid patient identification, since accurate patient matching will help reduce medical errors as well as costs incurred from misidentifications- speeding up the processes leading to improved and coordinated care. This is one of the reasons why UPIs are in the news again, regarding the abolishment of the ban on funds to create a unique patient identifier. However, this has yet to be processed, and it will be a long time into the future before it will see the light of day. Let’s focus on the here and now- what are these UPIs, and why are they so sought after? Let’s analyze.

If a standardized patient identification system were used nationwide, each patient would have a unique ID with which their healthcare providers, insurance companies, as well as other relevant parties will be able to identify the patients accurately, so that they would be able to manage all  relevant information without mixing it up with someone else’s information. In times of necessity, this information can also be shared with other parties; for instance, if the patient goes to some other care provider. This can be done confidently and error-free using the unique patient identifier. These are only a few of the benefits of UPI. However, enjoying such benefits in the USA is still a dream.

The USA is one of the only developed countries in the world which does not utilize a UPI. The usage of UPIs varies from country to country; whenever the need has arisen, countries have implemented some form of UPI which could easily be used by everyone involved in the healthcare sector and sped up the identification process by simplifying it. However, it is badly needed in the US, and it looks like it is nowhere near being available shortly.

A single entity does not provide healthcare to an individual patient- it is a complex process where many parties are involved in providing healthcare services to the patients in exchange for their hard-earned money. Thus, it means that teamwork is very crucial in this industry so that the providers do not mix up the patients and provide consistent care.

Why a Unique Patient Identifier is so important in the healthcare industry?
Why a Unique Patient Identifier is so important in the healthcare industry?

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From a patient’s perspective, it would be extremely beneficial for them if a standardized patient identification system is chosen which will be used to treat them, bill them, and apply for all other formalities, so that everything is concise and present at one place, and so that the same set of data is available whenever their records are brought up. This will also help increase coordinated care so that if a patient has multiple healthcare providers for his/her different ailments, everyone can access the same level of data. For instance, everyone can access the same set of test results, medical records, and other relevant data regarding the patient. 

So, what can be a UPI? RightPatient seems to be a perfect candidate for becoming a unique patient identifier for the US healthcare system. It already has a lot of users, and all of them are reporting the same results- positive patient identification, enhanced patient safety, as well as improved patient experience. RightPatient focuses on biometrics, especially iris scanning, and once the patients are registered, all they need to do is look into the camera, and they are accurately matched with their medical records within seconds. A lot of health systems have used it to reduce losses by reducing misidentifications as well as insurance frauds. Not only does it speed up patient identifications, which earlier took forever, but it also cuts costs and helps save millions of dollars for the health systems using it.

doctor treating patient for better patient outcomes

Seven strategies ACOs use for better patient outcomes and lower costs

According to recent studies, it is expected that Medicare’s projected spending will be well over $1.5 trillion by the year 2028- that is more than double what the value was just two years ago! All Medicare asks from ACOs are better patient outcomes.

doctor treating patient for better patient outcomes

Many ACOs have already reduced costs and thus saved Medicare approximately $1 billion during 2013-2015. Not only did they reduce costs, but they also improved quality across the majority of the metrics required by Medicare. These exemplary ACOs depended on primary care visits, which they used to reduce ER visits and in turn, cut costs by around $700 per patient. 

Some of the strategies which ACOs can follow to improve their healthcare spending patterns and generate better patient outcomes are: 

Collaborate with the physicians they work with

ACOs highlighted the fact that one of the ways to enhance the quality of healthcare as well as reduce the costs was to work closely with the assigned physicians. They also stated that these physicians are usually ordering services like lab tests for the patients or referring to other specialists without keeping the costs in check, and may inadvertently end up incurring more costs than necessary. However, if the physicians and ACOs collaborated frequently, the former can make informed decisions regarding the costs which will be beneficial for both the patients as well as the ACOs by reducing costs while keeping quality in check. Other than that, the physicians have to be busy with administrative issues, which can be quite hectic for them, which causes them to focus more on these tedious tasks rather than focusing on the patients. ACOs can collaborate with the physicians regarding these issues, as well, to reduce the time spent on such matters and focus more on the patients instead.

Encourage the patients to take initiatives regarding their health

A common yet effective strategy used not only by ACOs but by any health system is to encourage their patients to take charge of their health and adopt a better, more active lifestyle. However, ACOs are reporting that this can be quite challenging, especially if there are multiple physicians which is common in ACOs. What ACOs can do is adopt the strategy used by conventional health systems- use patient engagement apps like CircleCare. It has all the necessary features required for active patient engagement. Patients can track not only their steps but also keep track of their blood pressure, blood glucose level, schedule medicine reminders, and so on. It helps patients to maintain even the most complex medication routines as well as encourages them to lead a healthier lifestyle. However, these are not the only features of such apps, as will be explored further down the line.

Seven strategies ACOs use for better patient outcomes and lower costs

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Emphasize on patients requiring extra care

Care coordinators are professionals who are entrusted to make sure that the patients requiring extra care receive it, especially when they are discharged along with their proper medication as well as necessary materials. Nearly all the ACOs utilize such personnel who even help schedule follow-ups. However, ACOs can also use CircleCare in this context for better care, since these apps help patients and these caregivers to stay connected and exchange health information easily, perhaps about minor complications and so on. 

Reduce ER visits and readmission rates

Most ACOs face the problems of ER (emergency room) visits which in turn generate hospital readmissions, many of which are preventable. However, it is notably more of a concern for ACOs since they are fined based on the readmission rates. One strategy ACOs can use is providing digital solutions to patients such as patient engagement apps like CircleCare. Since these apps push the patients to be physically active, these can create better patient outcomes- the more active the patient, the healthier they will be. Also, since these apps have two-way communication facilities, they can contact their physicians regarding any minor health issues and resolve them outside the ACO premises, thus, reducing ER visits.

Enhance patient identification and data sharing

Patient identification is one of the major problems of the US healthcare system, and it is a massive concern for ACOs as well- they need to share patient data among themselves, and the data needs to be as immaculate and consistent as possible. Thus, ACOs can overcome the issues with conventional EHRs by using biometric patient identification solutions like RightPatient. It uses iris scanning to accurately identify the patients and match them with their appropriate records within seconds. This will improve the match rates as well as enhance the patient experience along with data sharing, which are all must-have features for any ACO as these lead to better patient outcomes.

Make sure medication adherence among patients is present

According to statistics, two-thirds of the prescribed patients are non-adherent regarding their medications. This generates 50% of treatment failures, causing up to 125,000 preventable deaths per year in the US. These could have been prevented if the patients were adherent to their medications, and for that, CircleCare is the perfect solution. Its medicine reminder makes medication adherence as easy as it gets- the patients using the app can set the type, color, look, frequency, dosage, starting/ending date, and duration through an intuitive yet simple interface. Even the most complex regimens become manageable due to CircleCare, ensuring medication adherence and thus fewer ER visits for ACOs.

Ensure patient education is provided

Patient education is another problem which generates frequent ER visits as well as hospital readmissions. Most patients have minimal knowledge regarding their health- 50% of them experience difficulty in understanding as well as using health information and 40% of them do not remember most of the information in the first place. CircleCare provides meaningful and easy to understand information for patients, customized according to their health conditions so that they can receive the latest knowledge regarding their health and make informed decisions if required. Moreover, it also provides general health tips regarding food and physical activities, which can help patients follow those tips for a better lifestyle and better patient outcomes.

improve patient outcome

Strategies which help ACOs to improve patient outcomes

The individual entities in any Accountable Care Organization (ACO) are always under the pressure to reduce their costs as well as strengthen their healthcare strategies to improve patient outcomes and maximize the benefits of being a part of the ACO. Thus, they are familiar with the fact that they need to develop strategies for accomplishing these targets- reduce costs, improve patient data sharing, care coordination, and improve patient outcomes as well, with an emphasis on post-discharge patients via reduced hospital readmission rates.

improve patient outcome

Take post-acute care networks as an example- north of 40% of Medicare patients receive post-acute care after they are discharged from the hospital, costing more than a whopping $60 billion back in 2015. Variation in post-acute care also caused Medicare spending variance by more than 73%- these variances were tied to healthcare costs, outcomes, and quality- the better the quality, the lower the costs, and vice versa.

If these standards are not satisfied, then the ACO receives penalties in the form of lower payments or fines. Thus, any given ACO needs to generate an exceptional patient experience via better healthcare, improving the coordination among the organizations regarding data sharing, reducing the readmission rates and minimizing the costs incurred. 

Here are some strategies which will help the ACOs to achieve these targets: 

Use biometrics for patient identification

Biometric patient identification systems are being used by over one hundred health systems and are reported to increase patient matching significantly– something which is sorely needed within the healthcare industry currently. In the case of ACOs, a single patient’s data is shared by all the systems within them, such as health systems, hospitals, physician groups, and insurers. Thus, interoperability is a must-have feature. EHRs are already known to cause identification errors and have unintuitive interfaces, inherently low patient match rates, and lack of interoperability, which is why health systems are using add-ons like RightPatient to accurately match the patient with his/her appropriate medical record. EHRs are supposed to cause physician burnouts as well, as they need to click through the interface thousands of times. Thus, adopting a solution like RightPatient will not only improve the match rates but also improve the patient experience as well as reduce physician burnouts, generating improved coordination. Patients only need to get their irises scanned to retrieve their accurate medical record for usage. Thus, faster matching creates better coordination and sharing of uniform and clean data among the organizations funded by Medicare. 

Strategies which help ACOs to improve patient outcomes
Strategies which help ACOs to improve patient outcomes

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Ensure proper medication adherence 

One of the biggest problems for ACOs is ER (emergency room) visits, which generate hospital readmission rates- occurring due to the unhealthy population under their care. According to a study, two-thirds of the patients who are supposed to take medications are non-adherent; that is, they do not take their medications properly. This non-adherence creates around 50% of treatment failures among those patients and causes up to 125,000 deaths per year. The fact is that these deaths could have been prevented if the patients were adherent to their medications. All these generate up to an unbelievable $300 billion in costs. Apps like CircleCare have a feature which could have ensured medication adherence- Medicine Box- a medicine reminder where patients can easily set reminders for their medications.

Thus, even if the medication regimen is complex, CircleCare makes it easier than ever for the patients to take the right medicine at the right time.

Provide patient education

Another challenge for ACOs is that their patients are not adequately educated regarding their medical conditions. Research shows that over 50% of adult patients experience difficulty in using and understanding their health-related information, whereas around 40% forget most of the data. CircleCare provides health-related information which is customized according to the patient’s disease(s)- this helps to keep the patient up to date with the latest information regarding his/her medical condition so that informed decisions can be made. This ensures effective patient education, leading to better patient outcomes. Once an ACO registers with CircleCare’s service, all it needs to do is direct the patient to download it. Afterward, the patients can schedule their medicine, track steps, record blood glucose levels, record blood pressure, and communicate with their healthcare provider- all of which helps to improve patient outcomes, lower readmission rates, and reduced costs as well as higher quality healthcare. 

patient matching challenges

Unique identifiers will lead to a reduction of patient matching challenges

If you are a follower of this blog, then you will know how huge a problem patient matching challenges actually are for the whole healthcare industry. As the health systems are brainstorming workarounds to make sure patient matching is increased, they should also keep in mind some other factors. According to a report from Pew Charitable Trusts, if the industry wants to ensure that patient matching errors are eradicated or at least substantially reduced, they should focus on developing robust data standards and patient engagement alongside the search for an effective patient identification system.

patient matching challenges

But why should it matter? According to the researchers, they have found positive correlations between patient matching errors and adverse effects. To put it simply, if a health system cannot match a patient correctly to his/her existing medical record, then problems like rising costs, medication errors, and adverse patient experiences will take place. Thus, patient matching is not an issue which can be underestimated. Concerns such as data integrity failures, lack of clean records, and patient mix-ups can all lead to patient identification errors and disrupt the patient experience as well as threaten patient safety. For example, if patient A has heart disease and patient B has kidney complications, and their records somehow got mixed up, then both of them will receive improper care, which could be fatal. Such mix-ups usually occur because of common names, demographics, addresses, as well as the format of the data stored within the EHRs of the patients. Formatting refers to how a health system saves the data and how many data fields it uses. For example, one health system may keep email addresses, whereas another one may not.

Another example can be a health system saving the full name of a patient in a single data field, whereas another may use three fields to save first, middle, and last names of the patients. Due to such errors, interoperability is generated as well. Other issues which cause patient matching errors can be incomplete or blank data. 

The research said that if common elements used by all the health systems were to be standardized, that is, the data is entered using a standard guideline rather than each health system doing so independently, these patient matching errors would decrease by a considerable amount. However, this may not reduce patient mix-ups between individuals with common characteristics like names and addresses, as these are still bound to happen. 

Another suggestion the research made was that active patient participation is needed to ensure that they are correctly identified and matched with their appropriate record. However, patients can sometimes absentmindedly or inadvertently choose a wrong record, while in other cases, the hospital staff may do it on their behalf and create a whole new record for the patient, known as a duplicate ID. 

Unique identifiers will lead to a reduction of patient matching challenges
Unique identifiers will lead to a reduction of patient matching challenges

#1 Biometric Patient ID Platform

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The third and most effective suggestion the research made was to emphasize on using a unique patient identifier, something along the lines of RightPatient, that is, biometric patient identification systems. The study has shown that such a system helps in improving accurate patient identifications. The research further stated that biometric modalities are unique, cannot be counterfeited, and have excellent potential in the healthcare industry. They also found that hundreds of health systems have widely utilized some form of biometric patient identification system, and among them, one health system stated that over 90% of their patients accepted to use their biometrics to be identified since it is easy to use as well as accurate. Both the providers of healthcare as well as the receivers agreed that biometrics are helping to reduce patient matching challenges. 

RightPatient falls in line with the research’s suggestion. It is a biometric patient identification system which uses iris scanning to identify patients. Once a patient’s irises are registered into the system, the data is then integrated with the patient’s health record. All the patient needs to do is look at their camera- RightPatient then accurately matches him/her with the proper ID- it is that easy and convenient. Since it does not require any physical contact, there are no risks for contracting new diseases during the identification process. Even the health systems love RightPatient since, with its help, the physicians can focus more on the patient rather than spend time matching the patient with the correct record, enhancing the patient experience along the way. Over one hundred health systems are using it and have reported that it has reduced losses which they incurred due to patient matching challenges, saving millions of dollars in the process. 

unique patient identifier

Unique patient identifier is what everyone is demanding for patient safety

Patient identification errors are nothing new– everyone in the U.S. knows what it is and by now how it is affecting those who are unfortunate enough to be misidentified, thanks to the numerous reports, surveys, and researches conducted regarding this topic. However, what everyone is now demanding thanks to all these studies is a unique patient identifier.

unique patient identifier

Let’s jog our memories for a moment. Patient identification errors have been abundant in the healthcare industry since its inception. However, these patient matching errors are at an all-time high now, thanks to EHR related issues like unintuitive interfaces, interoperability issues, and low patient match rates within the systems themselves. It is quite problematic for the healthcare providers as patient misidentification causes losses of millions of dollars per year and problems like physician burnouts due to unintuitive EHR systems. But that’s not all; patients suffer, as well – financially, physically, or both- they very likely may receive the wrong treatment, undergo incorrect surgical procedures, and in some cases, may face death. It is a multibillion-dollar issue of the healthcare system and causes suffering to everyone who comes into contact with it like a plague. In the early days, nobody used to pay much attention to this, but now, thanks to numerous reports, statistics, and data available to the public, everyone knows how much of a problem inaccurate patient identification is.

However, recent developments seem to point to a brighter future for patients and healthcare providers alike. CHIME, also known as College of Healthcare Information Management Executives and the American Health Information Management Association (AHIMA) members pushed the US Senate to demolish the ancient ban regarding a unique patient identifier which could be used nationwide, following the House of Representatives’ decision.

Key individuals from reputed organizations like CHIME and AHIMA, which are full of healthcare IT experts, demonstrated to Congress the benefits of demolishing this ban on a unique patient identifier. The abolishment of this ban would result in the U.S. Dept. of Health & Human Services to work in tandem with private organizations to research and find a unique patient identifier which will help to create accurate patient identification while keeping in mind patient privacy- or does it exist already?

However, the supporters for lifting the ban were not only AHIMA and CHIME- the American College of Surgeons as well as the American Medical Informatics Association chimed in as well, no pun intended. Jointly, they all demonstrated to the Senate the current challenges they face due to patient misidentification and what types of problems the patients might face due to these errors like wrong treatments, financial losses, and so on. Adding to the list was incomplete patient data in EHRs and duplicate records, as well, which results in the reduction of data integrity. A recognized healthcare professional stated that the employees of health systems have the first-hand experience of seeing the implications of patient matching errors and how it adversely affects not only the patients, but also their families. He further said that inaccurate patient matching is one of the sole reasons for hampering patient safety as well as generating extremely high costs, falling in line with all the studies and statistics related to patient matching errors. To put things into perspective, a single patient matching error costs around $1000-$5000 to fix, depending on the complexity of the issue for any given healthcare provider. All this is happening while everyone within the industry as well the Congress is doing their very best to reduce healthcare expenses. However, this will only be possible nationwide if the ban is demolished, and a unique patient identifier is selected.

Unique patient identifier is what everyone is demanding for patient safety
Unique patient identifier is what everyone is demanding for patient safety

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But why has everyone been so late to tackle this issue? Well, they weren’t – it was addressed before, but was dismissed. Decades ago, HIPAA (Health Insurance Portability and Accountability Act) required a unique patient identifier for utilizing its full potential, but it did not materialize due to privacy concerns. Rules were later added, which banned the HHS from developing a unique patient identifier using federal funds. It has come full circle, as everyone is clamoring for a unique patient identifier now.

However, let’s go back to the past again. As healthcare providers were rapidly adopting EHR systems, they were also experiencing the many problems associated with using them. Thus, they had to resort to other methods to accurately identify their patients, decreasing their reliance on EHR systems.

What should be the unique patient identifier?

Everyone related to the healthcare industry is urging for the creation of a unique patient identifier. What if it exists right now? Over a hundred health systems are using RightPatient – a biometric patient identification system. RightPatient focuses on iris scanning, which is beneficial for everyone involved – it eliminates any risk of catching diseases as it is a non-contact modality and is very easy to use for the patients. All a patient needs to do is look at the camera, and the patient is quickly and accurately matched with his or her health record. It is also reducing losses for its users by reducing denied claims. The health systems have also been reporting promising results like improved patient safety, and enhanced patient experience. It is also causing fewer physician burnouts – they can focus on the patients rather than spending time matching the patients with their EHRs, because RightPatient does it for them. Thus, as such a tried and tested solution as RightPatient exists, it seems to be a viable candidate for being the unique patient identifier of the U.S. healthcare industry.

Doctor-looking-at-EHR-system

Importance of patient identification and EHRs- What you need to know

When it was at its introductory stage, the official representatives had stated that medical records going digital and becoming electronic health records (EHRs) would change the healthcare system of the US entirely. They said that EHRs would be the future of the healthcare industry as they will be safe, inexpensive, and easy to use, with a focus on the importance of patient identification. They were leaving conventional paper records in the dust. They were right- partially. EHRs did change the healthcare industry as we know it, it did prove to be the future, and it did make paper records obsolete, only not in the way everyone thought it would. Almost a decade later, EHRs have created abundant problems in the healthcare industry– for patients, health systems, insurance providers, and everyone else involved with it. Moreover, the biggest challenge it caused is patient misidentification, which is a multibillion-dollar burning issue, and presently, everyone is clamoring for a viable solution for the errors caused by EHRs.

Doctor-looking-at-EHR-system

These are some findings by a study which highlights some of the biggest problems of patient misidentifications via EHRs. 

Patient safety

The most obvious and most dangerous problem caused by EHRs is reducing patient safety- EHRs, since their introduction they have created several issues which compromise patient safety. Innumerous incidents have been reported including as wrong treatment, wrong surgeries, even deaths and many more, all of which lead back to software issues, errors, bugs or flaws of EHRs and how it misidentifies patients. We have read many stories of how EHR misidentifications have led to surgeries of wrong patients, or how they have caused financial losses for patients, or, in unfortunate cases, deaths. It has been years that EHRs have become standardized, but there are no efforts to fix these problems within the EHRs to improve patient safety. The importance of patient identification has been underestimated which is why these problems occurred. 

Medical identity theft 

The next issue caused by patient misidentifications is fraudulent activities. EHRs can be tricked since no unique patient identifier exists in the US, which can verify the authenticity of the patient. This fact is commonly known, and due to this, many miscreants can attempt to fool the system and officials and commit medical identity theft, healthcare fraud and many other unlawful activities with the patient ID and get away with it. Such incidents cause financial losses for the patients whose IDs are stolen, and it can also be used for more nefarious purposes like obtaining unprescribed drugs to consume or sell them, and events like these have caused the opioid crisis.

Importance of patient identification and EHRs- What you need to know
Importance of patient identification and EHRs- What you need to know

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Interoperability issues

When EHRs were introduced, it was expected that given it will be completely digital, there will be some form of seamless integration of the data which can be accessed by a patient’s different healthcare providers. However, fast forward a decade, and the reality is entirely the opposite. Forget about obtaining the same data around the nation. Research has shown that even after using the same EHR system, two different healthcare systems cannot also match a patient correctly, as the match rates are as low as 50%. Thus, information exchange is next to impossible with EHRs, which is why there are so many interoperability seminars being held nowadays.

Physician burnouts

Many doctors have reported dissatisfaction with EHRs, as they spend almost half their day clicking on the system and inputting data to match the patients instead of interacting with the patients themselves. This is problematic not only for the physicians but for the patients too, as more time is spent on EHRs rather than patients. Even then, patients sometimes cannot be accurately matched with their health records.

How to fix these errors?

EHRs’ biggest problem is patient misidentification, and that itself causes all of the above issues. Everyone in the US healthcare learned the importance of patient identification the hard way. However, for the past few years, many have tried to come up with innovative solutions to combat patient matching errors, but the best one is RightPatient– a biometric patient identification solution. It uses the iris scanning modality to ensure a safe, hygienic, and convenient way to detect the patients accurately. Since there is no necessity for physical contact, a look at the camera is enough for identification, and patients find this extremely convenient and easy to use. Once a hospital registers a patient with their proper EHR via RightPatient, he/she can be identified by their biometrics only, which improves patient safety and provides an exceptional patient experience, as per the reports of the hundreds of health systems who are currently using RightPatient to eliminate patient matching errors and saving millions in the process.

patient-safety-issues

Patient safety issues occur due to EHR misidentifications

When electronic health records (EHRs) were introduced, people lauded it as the next big thing in the technological landscape of the healthcare industry. There were many reasons- it was entirely digital as the name suggests, could be accessed quickly and whenever required, reduced paperwork, among many other reasons. However, once it was widely implemented, the reality was drastically different. Instead of solving these problems, EHRs added additional ones along the way- patient safety issues.

patient-safety-issues

EHRs have created many problems for patients and healthcare providers alike. They have created risks which were unpredicted at the time of their implementation, which can potentially generate the chance to make grave errors in the treatment processes for patients, specifically if the treatment involves medicines. If this seems terrible, it gets even worse. These problems associated with EHRs are much more catastrophic for children and younger patients since their prescribed drugs are age-based. A study has found that EHRs do not take age into account; thus, it does not tackle the problems associated in a pediatric environment. Other than that, patient safety issues like matching errors are synonymous with EHRs. This is where biometric patient identification systems like RightPatient come into play.

The problems healthcare providers face while using EHRs lead to misidentifications mostly. Some of the challenges EHR users face are:

  • Problems associated with displaying patient information, or incomplete/corrupt patient data
  • Issues related to patient data entries which cause delays
  • Problems with EHRs regarding feedback or notifications
  • Disruption in the workflow if data needs to be shared 

So what are the actual problems associated with patient safety issues caused by EHRs? 

Restricted information results in wrong medications

EHRs usually provide the hospitals with blank data fields which the latter can fill in, if required, regarding making notes making it easier for colleagues. However, they do not know whether their colleagues have access to those specific fields, which can create many problems. For example, if a doctor had made a note within the EHR regarding the medical condition of a patient, say glucose level, the nurse who will administer the medication may not be able to view this note because her access is restricted, not taking into account the medical condition. Such problems lead to a lot of medical complications. Likewise, if required fields are not available to be viewed by everyone in the hospital, the staff may get confused between patients with common characteristics like name, address, etc., causing patient matching errors.

A patient is provided with excess or wrong medication due to an entry error

This is the primary cause of confusing units- between imperial units and metric units. Thus, as it is common in the US to use pounds, and if the weight is entered in pounds, but the EHR accepts only kilograms, this will hamper with the medication. Medications are sometimes dependant on the weight, especially in the cases of children, and they may, unfortunately, receive larger doses of medicine than required, which can be fatal. Other than that, if a patient is misidentified, then this will cause the patient to receive the wrong medication as well.

Patient safety issues occur due to EHR misidentifications
Patient safety issues occur due to EHR misidentifications

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Missed doses of medications occur due to problematic information displays

EHRs can usually list all the medicines that have been scheduled for patients, along with time and dosage required. However, sometimes due to patient matching errors, they may end up with the medicines planned for some other patient, and this can be fatal for both the patients involved if someone is not cautious enough while administering the medications.

Duplicate patient IDs are created

By far, one of the most significant flaws of EHRs is consistent to this very day. News regarding patient matching errors are very common, and at least one person you know has faced it. How does it happen? Very simply- once a patient comes in and a hospital representative does not find the individual’s record in the EHR, the employee tries to save time by creating a new ID instead of searching more in-depth for the correct record. The staff thinks that this is the way to save time and effort but generates another source for losses by the employer. Sometimes even the patients are to be blamed- if they are not attentive enough while verification, the hospital staff may pick the wrong record for them. Its effects can range from being financial losses to even life-threatening. Due to this single issue, everyone involved with healthcare has suffered- patients, healthcare providers, insurance companies, and so on. Healthcare companies are now clamoring for a unique patient ID solution to eliminate these errors. 

Medical ID thefts take place

Another consequence of patient safety issues via EHRs- fraudulent activities. Addicts and professional thieves can very easily misuse others’ IDs and gain access to healthcare benefits or drugs which are entitled to the actual patients, resulting in financial losses incurred by the unfortunate patients. All this happens because there was no sure way to identify whether the medical record belonged to the perpetrator, until now.

What can be the solution to patient safety issues?

As seen from the problems, all of them point in one direction- patient matching errors. From all of this, patient identification error is seen as a disease in itself of the healthcare industry. Everyone involved is affected and suffers due to it in various ways and degrees. It is a multibillion-dollar problem in the US, where fixing a single entry costs from $1000-5000.

However, its days are numbered, it seems, as biometric patient identification systems like RightPatient are successfully eliminating it from the healthcare providers who use it. It uses iris scanning, which is easy and convenient for patients- all they need to do is look into the camera, and they are identified accurately. Another benefit of this biometric modality is that it also correctly identifies the irises of the younger patients as irises are formed within ten months of birth and remain unchanged. Patients also love it because there is no chance of getting any contagious diseases as it does not require physical touch. Over a hundred healthcare providers are using it, and they are reiterating the same thing- patient experience has improved along with patient safety due to the reduction of errors and the speed of the process.

patient matching improvements

Hospitals are Prioritizing Patient Matching Accuracy

Patient identification has been haunting the healthcare industry since its inception. Using the existing practices in the industry, accuracy rates are significantly low and cannot be used to exchange health data effectively, as reported by officials from different healthcare systems such as hospitals and physicians. The industry is in dire need of patient matching improvement. 

patient matching accuracy

However, the above report is not the only one- other statements point towards the same conclusion of requiring patient matching improvement, as per the research brief from Pew Charitable Trusts. A study was conducted by Pew researchers along with Massachusetts eHealth Collaborative (MAeHC) that sought to identify the current situation of patient identification in the healthcare industry. They did so by collecting information from different healthcare executives with the use of interviews. Another aspect of the study was to identify how to achieve patient matching improvement. The sample of this study was healthcare experts and influential figures from various practices and sizes who served numerous patients in diverse regions all over the country.

A vast majority of the sample expressed the same view- patient identification and matching were quite inaccurate and desperately needs an overhaul, thanks to the increasing demand for interoperability.

Healthcare providers are now motivated to exchange more health data due to the recent CMS Promoting Interoperability program. That’s not all! CMS is also going to be granting incentives to accountable care organizations (ACOs) who will show savings through activities which support care coordination.

According to the Pew researchers, healthcare systems like hospitals and clinicians eligible for these programs need to exchange information with others so that all of the parties have the latest patient data from other various institutions.

Hospitals are Prioritizing Patient Matching Accuracy
Hospitals are Prioritizing Patient Matching Accuracy

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The hospital officials stated that it is quite challenging to measure the match rates, resulting in their efforts being ineffective to examine and improve the patient identification rates. They also had difficulty providing a number when asked for the identification rates within their organizations. This was because many hospitals only keep a record of the duplicates identified through EHRs, whereas others do not know which files are relevant and which are unlinked.  Thus, without knowing the actual number of correct matches, these healthcare systems cannot determine their match rates. Therefore, only the amount of misidentifications was provided by them, thus summarizing the research.

It was also identified that healthcare systems could easily match patient identities when asked by organizations they are in constant contact with. Both automated and manual processes are utilized to link records to the correct individual.

However, whenever it is an organization with whom the healthcare system is not in contact with regularly, match rates are inclined to be lower. This is because these unsolicited requests introduce more blockades because the healthcare system may not have a record of that individual, and the healthcare system uses automated processes for such applications. On top of that, the research also showed that urban areas require better identification rates compared to rural areas as not much-sharing activities take place in the latter.

Some healthcare executives also think that improved patient identification matching requires significant costs. However, many believe that biometric patient identification is the solution to improve matching rates and is worth the cost. Some hospitals are even utilizing iris scanning solutions like RightPatient to identify all their patients and pull their relevant data from their EHRs and show a significant change. They report that it is fast, accurate and improves the overall patient experience as well as speeding up the whole process and saving valuable time of the physicians so that they can concentrate on more critical tasks such as the patients themselves.

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HIMSS 2019 – Interoperability Showcase; What Is the Foundation of Interoperability?

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HIMSS19 Global Conference & Exhibition, Orlando, FL

On the last day before leaving, I decided to stop by the interoperability pavilion at HIMSS – this was one of the busiest and well-presented parts of the show. The section, showcased by the VA (US Veteran Administration), was very extravagant – you usually see such displays from any of the federal government agencies only in Washington D.C. The VA is definitely a front-runner in interoperability – they are the first one to initiate the blue button program to share medical records. The jam-packed area with vendors and exuberant people from all corners of the HealthCare industry clearly shows the importance of the mission. As I was snapping a selfie, Andy Pincsak from Phillips Health jumped in & joined my memory lane – I thought it was a very nice and friendly gesture! Why can’t we all be like that with each other?

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Snapping a selfie with Andy Pincsak from Phillips Health

HIMSS 2019 – Interoperability Showcase; What Is the Foundation of Interoperability?

The HIMSS Interoperability Showcase™ was the highest trafficked area of the exhibit floor

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Innovative Solutions on the Exhibit Floor

Why Is Interoperability Such a Big Deal?

The fundamental premise of interoperability is to share data between organizations – so a patient can move from provider to provider and his/her data can be seamlessly shared between the providers. This is very serious because an average American with chronic conditions, such as diabetes, sees multiple physicians from various organizations. To orchestrate a meaningful treatment regimen to such patients, it’s imperative that each of these providers has real-time visibility of each patient’s care-cycle. Hence, interoperability is extremely crucial.

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Innovation Live brought together startups, accelerators, and other innovative companies to showcase the future of healthcare IT

What’s the Fundamental Flaw in the Healthcare Interoperability Movement?

For interoperability to be successful, the providers must match and identify the patient as they move between the organizations – to be clear, your social security number is the unique identifier. But in healthcare, every organization assigns its own unique numbers to each patient. Therefore, how will organization A notify organization B that John Joe with ID “DX213” is the same “John Doe” with ID “74537”? Currently, this is done using fuzzy match. However, on an average 8% of the time, a patient is registered under a different name – I am serious – this is called a duplicate patient record. Since many people have common names and there is no social security number in their health record, a simple mistyping – usually called fat finger – causes the creation a different record for a patient that already has a record. Therefore, how in the world can all these providers really work in harmony and share data with such a mess? It does not take a rocket scientist to understand these issues. To achieve real interoperability, we need clean and uncorrupted data.

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HIMSS Interoperability Showcase

Is There Any Solution Without Using a Social Security Number?

Of course there is. Since we can’t rely on names and names also change, we can easily add patient biometric data with each medical record. Once a patient is tagged with his/her biometrics, they will always be identified with just biometrics. Basically, a patient will just walk into a provider’s office, have their biometrics taken and the system will find the record with biometrics. Now, if all providers are using a photo based system like RightPatient, then the patient can move between whole ecosystems without ever worrying about ending up with corrupted data. Why we are not using our natural identifier to protect our health and implement seamless interoperability?