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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.

biometrics-helping-with-patient-identification

Another one added to the endless list of patient misidentifications stories

Another day, another one added to the endless patient misidentifications stories– makes the need for an effective patient identification solution like RightPatient even more urgent. 

biometrics-helping-with-patient-identification

However, medical record mix-ups occurred even before EHRs were implemented. Years ago, a woman called Liz Tidyman’s parents decided to spend more time with their daughter and grandchildren, and thus moved close to their home. While they did so, they carried everything important with them, especially the hard copies of their medical records (EHRs did not exist back then).

Exactly two days after the parents moved in with Liz, the father unfortunately fell. Since this has never happened before, the family was concerned, and they took him to a hospital for a checkup. While sitting in the waiting room, Liz took out her father’s medical record right on time, or else there would have been some grave consequences in store for the family. As Liz went through her father’s health record, she saw some abnormalities- there were numerous pages regarding the medical history of an entirely different person. The only thing Liz could associate with her father was the name of the other patient, everything else regarding the medical history was unrecognizable by Liz- the other patient had much more complex problems than her father did. At that instant, she took out those irrelevant pages about the mistaken patient and decided that she will always double-check such sensitive records, medical or otherwise, in the foreseeable future.

This was just one story, and that too before the introduction of EHRs and the mess they created. There are many such stories and incidents before and after EHRS which have created the billion-dollar problem- patient misidentifications. These have also led to numerous patient misidentifications stories, due to which everyone is taking it seriously now.  

Another one added to the endless list of patient misidentifications stories
Another one added to the endless list of patient misidentifications stories

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No patient, old or young, is safe from patient matching errors, but since the older ones are less comfortable with technology, they need to be more careful regarding their medical records. According to a healthcare official, one out of ten patients who have seen their records say that there are inconsistencies and demand corrections. This is not really surprising, given the number of problems we read about everyday regarding patient identification. For instance, some patients may see that inaccurate medical test results, treatment plans, or diagnoses have been attached to their medical records, raising doubts regarding what else is mixed up with other patients. However, this actually happened with Liz’s father as well.

When asked about kidney cancer, Liz’s father denied he had it. Afterward, Liz viewed the materials and realized that the mix-up was due to the name, and it was listed kidney cancer instead of skin cancer, the latter which her father actually had. Likewise, omissions, patient mix-ups, and duplicate records create all kinds of ruckus and devastate families, end the lives of individuals and cause losses in millions of dollars. This has been the scenario for years, and EHRs did not fix them, they only amplified the problems further.

Health systems have finally begun to address how serious of an issue patient misidentifications can be, thanks to the endless pile of patient misidentifications stories. While some hospitals are struggling with using only EHRs for patient identification, others are clamoring for an effective solution to end these patient matching errors. However, other advanced and forward-thinking healthcare providers opted for RightPatient– a biometric patient identification system. It uses the iris scanning modality to identify the patients. Once the hospitals enroll the patients with RightPatient, they can be recognized and matched with their records easily and conveniently, all it needs is a look at the camera- it’s that easy! Patient acceptance to RightPatient has been high as well since they perceive it as safe and hygienic- no physical contact required; thus, no risks of contracting any diseases. RightPatients helps in saving the lives of patients and reducing denied claims and ultimately saving money along the way. 

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.

unidentified-patient-identification-error

Patient identification error causes yet another grave mistake

Another day, another mistaken patient identification error. However, it was a bit different in this case. Two sisters were informed that their brother was on life support and that is the premise of the whole fiasco.

unidentified-patient-identification-error

The sisters, Rosie Brooks, and Brenda Bennett-Johnson received a call from an official that someone they believed to be their brother Alfonso was breathing with the help of a ventilator at Mercy Hospital and Medical Center of Chicago. However, the sisters stated that they didn’t talk much to their brother. The call started with someone enquiring about relatives of Alfonso, and Brooks replied that she was the sister, and then the official broke the news- that he was fighting for his life in the ICU, explaining that he was beaten quite severely, especially the face.

The Chicago police had found the man beaten to a pulp, and according to reports had neither clothes nor any means of identification on his body. A police spokesperson said that witnesses of the incident identified the injured man as one Elijah Bennett. Later on, he was rushed to the hospital and was on life support. 

During his time in the hospital, as nobody came looking for him, the hospital staff had to take the help of the police in identifying him. The spokesperson said that their database had no “Elijah Bennett,” however, they did find “Alfonso Bennett.” The police later on handed over a picture so that the hospital could help identify any family members of the unfortunate patient. All these events led to the call to Brooks, yet another patient identification error. 

Patient identification error causes yet another grave mistake
Patient identification error causes yet another grave mistake

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When the sisters rushed to the hospital, they failed to identify the man as their brother Alfonso. However, CPD kept saying that it was their brother. According to the nurse, police used the help of mugshots to identify him, but due to budgetary issues, a proper ID could not be made. 

However, the patient’s situation was worsening, and the sisters faced a challenging situation- whether or not to remove his life support. With immeasurable sadness, they had to sign papers stating that this man was their brother and to remove his life support, and as expected, the man passed away, unfortunately.

After this series of events, the story did not end. After the untimely death of the “brother,” the sisters started making preparations for his funeral, to give him a proper sendoff. Before they could carry out the planning, however, what happened next was a scene out of a dramatic movie- the brother, Alfonso, walked right through the front door of the house of the one sister! She shouted over the phone to her other sister, exclaiming that the brother they had thought was dead is very much alive and healthy and that it almost gave her a heart attack. 

However, this newfound relief and happiness quickly turned into sadness, regret, and remorse- they realized that they had given the green light to end the life of a stranger, thinking it was their brother. They shared how they felt with the media and that they were extremely remorseful about deciding everything about someone unknown. However, the police, later on, identified the person with the help of fingerprints and started looking for his family. Everyone involved was deeply disturbed by this incident and thinking that there are no procedures or strategies to ensure such cases do not happen again in the future. However, this is not an isolated incident, as a very similar situation occurred in 2018. 

Many people are worried that as these incidents are recurring, there is no way to avoid this. They are wrong. RightPatient would have helped the situation in reducing such errors. It is a biometric patient identification system which, and with the help of iris scanning modality, it reduces not only any kind of patient identification error but is also safe, convenient, and quick. Since no physical contact is required, all it needs is a glance from the patient for registration and matching- thus being hygienic and easy to use for both patients and physicians. All these features help to enhance patient safety as well as improve the patient experience, reducing claims by 35% and saving a lot of costs of healthcare systems in the process.

Scanning a patient for identification

Hospitals Need a Better Patient Matching System to Identify “John Does”

Patient identification or lack thereof is a topic which we hear about every day. We always read news about mistaken patient identities due to mix-ups, frauds, insufficient patient matching system, etc. What about those who arrive at the hospitals and are never identified? Let’s look at these John Does but from a different angle- from the perspective of the emergency hospital staff who receive and treat them rather than from the outside viewer.

Scanning a patient for identification

Imagine this: A man in his 50’s arrived in the emergency room, wheeled in by paramedics, shaven head, brown eyes, unconscious. To make matters worse, he had no materials on him that could have helped the staff with his identity for crosschecking with their patient matching system– no wallet, cellphone, papers, or anything at all. To top it all off, he did not have any distinguishing features such as a tattoo or scar. This incident was back in 2017- a car hit him in January, and he was rushed in with a fatal brain injury to Los Angeles County+USC Medical Center. He did not have any visitors, nor was he ever reported missing. Sadly, he passed away being a John Doe, no one ever knowing who he was.

This is just one example of how serious and pressurizing it is for the hospital staff to deal with such emergencies regarding patient matching systems, primarily when they consist of a John Doe. In these cases, they are required to become a form of detective in order to determine the identities of these unknown patients when they arrive at the hospitals. This is done for several reasons: firstly, finding the identity helps with the treatment- the staff can then determine the patient’s medical history and whether he/she has any complications or not. Also, it allows them to find and contact a next of kin or close one to make any critical decisions if it becomes necessary. The identity also helps the hospital to contact the insurance company or government health programs, whichever the patient is associated with, regarding payment of their services.

However, there is a catch- federal laws concerning privacy make it difficult for the hospital staff to determine the unknown patients’ identities. In the previously mentioned example as well as in many similar cases, the team along with the social workers frantically rummage through whatever a John Doe brings with him- bag, clothing, phones without passwords, receipts, or whatever piece of document or device which can help them identify the individual and proceed to their patient matching system. Their efforts don’t stop there- they also question the paramedics and dispatchers. Tattoos, piercings, and scars are duly noted, and when all else fails, dental records are checked against the individual. However, because the police can only access fingerprints, it is often left unchecked, mainly because the police only involve themselves only when a criminal element is present in the situation.

Hospitals Need a Better Patient Matching System to Identify “John Does”
Hospitals Need a Better Patient Matching System to Identify “John Does”

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These John Does are usually the ones hit by vehicles and had unfortunately left their IDs back at home, and can also be poor people with cognitive diseases such as Alzheimer’s. Other times, they are overdosed individuals. Unsurprisingly, socially isolated individuals like homeless people are the ones who are the most difficult to identify, and sadly, they are the ones who are the most common John Does in recent years.

The Health Insurance Portability and Accountability Act (HIPAA) was made to ensure the privacy of an individual’s medical data. However, in cases of these John Does, it can make patient matching increasingly difficult as the hospitals cannot release any information to those searching for missing family members regarding these patients. For instance, a patient with Alzheimer’s was admitted to a NY hospital with the name “Trauma XXX.” The police and his family members went in search for him several times at the very same hospital, but they were told nothing. Weeks later, a doctor while watching television saw that man in the news and identified him as the patient “Trauma XXX.” Afterward, when charged with why the hospital hid the patient, the staff said that they did not ask about “Trauma XXX” specifically.

Due to this incident, a lot of rules were set up and changed regarding information requests about missing persons. It consisted of following over twenty steps for hospitals, starting from notifying the reception, to taking DNA samples.

All of this could have been avoided if a fast, accurate, and reliable patient matching system was used. RightPatient is one such patient identification system that utilizes biometrics and AI. Through this, it uses iris scanning to quickly match the patients with their EHRs so that the whole patient experience can be enhanced. It also helps the physicians focus on more critical tasks such as the patients themselves instead of going through matching patients. Thus, not only is it beneficial for the patients, but it is also beneficial for the hospitals as well, creating a win-win situation for all and ensuring patient safety through the enhancement of the whole patient experience.

Statistics regarding how low HAC score reduces CMS and incurs loss

CMS cuts payments to 800 hospitals for patient safety incidents – is yours next?

Patient safety incidents should be taken seriously by all hospitals. Unfortunately, CMS is penalizing 800 of them for having the highest rates of patient injuries and infections. The agency will trim these hospitals’ Medicare payments in the fiscal year 2019.

The HAC Reduction Program is a Medicare pay-for-performance program that supports CMS’s long-standing effort to link Medicare payments to healthcare quality in the inpatient hospital setting. Put more simply, hospitals are offered a financial incentive for preventing harm to patients! Under the program, a hospital’s total score is based on its performance across six quality measures. Each year, Medicare cuts payments by 1 percent for hospitals that fall in the worst-performing quartile due to patient safety incidents.

It’s alarming that, according to Kaiser Health News, 110 hospitals are being penalized in the fiscal year 2019 for the fifth straight time. Considering the daily news announcements about hospitals that are suffering financially or have gone out of business, we wonder why they aren’t taking more steps to address this issue.

Statistics regarding how low HAC score reduces CMS and incurs loss due to patient safety incidentsIf you think that only small rural hospitals are facing this problem, you will be surprised. CMS recently threatened to terminate Vanderbilt’s Medicare contract after a fatal medication errorVanderbilt!

Since patients share common names and show up to the hospital many times without proper identification, 8-10% percent of the time their existing medical record is not found or they are potentially treated as a different person. This is a serious incident that can happen in every hospital at any time.

While the industry is going through serious financial pressure, I don’t think any hospital can afford to wait on this issue and get carried away with focusing solely on switching or upgrading EHR systems. Your hospital is just an event away from losing medicare payments due to patient mismatches. Someone can lose their life and the reputation of your organization will forever be tainted. That’s why many prominent healthcare providers have implemented our RightPatient biometric patient ID method to protect their patients and to protect themselves by preventing patient safety incidents caused by identification issues.

Piece of medical record over other documents

The curious case of a mistaken patient identity

Mistaken patient identities in the healthcare industry are nothing new- a lot of people have faced it, and it occurs almost every day in the US. However, this time, it was not news of someone who suffered from it, but rather a couple who got saved from just being another mistaken patient identity. This mishap was properly detected and the victims were fortunately saved from a huge financial loss.

Piece of medical record over other documents

The actual story

A Florida-based couple would have been the victims of mistaken patient identity and almost lost a lot of money. Mrs. Barding detected the error when she identified that Cigna, her insurance company, was processing a whopping $2.2 million in medical bills.

How did she figure it out? With the help of Mr. Barding, the couple identified that the bills were actually associated with his identical twin, Vance Barding, who was burned in a work accident and sadly passed away six weeks later from complications.

Mrs. Barding told that Cigna billed them for her brother-in-law’s care and had deducted $3000 from her health reimbursement account. However, after notifying the insurance company, they verified the claim and stopped billing the couple, as well as returning the money to Mrs. Barding’s account. This was all due to the mistaken patient identity. 

Cigna also stated that there are always a large number of claims which are made in error by different healthcare providers, and they have thus discussed with the latter in order to be more vigilant about such erroneous bills.

The healthcare provider in question is Orlando Health and it was provided incorrect information, due to which this whole situation arose. However, as it was made aware, they worked with necessary parties in order to rectify the mistake. This was a fortunate case where the would-be victims were saved due to the vigilance of the wife. Unfortunately, not every victim has a Mrs. Barding beside them.

Some statistics regarding mistaken patient identity errors 

A survey conducted by Patient Safety & Quality Healthcare (PSQH) revealed that 54% of the respondents are unhappy with the current patient identification methods. Another research shows that 10% of the overall patients are misidentified during entry. This mostly happens due to the large healthcare systems, which have a lot of patients to cover, and thus they make mistakes due to human errors, miscommunication, and sometimes in order to save time. The PSQH survey also shows that 89% of the respondents believe that proper patient identification is a vital part and is of paramount importance to their organizations. On the other hand, only 4% believe that the current patient identification process is completely accurate.

The curious case of a mistaken patient identity
The curious case of a mistaken patient identity

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How to avoid patient identification errors? 

Patient identification using biometrics is the only way to eliminate this problem. It not only is error-free, but it is also instantaneous, speeding up the process for patient care, as well as safe.

RightPatient AI is used by a number of notable hospitals as well as thousands of outpatient sites, transforming the experience of the patients as well as the healthcare professionals. It not only eliminates the errors, but it also saves time in order to focus on patient care. It is also fully compatible with any EHR system as well as third-party apps, thus creating a seamless experience for the end user. It uses iris scanning to identify the patients and then pull the relevant data from their EHR. Take Terrebonne General Medical Center (TGMC) as an example. It is located in an area where a lot of people share common names, either first or last. Thus, it posed risks of incorrect record documentation, patient record mix-ups, and providing wrong prescriptions. RightPatient has helped TGMC in eliminating this issue entirely using Photo Biometrics along with iris scanning. It has an advantage over most other biometric modalities- iris scanning does not require any physical contact on the patient’s end, thus, no risks of infections or diseases via contact. Duplication and errors are all things of the past with RightPatient. 17 years of experience in AI and human recognition is proof of it.

reducing-opioid-abuse-by-knowing-the-right-patient-rightpatient

Reducing opioid abuse by knowing the right patient

The US is enduring a massive opioid abuse epidemic. Not only are they widely prescribed, but prescription opioids are now more widely abused than street drugs. If we look at the anatomy of the opioid crisis, it is genuinely frightening. In 2016, 116 people died each day due to opioid overdose, resulting in more than 42,000 fatalities in a single year.

The question is, why is this happening? How are 11.5 million individuals misusing prescription opioids? How is it that each year, 2.1 million people misuse opioids for the first time? It seems that, at present, there is no clear path to stunting this epidemic. Opioid abuse is already costing the US economy more than half a billion dollars annually.

How did we get to this point?

Since the 1990s, the pharmaceutical industry started pushing opioids and assured doctors that these drugs were safe. Consequently, doctors began widespread prescription of these drugs. However, blaming the pharmaceuticals industry and doctors alone ignores many other pertinent factors.

There have been many changes regarding the prevalence of various diseases over the last three decades. Slowly and steadily, medicine has become dominated by chronic and painful health conditions. It is estimated that one-third or the U.S. population or 100 million Americans are living with a chronic and acute pain condition. Among them, one-fifth are living with moderate to severe pain. Considering these statistics, it follows that opioids would be widely prescribed. However, 8-12 percent of those prescribed opioids result in patients developing an addiction.

Opioid misuse is not just limited to those living with painful conditions. Many of the prescribed opioids end up in the wrong hands. Many addicted to opiates hide their identity or medical conditions and visit various clinics under different aliases. For doctors, it is challenging to identify the right patient.

How can we reverse the epidemic?

To bend the trend downwards, efforts must be implemented at every level. At the community level, we must educate the public and raise awareness about the health risks of opioid abuse. Policymakers should advance legislation to address the problem. Above all, there is a need to change the way medicine is practiced; healthcare providers must take higher precautions at the clinical level.

Clinicians cannot and should not deprive people in pain from drugs that can bring them needed comfort. However, big data and technology can assist them in differentiating between the right patient and the wrong one. This is where RightPatient can play a vital role. Powered by artificial intelligence, the platform can help clinicians to thwart medical identity fraud and ensure that a patient’s complete and accurate medical history can be retrieved.

By recognizing the correct patient, clinicians can better understand the validity of patient complaints along with a patient’s disease history. When and where was the patient last prescribed an opioid? Did the patient rightly identify himself/herself?

RightPatient can be one way to prevent opioid abuse.

RightPatient augments population health investments

How Can You Protect Your Investment in a Population Health Solution?

Healthcare in the U.S. is going to see a paradigm shift in the next five years that will move it from a fee-for-service (FFS) payment model towards a value-based model. Simply said, those who produce better results and improve patient quality of care at lower costs will reap higher dividends. This shift will require better use of technology and significant changes to many platforms and their capabilities, including more investment in big data, analytics, and patient matching systems. These investments in population health management technologies will provide the real-time information needed to make more informed decisions.

Population health solutions play a critical role in moving healthcare from a treatment-based to a prevention-based model. These platforms enable providers to better prepare for patient-reported outcomes, provide data regarding social determinants of health and activity-based costing, and match extracted data outcomes with the right patient.

Current state of U.S. healthcare

The U.S. spends more on healthcare per capita than any other nation in the world but fails to produce better results for life expectancy and other health outcomes. Moreover, U.S. taxpayers fund more per capita on healthcare (64%) than those in other countries, including those with universal health programs.

These facts suggest that encounter-based medicine might be contributing to sub-optimal results in the U.S. and there is a need for change. That change is prompting the rise of population health management and data analytics technologies.

The population-based model is based on aggregating patient data across various health information resources, forming a comprehensive, longitudinal health record for each patient, and leveraging analytics to produce insights that clinical teams can use to improve care and lower costs. In addition to health and financial data derived from electronic health records (EHRs) and medical claims, information such as a patient’s socio-economic status, personal support network, and habitat conditions can be useful in building preventative care strategies.

For example, a patient diagnosed as prediabetes would be classified as high-risk in an encounter-based model. However, this does not take into consideration the patient’s lifestyle and behavioral patterns. Many prediabetics can avoid developing diabetes by modifying habits such as diet and exercise. Patients who smoke, abuse drugs, or have a sedentary lifestyle are much more at risk of developing the disease. Identifying these genuinely high-risk patients requires access to accurate data that is linked to the correct record. 

Challenges in moving to a population health solution

At present, a tremendous amount of patient data is available but it is not unified – it exists within different institutions and across various platforms. Thus, the available information is very difficult to match with the right patient (if not impossible in some cases) and such data has little practical value. Population health solutions need a system that can match patients with their available data and provide information on the best recommendations for preventative care, helping to improve outcomes and save resources.

Therefore, the most important variable in extracting value from a population health solution is ensuring that a patient’s captured data is matched to the correct record. Better data warehousing and mining capabilities will serve no purpose if healthcare providers lack the ability to match the output with the right patient. At present, not only do patient identification issues exist within a single healthcare institution, but these issues become even worse when patient data is exchanged across multiple systems, with error rates rising to 60%.

Failure to properly identify a patient means loss of historical medical history, social indicators, financial information, medications, allergies, pre-existing conditions, etc. – vital information that puts the patient and healthcare provider at greater risk. These data integrity failures can significantly dilute the efficacy of population health initiatives.

In fact, the transition from fee-for-service to value-based healthcare is only going to work if healthcare entities invest in patient matching technology alongside their investments in big data and analytics platforms. These investments should go hand-in-hand since patient matching errors can have such a substantial impact on data quality.

Population health management is among the top six categories in healthcare that are attracting investments from venture capital firms. Other segments include genomics and sequencing, analytics and big data, wearables and biosensing, telemedicine, and digital medical devices.

Thus, the industry is investing in technologies that will play a significant role in value-based care and population health management. However, the success of any population health initiative depends on the right patient being identified every time so that medical records and the corresponding patient data are not mixed-up. Considering the data fragmentation that exists in healthcare and lack of standards around patient identifiers, AI-based systems like RightPatient® are the only way to ensure reliable identification of patients across various data platforms and maximized investment in population health management.