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2021’s Patient Safety Goals Show that Patient Identification Is the Topmost Concern

This has been a devastating year all around for the entire world due to the COVID-19 pandemic and its effects. Even though there have been a lot of issues within the US healthcare system that surfaced during the pandemic, one of the more prominent problems healthcare providers faced (and are still facing) is patient identification errors. Experts have talked about and how patient misidentification is detrimental to both patient safety and quality healthcare. Thus, it isn’t surprising that improving the accuracy of patient identification takes the top spot of 2021’s patient safety goals as per the Joint Commission.

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Let’s take a look at the new goals set by the Joint Commission, why improving patient identification can help achieve the other goals, and how RightPatient can help healthcare providers.

Patient safety goals for next year

The Joint Commission outlines the top patient safety concerns that healthcare providers must address each year based on available information. Patient identification has been on the list almost constantly because errors can cause a lot of adverse effects for patient safety, healthcare outcomes, hospitals’ finances, etc. – more on that later.

Let’s take a look at the national patient safety goals for the upcoming year 2021:

  • Identify patients accurately.
  • Improve staff communication.
  • Safely use medicines.
  • Reduce patient harm by improving clinical alarm systems.
  • Reduce hospital-acquired infections.
  • Identify patient safety risks within the healthcare facility.
  • Prevent surgical mistakes.

While these are different issues, some of these patient safety goals can be met, or at least the unwanted incidents can be reduced, by ensuring accurate patient identification with RightPatient.

How patient identification ties in with other patient safety goals

While patient identification errors might seem trivial to some, there have been many complaints about the different problems which were consequences of misidentification – not finding the accurate medical record, delays in care, repeated tests, etc. As a result, many healthcare experts are clamoring for the mythical national patient identifier once again this year. However, national patient identifier or not, patient identification must be accurate to mitigate patient safety issues. Moreover, by ensuring accurate patient identification, other patient safety goals can be met – let’s explore how.

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Improving staff communication

Communication is crucial for ensuring improved healthcare outcomes and reducing patient safety incidents across the care continuum. By ensuring that patient data is accurate and consistent, it will enhance outcomes, as most patient safety incidents occur when patient data is corrupted, fragmented, obsolete, or inconsistent.

When patients are accurately identified every time at any touchpoint across the hospital, it helps maintain patient data integrity, ensures that the correct information regarding the patient is used, leading to accurate test results being passed to the appropriate personnel at the right time.

Safely use medicines

Many patient safety incidents occur because of simply giving the wrong patients the wrong medicine, incorrect doses, and/or at the wrong time, leading to preventable medical errors. While clearly labeling and rechecking do help, many medical errors occur because of patient misidentification. For instance, if the patient is misidentified right from registration, rechecking the name or information won’t help, as it belongs to someone else entirely.

If patients are accurately identified from the start, not only will patient misidentification be eliminated, but medical errors will be prevented too, enhancing patient safety and improving healthcare outcomes in the process.

Prevent surgical mistakes

This is somewhat related to the previous point, but medical record mix-ups do lead to the wrong surgeries being performed as well. If the patient is misidentified during registration, rechecking won’t help, as it will lead to the wrong surgery being performed on the wrong patient. 

Only by identifying patients accurately at the front-end can mistakes such as patient record mix-ups be prevented effectively.

Reduce hospital-acquired infections

Now, how can patient identification reduce hospital-acquired infections (HAIs)?

Well, as there is no standardized patient identifier present in the US healthcare system, many caregivers are using different solutions to fit their needs. However, many of these solutions can be ineffective and are touch-based, which is a major challenge, given the pandemic. These touch-based solutions can lead to infection control issues, as they require contact by multiple individuals. If an infected person uses it, the subsequent patients will be infected as well, leading to a disastrous situation.

However, many caregivers are using innovative solutions such as RightPatient – a touchless biometric patient identification platform. It uses the patients’ photos to ensure that the patients are who they claim to be, preventing patient identification errors, mix-ups, duplicate medical records, and more. It can also be used across any touchpoint, starting from appointment scheduling.

How RightPatient works – improving patient safety

Patients need to provide a selfie and a photo of their driver’s license – the platform automatically compares them for a match, remotely verifying their identities. During inpatient visits, the patients only need to look at the camera – the platform provides accurate medical records within seconds after comparing the live picture with the saved one.

RightPatient thus prevents HAIs as it is a contactless solution, enhancing patient safety, improving patient outcomes, and reducing preventable medical errors across the care continuum.

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4 Strategies to Optimize Revenue Cycle in Healthcare and Mitigate Losses

The US healthcare system has been going through a rough patch for a number of years now. When one problem is solved, other critical issues arise. However, with all these preexisting issues, it is now facing its biggest challenge in decades: COVID-19. With patients postponing regular visits and elective procedures, COVID-19 has created a severe financial strain and plunged hospitals and health systems into unprecedented losses. While hospitals are having to cope with these losses by closing down emergency departments, laying off employees, and so on, they can significantly reduce costs by focusing on their revenue cycles. Let’s explore why revenue cycle in healthcare is crucial, some strategies to optimize it, and how positive patient identification can help significantly.

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Why is revenue cycle in healthcare important?

Revenue cycle management is one of the most crucial aspects of any given healthcare provider. In a nutshell, it is the series of events that starts when a patient schedules an appointment and ends when the provider receives payment and is reimbursed. Since it’s related to patient service revenue, it has a direct effect on any hospital’s bottom line. 

If a hospital’s revenue cycle is optimized, then it will face higher margins, and if not, it will face significant losses. Complications such as billing and coding errors, patient misidentification at the front-end, and miscommunication lead to denied claims and delayed payments. In the end, patient volume won’t matter if a hospital takes a long time to capture the revenue or faces denied claims. Thus, optimized revenue cycle in healthcare facilities is extremely important if hospitals want to continue to operate in the foreseeable future.

4 Strategies to optimize revenue cycle management

Improve front-end and back-end collaboration

The front-end consists of activities where the hospital’s staff members interact with the patient directly: patient information collection, appointment scheduling, eligibility, verifying insurance coverage, upfront patient collections, and registration of new patients are just a few examples.

The back-end, on the other hand, consists of medical billing, claims management, denials management, as well as the collection of final “patient financial responsibility”.

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Usually, when it comes to revenue cycle management, most healthcare providers have their front-end and back-end tasks separated. However, collaboration between the two can significantly improve revenue cycle management. Effective and seamless communication is the key, and if that can be facilitated between the front-end and back-end teams, then it will result in faster, more accurate, and improved collections.

Improve front-end activities

According to a recent webinar, half of denied claims incurred by hospitals can be traced back to front-end activities, with the top contributors being registration and eligibility issues. These ultimately cause issues at the back-end of the revenue cycle in healthcare facilities, and the caregivers are forced to allocate significant resources such as FTEs (full-time equivalents) to fix billing and coding errors. If the front-end issues are not addressed, then this will lead to an endless cycle of lower productivity and an unoptimized revenue cycle.

If the front-end processes can be improved by preventing common errors such as patient misidentification or missing patient information, then issues like claim denials, underpayments, and lower productivity of the FTEs can be vastly reduced. Automating the front-end workflow is just one step towards improvement – but more on that later.

Adopt revenue cycle automation 

Revenue cycle automation is becoming more popular within the healthcare space, and for good reason. It leads to a significant reduction in the pressure that is put on healthcare professionals, reduces avoidable errors, and streamlines the entire process. However, organizations have to be cautious in their search for an effective automation tool.

Identify patients accurately

The most prominent issues that cause revenue cycle inefficiencies are patient identification errors, duplicate medical records, and medical record mix-ups at the front-end. If the accurate medical record isn’t identified, then the subsequent processes will be riddled with errors, leading to denied claims. Hospitals lose a huge amount of money – around $4.9 million – due to denied claims, many of which can be traced back to patient identification errors. Thus, revenue cycle in healthcare can be optimized if patient misidentification, duplicates, and mix-ups can be eliminated. This is exactly what RightPatient does.

RightPatient is a touchless patient identification platform that is used by several healthcare providers. It uses the patients’ photos to verify their identities, eliminating misidentification, avoiding duplicates, and preventing mix-ups at the front-end.

New patients need to take a photo during registration, locking their medical records with it. Enrolled patients only need to look at the camera – the platform identifies the patients accurately by matching the photos and provides the appropriate medical records within seconds. 

By eliminating misidentification, mix-ups, and duplicates at the front-end, RightPatient ensures that the accurate medical record is used across the care continuum, eliminating denied claims, boosting bottom lines, and enhancing patient safety in the process.

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Patient Data Accuracy is More Crucial Than Ever for Value-Based Care

While the US healthcare system, as well as the entire world, is still facing the effects of the COVID-19 pandemic, the former has several issues not directly associated with the novel virus. For instance, the lack of price transparency, increasing healthcare costs, healthcare data breaches, medical identity theft, the lack of interoperability, and the lack of effective patient identification in hospitals are just some of the many problems that plague healthcare providers. While we’ve already covered many of the aforementioned topics, today’s focus will be on value-based care, some upcoming adjustments, and why accurate patient data is crucial for it.

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Value-based care in a nutshell

Value-based care is a frequently discussed topic within the healthcare space – it’s supposed to transform healthcare for everyone. While healthcare costs have been ever-increasing and accompanied by all-too-often poor healthcare outcomes, value-based care is thought to be the game-changer. Instead of focusing on the fee-for-service model, value-based care focuses on paying hospitals and physicians based on the patients’ health outcomes.

Due to value-based care, patients will experience lower costs and better healthcare outcomes, healthcare providers will experience better patient satisfaction scores and improved efficiencies, and everyone involved in the model will experience reduced costs and better overall results.

Value-based care has been heavily focusing on:

  • reducing price and providing transparency regarding it,
  • enhancing care quality by providing a competitive environment for caregivers,
  • pushing for enhanced interoperability to improve coordinated care.

However, value-based care will be focusing on more areas as it seeks to improve healthcare as a whole. Let’s take a look at some of the recent updates.

Some current updates regarding value-based care

Medicaid will finally be integrated into value-based care, according to Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS). Medicaid directors across the States have been sent letters including ideas that will help incorporate value-based incentives within programs. Moreover, CMS wants all public and private entities to participate alongside Medicare and Medicaid.

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The Center for Medicare and Medicaid Innovation (CMMI) was established to test alternative payment models. It created fifty-four models; however, only five of them demonstrated savings, and only three of them are applicable for national expansion. CMS is hard at work observing the data in order to mitigate these issues.

Being flexible regarding regulations might do the trick, as the CMS believes that the exemptions introduced during the pandemic might be offered within the models for more participants.

There are many other proposed changes as well as those already underway, along with what might be the future of value-based care. A more detailed explanation can be found here.

However, even when value-based care was introduced, one thing was certain – accurate patient data is crucial for it to work. Let’s take a look at why patient data will make or break CMS reimbursements that focus on such models.

Accurate patient data is required for value-based care

Since the focus of value-based care is better healthcare outcomes, providers need to ensure that the right patient is receiving the right treatment at the right time. However, if patient data is inaccurate, it will significantly degenerate healthcare outcomes. For instance, if a patient is misidentified during registration, that patient will be treated using someone else’s medical record – someone with different diagnoses, test reports, ailments, allergies, and so on. If one takes previous patient misidentifications into account, both the misidentified patient, as well as the record holder, have faced adverse health outcomes. Thus, patient data integrity must be maintained to ensure that the information is consistent, accurate, and useful. That’s where RightPatient can help.

RightPatient enhances patient data integrity

Right from the beginning, RightPatient ensures accurate patient data by eliminating patient misidentification, avoiding duplicate medical records, and preventing medical identity theft.

It is a touchless patient identification platform used by several caregivers such as Community Medical Centers, Grady Health, MediSys Health, and Catholic Health of Long Island. By using patients’ faces, RightPatient locks the medical records upon registration with their photos. While scheduling appointments, patients only need to provide a personal photo along with a photo of their driver’s license – the platform automatically verifies the photos to ensure a proper match.

Within healthcare facilities, patients only need to look at the camera – the platform verifies the identities to see if the patients are who they say they are, preventing patient misidentification, avoiding duplicates, and maintaining patient data integrity as well. All these lead to better healthcare outcomes, something which is crucial for value-based care.

Choose RightPatient now and enhance healthcare outcomes by ensuring patient safety across the care continuum.

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Patient Safety and Communication are Critical as Patient Visits Return to Pre-pandemic Levels

COVID-19 has changed everything in unparalleled ways. Gone are the days when we could hang out casually with friends, be safe without PPE, and commute without the fear of catching the virus. It is quite natural that COVID-19 has impacted organizations and industries as well, and arguably, the US healthcare system is facing the worst consequences. The pandemic has affected every aspect of healthcare as we know it, and healthcare providers will be facing the consequences for years. They were forced to postpone elective procedures and outpatient visits to accommodate the surge of COVID-19 patients. While that was at the beginning of the year, many caregivers are now witnessing increased outpatient visits. Let’s take a look at some numbers regarding the fluctuation of outpatient visits, what caregivers should focus on now, and how patient safety and communication can be achieved with positive patient identification.

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What has been the situation since the pandemic hit?

While the novel coronavirus has rattled almost every country’s healthcare system, America’s is the one it hit the worst. In addition to the many pre-existing issues with the healthcare system, the US has the highest number of COVID-19 cases in the world. In order to make room for the numerous COVID-19 cases, as already mentioned, caregivers had to cancel elective surgeries and also encourage non-critical patients to opt for telehealth visits. 

Updates regarding outpatient visits

The Commonwealth Fund was closely following the updates of patient volumes within hospitals – let’s take a look at the numbers.

Outpatient visits took a significant hit – they had reduced by almost 60% during the early stages of the pandemic. The update provided by the Commonwealth Fund during May showed that patients were returning for outpatient visits, however, they were still one-third lower compared to pre-pandemic numbers. Also, the latest report shows that weekly outpatient visits are somewhat higher now, compared to the pre-pandemic period.

Outpatient visits vary

While this is a good sign for healthcare providers, it must be noted that these vary greatly depending on age, location, specialty, etc. For instance, in-person visits from younger patients are still lower than they were before the pandemic. Visits are higher for urologists, dermatologists, and adult PCPs, whereas behavioral health providers are experiencing lower visits. More Medicare patients are coming for inpatient visits compared to the pre-pandemic period. Telemedicine visits were higher when inpatient visits declined, but its usage is declining. However, its usage is still much higher than it was before the pandemic.

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All these comparisons show that providers and patients are adapting to the new normal. Many patients are suffering from complex diseases and, due to the pandemic, they have been postponing healthcare visits for far too long. However, since restrictions are being lifted, patients are returning for outpatient visits in order to avail healthcare services. While providers are opening their doors to treat patients, they also need to ramp up their patient safety and communication efforts. After all, the post-pandemic world is completely new for everyone – there’s no tried and tested formula to ensure everyone’s safety. Healthcare providers also must make sure that their patients are not contracting COVID-19. Let’s see how this can be a possibility.

How patient safety and communication are hampered

All of the patients of any given hospital must first be identified. This happens either at the registration desks or within the emergency department. Different caregivers have different patient identity verification methods in place. Now, many caregivers either use inefficient methods, like questioning patients, or use solutions that have become outdated, such as contact-based patient identification platforms. 

When asking patients questions, there are high chances that the registrar or nurse will identify the wrong medical record – they might need to find the record from an EHR system that contains thousands. Moreover, duplicate medical records are quite prevalent. Whatever the case may be, such inefficient methods hamper patient safety, lead to poor communication, and adversely impact patient outcomes.

While many used touch-based solutions to identify patients before the pandemic, COVID-19 has rendered these solutions unsatisfactory. Many caregivers have witnessed significantly lower utilization of these solutions – patients simply are reluctant to touch them. This is because of the pandemic and the fear of contracting the virus, which is not unreasonable. Every patient of any given hospital is processed from registration desks and EDs – can you imagine how disastrous it would be if one of them had COVID-19? Once the infected patient touches the device, it would lead to everyone else becoming infected. Before, infection control was a common headache of caregivers, and now it is a concern for patients too. Touch-based solutions have always had an impact on patient safety, but only the most forward-thinking caregivers foresaw this. That’s why they went with RightPatient, improving patient safety and communication in the process.

RightPatient enhances patient safety

RightPatient is the leading patient identification platform used by caregivers who prioritize patient safety. It’s an entirely touchless solution that uses a powerful photo-based engine and patients’ faces to identify them across the care continuum. 

Whenever patients arrive at the hospital, all they need to do is look at the camera – the platform matches the saved photo taken during registration with the present one, ensuring an entirely touchless, hygienic, and safe experience for everyone involved. This eliminates the risk of contracting infectious diseases and enhances patient safety.

By identifying patients accurately right from appointment scheduling, as well as other touchpoints, RightPatient ensures patient data integrity by preventing data corruption, improving communication across the care continuum and reducing the chances of medical errors based on incorrect patient data.

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Hospitals Are Facing Lower Reimbursements – Reduce Losses by Preventing Wrong Patient Identification

The COVID-19 pandemic has – and still is – left an unprecedented impact on our lives, and it’s safe to assume that it will leave a mark for years, if not decades. While the novel virus has claimed over 1 million lives around the world, over 219,000 of them were Americans. The US healthcare system is also on the receiving end – it is expected to face unprecedented losses of around $323 billion this year. Many healthcare providers have been forced to shut their doors permanently, furlough or lay off employees, or introduce pay cuts to deal with the financial blows. To make matters worse, healthcare providers are receiving small amounts of reimbursements for treating uninsured COVID-19 patients. Let’s take a look at the scenario, the numbers associated with the issue, and how providers can mitigate these losses by preventing wrong patient identification.

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COVID-19 has created an unprecedented financial strain for hospitals

COVID-19 has been spreading like wildfire, impacting everything and everyone it comes in contact with. After it hit the US, the healthcare system braced for impact the best way it could; hospitals canceled elective procedures and reassigned all resources to handle the surge of incoming COVID-19 patients. Naturally, hospitals and health systems are still suffering from the financial strain caused by COVID-19 as well as the cancellation of elective procedures.

Providers would get reimbursed for treating uninsured COVID-19 patients 

Back in April, the Trump administration’s coronavirus treatment reimbursement program was announced. Healthcare providers who treated uninsured COVID-19 patients would be reimbursed using the money from the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This has been done so that caregivers don’t incur any more losses as well as to avoid uninsured patients facing shocking bills related to COVID-19. As a result, the Department of Health and Human Services (HHS) has reimbursed $881 million to around 8,000 providers to date.

However, it was estimated previously that the reimbursement for treating uninsured COVID-19 patients would range from $13.9 billion to $41.8 billion. As hospitals are facing losses of around $323 billion this year, they need higher reimbursements if they are to survive in the post-pandemic world. 

Why is this happening? 

One of the reasons pointed out by the Kaiser Family Foundation is the eligibility for receiving reimbursements – hospitals treating uninsured patients who have a primary diagnosis of COVID-19 will be receiving reimbursements. This means that even though healthcare providers might treat uninsured patients, if their primary diagnosis isn’t COVID-19, the caregivers won’t be eligible for reimbursements.

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Another issue with the program is that it doesn’t guarantee that all caregivers treating uninsured COVID-19 patients will receive the reimbursements – it depends on the availability of funding.

Hospitals must cut costs by mitigating wrong patient identification

The biggest challenge hospitals are facing now is to survive the financial strain. As previously mentioned, many have already closed their doors. Others are utilizing alternative cost-cutting methods such as furloughing or laying off employees, introducing reduced salaries, or restructuring their operations.

However, healthcare providers have a long list of problems that stem from wrong patient identification, and if they can eliminate it, they can significantly reduce costs and mitigate losses – enough to survive the financial crisis. Moreover, patient identification errors have been impacting healthcare outcomes even during the pandemic – for instance, test results went to the wrong patients, treatment was delayed due to incorrect patient data, and so on. All of these issues can be eliminated with RightPatient.

RightPatient effectively prevents wrong patient identification

Wrong patient identification has been a significant problem for years. While many healthcare providers wisely chose RightPatient before the pandemic (thanks to its touchless nature) others are facing issues with their touch-based solutions. Many have even reported a significant drop in utilization of the touch-based patient identification solutions as patients are extremely reluctant to use them due to concerns regarding infections. While infection control used to be a concern for hospitals only, since the pandemic, patients are well aware of the consequences.

Thankfully, patients and caregivers don’t have to worry about this with RightPatient, the industry’s leading patient identification platform. It uses a characteristic that others cannot replicate or steal: patients’ faces. Using patients’ photos and a photo of their driver’s license or other identification cards after scheduling an appointment, RightPatient automatically matches the photos to ensure accurate patient identification right from the start and across the care continuum. 

Leading providers have deployed RightPatient across their facilities and are reducing denied claims, preventing duplicate medical records, and enhancing patient safety – ultimately eliminating redundant costs and boosting their bottom line in the process. After the pandemic, every hospital needs to reduce such costs to survive – use RightPatient to help you do so.

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Wrong Patient Identification Errors Lead to Several Issues – Are You Preventing Them?

Patient identification has always been hit or miss within the US healthcare system. Wrong patient identification errors cause a plethora of serious issues for not only healthcare providers but also patients. Patient mix-ups, patient safety issues, medical identity theft, duplicate medical records, and overlays are just some of the many issues that can be traced back to patient identification errors. These issues have been popping up even more during the pandemic, leading many experts to demand a patient identifier. While we’ve talked about all of that in previous articles, let’s take a look at a very recent patient mix-up, its consequences, and how positive patient identification can prevent such cases.

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Another one added to the list of wrong patient identification

The mix-up took place back in August at Washington-based Sacred Heart hospital. Interestingly, the person with whom the hospital mixed up the information was a former patient of the healthcare provider. 

For simplicity’s sake let’s call the actual patient Samantha and the former patient (who got the call) Rebecca.

Back in August, Rebecca’s daughter was called and she was informed that her mother was hospitalized due to a critical injury. However, the daughter responded that Rebecca was right in front of her and fine, but the staff at the hospital was adamant and said that her mother was injured and admitted. Understandably, Rebecca was quite worried about the real patient, Samantha.

Rebecca and her daughter reportedly informed the healthcare provider that they had a case of mix-up on their hands – she said that she didn’t know who was being treated under her name or why. In response, she was told that the hospital would rectify the issue. However, that was only the start.

What happened down the road?

Since Rebecca was a former patient of Sacred Heart, she checked her records to see if it was fixed or not. Unfortunately, the wrong information was still present, and to make things worse, other irrelevant materials were added, such as $3,000 worth of bills. Moreover, the provider also tried to bill her old insurer, which naturally didn’t work. Subsequently, the provider attempted to help her get insurance.

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The actual patient was safe

Rebecca heaved a sigh of relief when she found out that Samantha was out of danger – she kept in contact with the hospital over the phone. When this was over, Rebecca was also relieved that she didn’t receive the wrong bills as a result of the mix-up.

Wrong patient identification errors are quite common

While this case didn’t have any adverse consequences, not everyone is as lucky. Wrong patient identification errors occur every day and most are not identified until it’s too late. Not only are they problematic for patients, but they create issues for caregivers as well.

Patients face delays in treatment, incorrect procedures, and repeated lab tests – ultimately hampering patient outcomes as well as jeopardizing patient safety in the process. Moreover, they receive shocking bills for medical procedures or treatments they never received. The lucky ones can have them written off as denied claims, but this is still a huge cost for the providers. 

On the other hand, healthcare providers face unwanted attention, loss of goodwill, denied claims, lower scores, and might even risk losing CMS reimbursements (as they are tied to patient safety). 

All of this is leading to healthcare experts and leaders rallying for a state-funded patient identifier. While this appeal has been denied for over two decades, forward-thinking hospitals and health systems are not waiting for it, and have taken the initiative themselves to eliminate issues related to wrong patient identification errors.

Leading providers are using RightPatient

RightPatient is the industry’s leading touchless patient identification platform trusted by providers such as Grady Health, Catholic Health of Long Island, Terrebonne General Medical Center, and University Health Care System. Using the photos of patients, it prevents patient identification issues like mix-ups, duplicates, medical identity theft, denied claims, and more.

After successfully scheduling an appointment, patients receive an SMS or email, after which patients are required to provide a personal photo and a photo of their driver’s license. RightPatient matches the photos automatically and verifies the identity of the patients remotely. 

Be a responsible healthcare provider and prevent mix-ups and the issues associated with patient misidentification by deploying RightPatient.

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Patient Matching and Interoperability Are Ineffective Without Positive Patient Identification

The U.S. healthcare system has been inundated with several issues even before the pandemic. The lack of price transparency, medical identity theft, duplicate medical records, high costs, medical errors, and patient safety issues are just some of the issues plaguing providers. However, today’s focus is on another problem – the lack of interoperability. Many providers are thinking that interoperability will get a significant boost due to changes such as the 21st Century Cures Act and the CMS Interoperability and Patient Access Final Rule. While that might be true, many are overlooking the fact that it needs a particular component to work immaculately – patient matching. While some might believe that it is just a cog in the wheel, everything in healthcare heavily relies on accurate patient identification – without it, everything will go wrong.

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Let’s take a closer look at the rules, how they will boost interoperability, and why patient identification is crucial for interoperability to work.

The 21st Century Cures Act and Patient Matching

What it means

Several healthcare experts are quite content with the Cures Act, believing that it will usher in the era of true interoperability. In a nutshell, the implementation of certain provisions within the act will enhance interoperability and also support accessing, exchanging, and using electronic health information. What all this means is that patient data can be easily shared among caregivers, leading to better, more personalized care, as well as enhanced healthcare outcomes – but that’s only one side of the coin.

Interoperability requires more than the Cures Act

While the Act is a step in the right direction, interoperability won’t be successful solely because of it – other factors need to be considered. The most important factor is patient matching.

Imagine a scenario where a healthcare provider is abiding with the Act and has taken all the necessary measures to do so. However, due to issues like patient misidentification or duplicate medical records, matching patients to their proper EHRs will become nearly impossible. As a result, the wrong medical record will be sent to the wrong caregiver – jeopardizing patient safety and adversely affecting coordinated care efforts along the way. Thus, proper patient matching is an absolute must to make sure that the patient data exchanges are successful and error-free. Healthcare providers can do so by ensuring accurate patient identification across the care continuum by using solutions like RightPatient – more on that later.

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The Interoperability & Patient Access Final Rule

We’ve already talked at length about this rule and how it will enhance interoperability as well. In a nutshell, healthcare providers using EHR or EMR systems need to enable e-notifications support so that they can receive and send out real-time notifications during ADT (admission, discharge, and transfer) events with the patients’ other caregivers. While this rule has been established to boost interoperability and coordinated care efforts, this also requires proper patient matching. If a patient is misidentified, the caregiver will send out false alerts, jeopardizing the care coordination efforts. It will also put the provider’s CMS reimbursements at risk.

Thus, patient identity matching must be accurate at all times, if the providers want to ensure CMS compliance and abide by the 21st Century Cures Act. This is where RightPatient can help caregivers ensure accurate patient identification – and more.

RightPatient can improve patient matching 

RightPatient has years of experience with reputed healthcare providers such as Terrebonne General Medical Center, Community Medical Centers, and University Medical Center. It is a touchless patient identification platform that identifies patients with the element that cannot be copied or stolen – their face. Right from appointment scheduling, the platform ensures remote patient authentication – patients are asked for a selfie and a photo of their driver’s license. RightPatient matches the photos and ensures that patients are identified accurately – ensuring positive patient identification.

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Patient Safety and Quality Can Be Improved by Preventing Duplicate Medical Records

Patient safety is one of the more integral aspects of any given healthcare system. It ensures that patients are getting the required treatment without any medical errors or harm, healthcare outcomes are optimal, and healthcare services are delivered to the highest possible standard. While those are the common aims, the reality is quite different in the U.S. healthcare system. It has always been inundated with a number of serious issues – healthcare data breaches, medical identity theft, patient identification issues, lack of price transparency, and duplicate medical records are just some of them.  The root cause of many of the issues are duplicate medical records. While we already had a closer look at duplicate medical records and how it impacts revenue cycle optimization, let’s have a look at how preventing duplicates can lead to enhanced patient safety and quality, among other things.

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How duplicates impact patient safety and quality of healthcare

In a previous article, we’ve already seen how medical record errors like duplicates and overlays are created and how they cause claim denials. Let’s see how they impact patient safety and quality of healthcare as well.

AHIMA’s Shannon Harris and Shannon H. Houser stated in an issue of the Journal of AHIMA that duplicates and overlays don’t only cause financial woes, but lead the physicians and healthcare staff to inadvertently causing medical errors. For instance, imagine that a single patient has duplicate medical records in a hospital’s EHR system. While treating the patient, the physician will see the duplicates but chooses the one that has obsolete information. Since the information is not updated, the treatment or medication might very well cause adverse effects. Such cases might even lead to transferring the patients for emergency treatments, leading to jeopardized patient outcomes.

That’s not the only way duplicate medical records impact patient safety and quality of healthcare – let’s look at the latter. When you have fragmented information within duplicate records, issues such as repeated lab tests and delays in treatment are quite common. Since the majority of the healthcare providers’ registration systems have ineffective patient identity matching techniques, the number of duplicates keeps on increasing, leading to patient safety issues, patient data corruption, and financial troubles in the form of denied claims. 

How are hospitals addressing duplicates?

Sadly, rectifying duplicates and overlays are quite complex and a nightmare for any given healthcare provider. While most of the hospitals are trying to fix duplicates by reallocating their HIM resources and even dedicating some of their FTEs (full-time employees) to identify and rectify the erroneous records, unless they address the frontend issues (read: identify patients accurately), it will be a never-ending cycle. Patients will be misidentified, duplicates will be created, and FTEs will be assigned to fix them on the backend, taking up valuable time and resources.

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So, can hospitals address these issues and prevent duplicate medical records on the frontend?

RightPatient enhances patient safety and quality of healthcare

As previously mentioned, if the patients are accurately identified during the registration process, duplicates can be prevented right from the beginning. That’s what we do best with our industry-leading patient identification platform. RightPatient, with its touchless design, ensures that patients are identified across the care continuum, starting from appointment scheduling. Patients only need to provide their selfies and a photo of their driver’s license when they schedule appointments. RightPatient matches the photos and makes sure that the accurate patient record is identified every time the patient accesses healthcare services, remotely or otherwise.

When the patients arrive at the hospital, all they need to do is look at the camera – RightPatient matches the saved photo and the real-time photo during the check-in process, preventing duplicates, eliminating denied claims, and enhancing patient safety. The best part of RightPatient is that the entire identification process is touchless, creating a safe environment for all involved in a post-COVID-19 world.

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Revenue Cycle Optimization Efforts Are Hampered by Duplicate Medical Records

Medical record errors such as duplicate medical records and overlays are issues that keep resurfacing time and again, especially when they lead to patient identification errors. We’ve already taken a closer look at duplicate medical records, how they are created, and how they impact patient safety. However, these are not the only problems medical record errors create. Another prominent issue is that duplicates jeopardize your revenue cycle optimization efforts by creating denied claims. Let’s take a look at exactly how that happens, how denied claims can take up your valuable resources, and how RightPatient can help combat duplicates and overlays, and in turn, optimize revenue cycle management.

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How duplicates get created

To understand how duplicate medical records affect the revenue cycle, let’s take a brief look at how duplicates and overlays get created. These usually originate during the registration process, especially if the healthcare providers don’t have any effective patient identity verification system in place.

For instance, patients keep coming in and they need to be identified immediately so that they can be treated. This clearly shows that hospital registration desks are environments that are always hectic and staff is under pressure, more so for busy or larger hospitals. If you factor in outdated or ineffective patient identification platforms, duplicates are bound to occur, along with problems such as infection control issues that are associated with touch-based patient identification platforms.

Coming back to duplicates, the registrars have a very small window to identify the accurate medical records from an EHR system that might house thousands of records. Name changes, common names, misspellings, and nicknames only make matters worse. For instance, the medical record is saved under the name “Richard Grayson”, but the patient uses his nickname “Rick Grayson”. These are bound to create identification issues, and when the registrar can’t find the accurate record, they might end up creating a new one – leading to a duplicate record. Furthermore, existing duplicates will create more confusion for the registrars – AHIMA (The American Health Information Management Association) has stated that larger healthcare facilities have around 20% duplicates.

That’s how medical record errors usually begin, and while we’ve already talked about how it impacts patient safety, how exactly does it affect revenue cycle optimization and a hospital’s financial performance? Let’s analyze the issue.

How revenue cycle optimization is hampered by duplicates

According to a Black Book report, 33% of denied claims were caused by patient identification errors in 2017, costing the average healthcare provider $1.5 million and the entire U.S. healthcare system a whopping $6 billion per year. Let’s see how duplicates lead to denied claims that hamper the revenue cycle.

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It’s quite straightforward – as duplicate medical records consist of incorrect, obsolete, fragmented, or incomplete information, these lead to coding and billing errors. Moreover, as duplicates hamper patient care, litigation costs regarding such cases are not unheard of. Not only do healthcare providers lose money, but they also lose their goodwill – these stories spread like wildfire, whenever they occur.

Coming back to duplicate records and revenue cycle, let’s take a look at how they are related. One of the more common places where denied claims occur due to duplicates is during surgical procedures, according to an article from HIM Briefings. Let’s use the example provided by Letha Stewart from QuadraMed within the article.

During the presurgery phase, the patient comes in and is registered as “Richard Grayson” and has the medical record number 111. As previously mentioned, common names lead to confusion among the registrars, and thus, without an effective patient identifier, the registrar couldn’t find the accurate medical record on the day of the surgery. As a result, a new record gets created under “Rick Grayson” with a different number, for instance, 222. When the insurance provider verifies the claims regarding this surgical procedure, it will notice the glaring discrepancy – there are different medical records involved for a single procedure. Moreover, the insurer most likely will use the patient record available at their end, and seeing that the records don’t match, the claim will be denied. While this is a simple but illuminating scenario, this is how most of the claim denials that stem from duplicate medical records occur. To sum it up, incorrect, fragmented, or incomplete patient data and discrepancies lead to denied claims that impact revenue cycle optimization efforts.

Providers dedicate FTEs for fixing medical record errors

Duplicate records and overlays need to be identified and fixed to prevent impediments to revenue cycle optimization. Most providers do that by dedicating their full-time employees (FTEs) from their HIM departments. While these activities are necessary, they also consume a significant amount of resources and time. According to Stewart, many providers dedicate around five FTEs to solve these issues. However, if providers don’t have an effective patient identifier in place, they cannot take the load off their FTEs and they’ll need to continue fixing these errors for quite some time, leading to lower productivity and higher costs. Given the current pandemic, providers need to mitigate costs as much as possible. That’s where RightPatient can help them.

RightPatient enhances revenue cycle optimization

As we’ve mentioned several times, going to the root of the issue, patient identification, is the best strategy. If you avoid duplicates and overlays at the frontend, you won’t have to deal with them later and face consequences like denied claims, allocating FTEs for fixing the issues, and higher costs. But how can RightPatient help with that?

RightPatient is the leading touchless biometric patient identification platform used by many providers to prevent duplicates. With its photo-based search engine, RightPatient identifies patients from appointment scheduling and beyond. Be it remote patient validation or identification within the healthcare facility, RightPatient ensures that the correct medical record is provided every time within seconds. Reduce denied claims, prevent duplicates, and enhance patient safety with RightPatient now.

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A Closer Look at Duplicate Medical Records and How They Can Be Prevented

There are a lot of issues with the U.S. healthcare system, but a few of them can be traced back to medical record errors – duplicate medical records and overlays, to be precise. For instance, duplicate records and overlays lead to patient safety issues, reduced healthcare outcomes, patient misidentification, billing and coding errors, denied claims, and revenue cycle management issues. Even during the coronavirus pandemic, duplicates have been leading to poor patient identification – hampering the response rate and patient outcomes. Let’s take a closer look at how and why duplicates are created, their effects on patients and caregivers, and how they can be prevented with RightPatient.

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Duplicate medical records and overlays

With the technological advancements available today and being arguably the world’s most advanced country, one might ask why are duplicate records a thing in the U.S. healthcare system? Well, there can be many explanations for this – errors made during registration, already existing duplicate records, the lack of a proper patient identification system, pressure at the frontend, and so on.

Duplicate medical records and overlays occur especially within the premises of busy healthcare providers – when under a tremendous amount of pressure, registration employees are more likely to make mistakes. While hiring more staff to reduce the pressure might work, without an effective patient identification platform, these errors will inevitably continue to be created. Before diving into how they are created, let’s distinguish between duplicate records and overlays.

Duplicate records

It’s self-explanatory from the name itself. Duplicate records refer to more than one medical record assigned to a single patient – this itself implies the complications such records bring. For instance, it means that there will be redundant records within the EHR system, leading to patient data integrity issues. Moreover, each duplicate record will have different, incomplete, obsolete, or inconsistent information – leading to data corruption. Caregivers have to make important decisions based on the information within medical records (lab test results, vitals, medications, allergies), and when they are using wrong or fragmented information, quality of care takes a hit. Overall, patient safety is compromised – more on that later.

Overlays

Overlays are in a league of their own. The main difference between overlays and duplicates is that overlays are created when one patient’s medical record or its information is entered into an entirely different patient’s record – merging the information together. While they only occur rarely, they can be expensive and extremely dangerous for both patients and caregivers according to HIM Briefings as well as our own experience. Not only do overlays corrupt patient data, but they also lead to patient safety issues, repeated lab test results, wrong treatment, and so on.

Now that we’ve seen what duplicate records and overlays are, let’s see how they get created.

How are duplicate medical records and overlays created?

These medical record errors are usually made during the patients’ and caregivers’ first point of contact – registration. These are typically busy areas for any given hospital – naturally, the employees have a short amount of time and a huge amount of work. Add to that the lack of an effective patient identifier, patients sharing the same information (names, DOBs, etc.), and a sea of medical records, and you have an environment that is likely to result in duplicate records and overlays.

Most of these issues occur because the registrars have no concrete way to identify patients accurately. Moreover, common names, nicknames, name changes, entering incorrect data, and misspelling patient names are some factors that will hinder the attempts to find accurate records. For instance, there might be quite a few “Will Smiths” in the EHR system. Also, “William Smith” might have his record saved under “Will Smith”, but he mentions himself as the former in front of the registrar. Moreover, many patients have their names changed after marriages or separations. All in all, there are a lot of factors in play here.

The impact of medical record errors

There are many consequences of having duplicate records and overlays in EHR systems for both patients and caregivers.

AHIMA has stated that 20% of the medical records in healthcare systems with multiple facilities are duplicates, and they can cost up to $40 million for any healthcare provider. Moreover, these lead to wrong treatment, undesirable patient outcomes, and thus, lower ratings and loss of goodwill for hospitals. Other consequences faced by hospitals are denied claims and poor revenue cycle optimization, hitting their bottom lines, and reducing their already razor-thin margins.

Patient safety takes a huge hit – when a patient gets treated with a fragmented or an entirely different medical record, there are so many things that could go wrong! Wrong medications, delays in treatment, repeated lab tests, and even death are the consequences for patients. All of these issues are avoidable if the caregivers use an effective patient identifier to prevent duplicate medical records and overlays. This is where RightPatient comes in.

RightPatient prevents duplicate medical records and more

For years, RightPatient, with its touchless biometric patient identification platform, has been preventing medical record errors such as duplicates and overlays. Not only that, but it also ensures accurate patient identification using the one factor that doesn’t change and cannot be stolen or transferred – the patients’ faces. 

After scheduling an appointment successfully, patients are sent an SMS or email and are asked to provide their selfies and a photo of their driver’s license. The platform matches the photos and ensures that the patients are accurately identified right from the start. Whenever patients visit the hospital, those enrolled under RightPatient only need to look at the camera – the platform identifies them with the saved photo, retrieving the appropriate medical records, preventing duplicates in the process.

Prevent duplicates and enhance patient safety now with RightPatient.