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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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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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CMS Interoperability and Patient Access Final Rule Requires a Robust Patient Identification Software

This has been quite a year for the U.S. healthcare system – nobody could’ve predicted all the series of events. While the novel coronavirus is still raging on, telehealth is experiencing unprecedented growth. On the other hand, hospitals are facing immense financial strain due to the pandemic’s consequences such as the cancellation of elective procedures and lower inpatient visits. However, despite all the recent developments healthcare providers need to work on something else as well – supporting e-notifications. CMS has made some additional changes to the Medicare Conditions of Participation (CoPs), and while providers will be busy brainstorming about how to best approach the requirements, many will overlook one critical factor that will either make or break their e-notifications – patient identification. Let’s take a look at what the rule specifically says about e-notifications, who is eligible, how it helps caregivers, and how a robust patient identification software like RightPatient is a must for ensuring proper e-notifications.

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The Interoperability and Patient Access Final Rule – in a Nutshell

While the rule itself is quite vast and detailed, we’ll cover the e-notifications part briefly. The basic meaning of the rule is clear from its name. For years, the U.S. healthcare system has been suffering from the lack of proper interoperability for a number of issues – patient misidentification being a major reason. However, with the “companion final rule”, as per CMS, things are about to change for the better, as it will introduce a certain level of interoperability that will ultimately boost coordinated healthcare efforts.

The “companion final rule” states that healthcare providers such as critical access providers, acute care, or psychiatric hospitals must send out real-time e-notifications during ADT (admission, discharge, or transfer) events to a patient’s caregivers such as established primary care practitioners, post-acute providers & suppliers,  primary care practice groups & entities, as well as any other practitioners, groups, or entities primarily responsible for the patient’s care. The information sent must contain the patient’s name, the treating practitioner’s name, and the sending institution’s name, at the very least. Finally, these are applicable during inpatient ADT events and ED admissions or discharges.

Any caregiver that uses digital medical records such as EHRs or EMRs must support e-notifications by May 1, 2021, to ensure CMS compliance.

With that out of the way, let’s look at how the rule requires accurate patient identification and how a robust patient identification software is critical for its success.

Why patient identification will make or break your CMS compliance

Healthcare providers are already busy working on e-notifications support, and while there are a lot of great solutions out there, providers shouldn’t forget the foundation upon which e-notifications depend on – proper patient identification.

The Interoperability and Patient Access Final Rule requires hospitals to identify their patients accurately across the care continuum, especially if they want to send out e-notifications to the proper caregivers. Sadly, patient identification has always been problematic – it is an overlooked but significant concern for the U.S. healthcare system. One might ask how are patient identification and e-notifications related – let’s learn more.

Imagine this – a hospital already has patient misidentification cases because they don’t use an effective patient identification software. If a patient comes in and is misidentified, not only will the treatment be affected, but the hospital will be sending out false alerts to the wrong caregivers. This will wreak havoc for all the caregivers involved with the patient. 

If such cases become common, then the patients, as well as the care coordination teams, will start questioning the credibility of the caregiver sending out false alerts. As a result, the hospital will lose goodwill and risk its CMS reimbursements. After COVID-19, not a single hospital can afford to make such mistakes – the pandemic has already caused the worst financial strain on hospitals and health systems in recent times. Thus, patient identification is a crucial component for the e-notifications to work. If caregivers don’t have a robust patient identity matching system in place, they need to upgrade it before the e-notifications support deadline.

RightPatient is the most robust patient identification software

RightPatient has been accurately identifying patients for years. With its touchless patient identification platform, RightPatient ensures that patients are identified accurately and safely right from the start.

After a patient schedules an appointment, they are sent an SMS or email and are required to provide a selfie and a photo of their driver’s license. The platform automatically matches the photos and remotely ensures patient identification. If it’s a new patient, the platform will automatically assign new biometric credentials for them. 

During hospital visits, patients only need to look at the camera – RightPatient matches the saved photo with the photo taken by the camera – ensuring accurate patient identification. Best of all, it’s an entirely touchless process, something that is mandatory in a post-pandemic world.

RightPatient is the leading patient identification software in the healthcare industry and is used by prominent caregivers such as Terrebonne General Medical Center, Community Medical Centers, and Catholic Health Services of Long Island. Be a responsible healthcare provider and upgrade your patient identification system now to prevent misidentification cases, medical identity theft, and ensure compliance with the Interoperability and Patient Access Final Rule.

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CMS Compliance Requires Identifying Patients Correctly – Are you Ensuring it? 

From the title, it is quite clear what this is about. The changes made to the Medicare CoPs (conditions of participation) have attracted attention within the US healthcare system, especially after the introduction of mandatory e-notifications during every ADT (admission, discharge, or transfer) of a patient. While providers are more focused on e-notifications, most of them forget about one very important prerequisite: identifying patients correctly. While we have already touched upon the topic regarding CMS (Centers for Medicare and Medicaid Services) Interoperability & Patient Access Final Rule, this time, we will focus more on the practical aspects and how patient identification is a crucial component that is absolutely necessary for e-notifications to work properly as well as CMS compliance. Without further ado, let’s dive deeper into the topic at hand.

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A brief refresher

A few changes have been made regarding the CMS Interoperability & Patient Access Final Rule. As the name suggests, it has been done to boost interoperability efforts within the caregivers of the patients. Let us look at why it is required within the healthcare system.

There are many cases where a patient is not restricted to a single healthcare provider;  especially if they have complications, multiple ailments and so on. Such patients need to visit and consult with multiple healthcare providers in order to receive the best patient care. For this to be effective, caregivers need to have access to the patient’s medical record, history, medications, vitals and other necessary information. In order to make the caregiving process seamless and boost interoperability, the Final Rule was introduced.

The “companion final rule” states that e-notifications must be sent out by healthcare providers (such as acute care, psychiatric, critical access providers, etc.) during every ADT to the appropriate recipients, i.e., the other caregivers (post-acute providers & suppliers, established primary care practitioners, or any other entity primarily responsible for the patient’s care). This rule applies to inpatient admissions as well as ED admissions. 

Who needs to ensure it?

Applicable healthcare providers are those who use digital medical records like EMR or EHR systems. They need to ensure compliance and have proper systems set up by May 1, 2021 so that they can send out e-notifications during ADTs. 

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While that’s a succinct summary of the most recent change in the CoPs, every healthcare provider needs to ensure that they are sending out e-notifications. Otherwise, they can face undesirable consequences such as receiving penalties for non-compliance, or worse, jeopardizing their CMS provider agreements. But how is identifying patients correctly related to CMS compliance regarding e-notifications?

Identifying patients correctly is required for CMS compliance

As previously mentioned, the CMS rule requires healthcare providers to send out notifications during ADTs. But there’s a catch.

Identifying patients correctly is quite important for e-notifications to work. Think about it: if a patient is not accurately recognized or is misidentified as a different patient, the healthcare provider risks sending alerts to the wrong caregivers. Worst of all, the provider risks that they won’t be able to answer alerts other caregivers are requesting.

Without a reliable way to identify patients, things can escalate quickly. If a provider cannot fulfill alert requests or sends too many incorrect alerts, care coordination teams will start to lose faith and miss opportunities to improve patient outcomes. Noncompliance will also incur CMS penalties, which can result in hefty fines. After COVID-19, nobody can afford such costs.

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While healthcare providers are busying themselves by deciding how to best implement e-notifications, they should also assess the effectiveness of their patient identity matching systems. Clearly, the former is dependent on the latter. Those who are struggling with patient identification need to upgrade their systems to futureproof, easy-to-use and hygienic ones. 

RightPatient helps identify patients correctly

We ensure that patients are always identified correctly with our industry-leading touchless biometric patient identification platform.

How it works

After making an appointment, patients receive an SMS or email to validate their identity. During this process, the patient takes a photo of their driver’s license and a selfie. RightPatient automatically matches the selfie photo with the photo on the driver’s license to ensure a proper identity match. If the patient is not already in the system, RightPatient assigns biometric credentials to the new patient.

This is how we prevent patients from registering under a different identity or medical record mix-ups. There’s no need to worry about name changes, mistakes when entering a patient’s name or other common issues. Patients are recognized with their selfies.

We have been helping prominent health systems like TGMC, CMC and CHSLI fight the battle against patient misidentification for years. With RightPatient, responsible healthcare providers can send e-notifications and comply with CMS without worrying about faulty alerts.

If we haven’t convinced you by now, why don’t you try our free trial? No gimmicks – it’s really free!

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Patient Identification Errors in Hospitals Should be Eliminated Now Instead of Waiting for a UPI

Patient identification errors have been haunting the US healthcare system for decades now. In fact, the lack of effective patient identity management within the majority of hospitals and health systems is quite well-known as it is prevalent. Otherwise, groups would not have formed every year to appeal to Congress to finally approve a state-funded unique patient identifier (UPI). However, the coronavirus pandemic has been wreaking havoc across the US, which is why accurate patient identification is needed more than ever. But should they still wait for Congress for a UPI, or is there a way to eliminate patient identification errors in hospitals now? The short answer to the latter is yes – RightPatient. Let’s dive deep into the issues caused by patient misidentification, what the healthcare industry is doing about it, and how leading providers are solving it.

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Issues caused by patient misidentification

Patient misidentification has always caused a plethora of problems – for patients, healthcare providers, insurance companies – basically anyone involved with patient care. However, the pandemic has deemed the elimination of patient identification errors in hospitals more necessary than ever, so that patients can get faster, more accurate care, leading to improved health outcomes. So, what are the issues caused by patient identification errors?

The lack of accurate patient identification can create duplicate records or overlays (merged medical records of the same or different patients), causing a ripple effect and hampering patient safety by generating inaccurate patient information. For example, a patient with a common name comes into a provider’s facility, and without a robust patient identification platform, it will be quite difficult for the EHR user to determine the correct medical record for the patient. Thus, the healthcare official will either painstakingly search for the correct record, which is quite time-consuming, or else an entirely new record will be created, leading to just another duplicate record among the several existing ones. Duplicate records create patient safety issues – patients will be treated based on an incomplete or inaccurate medical history. For providers, the financial cost of duplicates can be up to $40 million, according to AHIMA.

Patient misidentification can also cause denied claims, which have a severe impact on the financials of hospitals and health systems. Suppose a patient is misidentified by the provider using an obsolete patient identification system. While the patient at the facility will be receiving the care, someone else will be charged inadvertently for the services as a result of patient identification errors. However, the medical record holder can simply let the authorities know that someone else had used the healthcare services, and thus, he/she will not be charged – leading to a case of claim denial. Denied claims can cost up to $4.9 million on average for any given healthcare provider.

Even during this ongoing and unprecedented health crisis, patient misidentification is quite common. It occurs because there is no proper way to match patients to their electronic health records (EHRs) within those providers’ facilities, and it leads to patient safety issues as well as reduced quality of care. Other issues patient misidentification causes are incorrect treatments, medications, and lab test results – hampering patient outcomes significantly. Given the current scenario of the healthcare system, these issues should be minimized as much as possible – something that RightPatient can help hospitals with.

What is the healthcare industry doing about it?

During a virtual briefing, the CEO of AHIMA, Wylecia Wiggs Harris, stated that COVID-19 shows how important accurate data is and why patient misidentification issues must be solved as soon as possible. 

Leading-healthcare-providers-use-RightPatient-for-positive-patient-identificationLikewise, other experts have been making similar statements. For instance, even COVID-19 test results were affected by patient identification errors. After the results came in, it was quite difficult to identify and search for the patients, as no accurate patient identity management system existed within the facilities.

Thus, healthcare leaders across the states are coming together to once again to ask Congress to lift the archaic ban on a state-funded UPI. However, if the past has anything to teach, it is the fact that the ban has been in effect for decades now. Lawmakers and officials placed the ban citing privacy concerns regarding a UPI, and it is quite unlikely that they will budge now.

Instead, many leading providers have taken it upon themselves to eliminate patient identification issues within their premises themselves. How are they doing that?  

Eliminate patient identification errors in hospitals now

Forward-thinking providers did not rely on Congress to remove the ban, which might not happen anytime soon, admittedly. Instead, they deployed RightPatient – the leading photo-based biometric patient identification platform.

It locks the medical records of the patients with their photos – a returning patient looks at the camera, allowing the platform to identify the correct medical record within seconds. It is completely hygienic and ideal for the current crisis. 

Our platform has been successfully reducing patient identification errors in hospitals and health systems. RightPatient ensures accurate patient identification, reduces claim denials, avoids duplicate medical records, and even prevents medical identity theft – improving patient safety and quality of care in the process.

Contact us now and ensure accurate patient identification at your facilities to stay ahead of the curve.

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Patient Identification in Hospitals is in Dire Need of an Upgrade After COVID-19

COVID-19 has changed the world around us in unprecedented ways. In fact, it is still shaping how we will interact with each other in the future for years to come. Social distancing, ensuring proper hygiene at all times, and wearing PPE whenever we step outside have become the norms and it will be so for quite some time. Naturally, hospitals have been the most affected parties due to the coronavirus, since they are the ones treating the patients. As different parts of the US are opening up gradually, it is quite natural that healthcare providers would open their doors too. However, changes are advised to ensure that patient safety is improved while hospitals are reopening. One of the most important changes required is the overhaul of patient identification in hospitals since that is usually the first point of contact for both patients and caregivers. Let’s look at why most of the current patient identifiers can pose threats now, and how a touchless solution like RightPatient is the only choice going forward.

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Why is patient identification in hospitals important?

Patient identification errors have been haunting the US healthcare system for a long time now. The consequences of patient misidentifications can be quite severe for both providers and patients. Patients can suffer from shocking bills, the wrong treatment, repeated care or lab test results, and even death. Providers, on the other hand, may experience denied claims, unwanted attention, the costs associated with fixing duplicate records and overlays, and loss of goodwill. As can be clearly understood, patient identification errors can cause irreparable damage to all those who are associated with them. But how is the US healthcare system identifying its patients?

What patient identification was before COVID-19

Patient identification in hospitals has, admittedly, been quite fragmented. Different providers use different strategies to identify their patients. Let’s look at some of the common means of patient identification along with their pros and cons, as well as why RightPatient is the perfect choice for accurate patient identification.

Even though there are a variety of patient identification solutions available, some hospitals still prefer to use the decades-old method of identifying patients by asking them questions to find their respective EHRs. The EHR user may ask the patients to state their names, addresses, DOB, ID numbers (if appropriate), and so on. The only good thing about this is it is mostly touchless. However, the costs outweigh the only benefit of this archaic method. It is slow, tedious, time-consuming, and cannot detect if someone else is pretending to be the patient, leading to medical identity theft.

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Another popular method is using patient ID wristbands. While this is more accurate than just asking questions, it has its drawbacks as well. It can be transferred or stolen, leading to others using healthcare services assigned for a different patient, committing medical identity theft. More importantly, it is also contact based, something which everyone is quite reluctant to do nowadays, but more on that later.

One of the most accurate ways to identify patients is by utilizing features patients do not share with anyone else, that is, the features that are unique to them. This is where biometrics comes into play. For instance, modalities like fingerprint and palm-vein scanning drastically improve accurate patient identification. However, these would require the patients to touch the devices for identity verification, which was off-putting for leading healthcare providers. These would cause infection control issues. For instance, a patient with a contagious disease could come in, touch the device, and effectively contaminate it, unless it is cleaned after every usage. It would be a nightmare for all those involved in the process.

What COVID-19 taught us

Prior to the pandemic, not many patients would have thought about it. After COVID-19, however, the majority of patients would be extremely reluctant to use touch-based solutions for patient identification, as they have a fear of contracting the highly contagious virus now. Thus, acceptance rates for touch-based solutions would be quite low now. Thus, patient identification in hospitals needs to be upgraded to enhance patient safety as well as accuracy. 

So, what are the leading healthcare providers using for accurate patient identification?

What patient identification should be after COVID-19

The leading touchless biometric patient identification platform, RightPatient, is being used by providers like Grady Health, Duke Health, and University Health Care System. So, what makes RightPatient so different yet effective? 

It locks the medical records of the patients with a photo of them upon registration. When registered patients return, all they need to do is look at the camera; the platform recognizes them and produces the correct medical record within seconds. All of this can be done easily and without a single touch from the patient!

RightPatient ticks all the right boxes – it ensures accurate patient identification, successfully prevents medical identity theft, reduces denied claims, prevents new duplicate records, and enhances patient safety by providing them a touchless solution. All of these benefits lead to boosting the bottom line of healthcare providers – something that they really need right now. 

RightPatient has been protecting over ten million patient records already, and with the COVID-19 pandemic, it has become the only viable solution. Are you still using outdated platforms? It is high time to make the change and upgrade to RightPatient. 

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Patient Identity Matching – Solving an unsolved crisis with RightPatient

Accurate patient identity matching holds paramount significance across the U.S. healthcare system. Delivering the best possible patient experience, including safety and outcome, hinges on the ability of the healthcare providers to keep and maintain accurate medical records. Healthcare providers continue to struggle to accurately match their patients’ identities to their health records, and blame it on inaccurate and incomplete patient data, says the Government Accountability Office (GAO). Physicians should be able to retrieve accurate records on each patient’s medical history, including lab results, diagnoses, medications, imaging, surgeries, etc. to deliver the best patient care. Needless to say, accurate patient identity matching during the COVID-19 crisis is vital for ensuring a positive patient experience.

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Can healthcare providers solve the patient identity matching crisis? Yes, and the solution is RightPatient – a leading touchless biometric patient identity management platform that has been successfully helping many leading hospitals address this specific issue.

Accurate patient identity matching ensures that the right patient is associated with the right medical records within a healthcare system. It means knowing with certainty that a piece of medical information belongs to the correct individual. There are many consequences if records are mismatched, such as incorrect treatment, improper data entries which can lead to the creation of duplicate records, and medical identity theft. Effective patient identity matching is not just about patient safety, it also helps healthcare providers avoid financial losses associated with duplicate records and claim denials from medical identity theft. 

How costly are patient identity matching errors?

Let us look at this example. A patient’s kidney was surgically removed by the time physicians realized that there was no tumor. This blunder in the operating room of Saint Vincent Hospital in Worcester, Mass., occurred when the patient’s CT scan was accidentally mixed up with the record of another patient who had the same name. The incident was widely reported in July 2016 when regulators came to investigate what exactly happened. Most people who read the accounts thought it was a rare blunder. But this type of blunder is not rare at all. 

Every day in medical clinics and hospitals, physicians assume they have an accurate picture of a patient’s medical history, diagnoses, lab results, and other information when they click into an electronic medical record (EMR). But this assumption can lead to fatal consequences, like the example mentioned above.

The problem is called patient identity matching error, a crisis that RightPatient has been addressing for years. One of the most severe match errors is when two patients’ medical records, with a similar or same name, get merged, leading to an erroneous organ removal or other nightmares. More common than this is the creation of duplicate medical records. For instance, Christina Elizabeth Smith, Cristina E. Smith, and C. E. Smith refers to the same individual, but her medical information is filed under three separate records. Neither the physician nor the patient will be aware of missing data points when they are discussing treatment decisions or procedures. 

The problem with common identifiers

Duplicate medical records can be created in many ways. One of the most common sources of duplicate records is making errors during the patient registration process. Other variations can be associated with identifying an unconscious patient when they are in the ER. Many times, duplicate records are also created due to demographic changes for the patient. Registrars face difficulties when patients change their last name or move to another place, so they create a new record for that individual. 

Patient identity matching errors can also occur when there is a variation in using common identifiers during the registration or identification process. A simple typo or mishearing the correct word can result in a mismatch in records. 

Common identifiers are also used to commit medical identity theft, an issue that healthcare providers have been trying to avoid for the past several years. A fraudster can easily get access to this type of information and fraudulently imitate someone else’s identity to get medication/benefits for their own use. 

These kinds of problems can be mitigated if common identifiers such as names, DOB, SSNs, or other demographic data used during the initial registration and identification process are replaced with the unique identifiers that RightPatient uses. For instance, identifying and authenticating an individual by using their iris pattern or a photo of their face. 

Accurate Patient Identity Matching with RightPatient

RightPatient is a touchless biometric patient identity management platform. Problems pertaining to duplicate records, medical identity theft, and record mismatch have been successfully mitigated by using RightPatient. Leading healthcare providers such as Terrebonne General Medical Center and The University Health Care System have successfully eliminated these sorts of problems and are continuously delivering the best experience for their patients with utmost clinical efficiency. 

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During the initial patient enrollment process, RightPatient will lock an individual’s medical records using their iris pattern or a photo of their face. Each time a patient arrives at the continuum of care, RightPatient will verify and authenticate their identity through an iris scanner, camera, or a webcam and retrieve their accurate medical records.

As a leader in the patient identity matching process, RightPatient helps healthcare providers to keep and maintain accurate medical records of their patients. Patient identity matching problems related to aggregating patient data via Health Information Exchanges (HIE) can be eliminated if all the healthcare providers adopt RightPatient, ensuring the best clinical outcome and data integrity across the healthcare system.

Due to the COVID-19 pandemic outbreak, touchless biometric technologies will play a key role in the next few years. RightPatient ensures safety and hygiene in a health facility by limiting physical contact between people and frequently touched high-risk surfaces, such as fingerprint scanners. Adopt RightPatient and make sure that one patient does not have multiple records in the master patient index (MPI) and that each piece of health information ends up in the correct patient record.

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Duplicate Medical Records and Patient Misidentification Frequently Affects Hospitals

The U.S. healthcare system does not seem to catch a break. The coronavirus outbreak is the latest problem added to the already formidable list of issues plaguing the U.S. healthcare system. Lack of price transparency, outrageous costs, and archaic laws are just some of the problems. However, let’s talk about a problem that has been around for many years and still haunts several (if not all) hospitals – lacking an effective patient identification system. 

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A study regarding patient misidentification 

Not so long ago, a study conducted by the Pew Charitable Trusts and Massachusetts eHealth collaborative shed light on a known issue – wrong patient matching is very common in U.S. hospitals. Let’s see what wrong patient matching leads to and what causes the errors, so that we can understand why healthcare providers must ensure accurate patient matching. 

Patient matching and duplicate records explained

Firstly, the meaning of patient matching is quite self-explanatory. It refers to matching a patient with his/her health record so that the hospital can proceed on providing healthcare services. Now, it seems quite simple, but patient matching issues exist, according to the aforementioned study. What makes it so tough? The most common reasons are duplicate medical records and patient misidentification, also referred to as mismatched patient records.  

Duplicate medical records are created when a patient has multiple patient records at a given healthcare provider’s EHR system. This happens for a variety of reasons – poor communication between the hospital staff and the patient during patient admission or checkup, failure to find the existing patient record within the database, and so on. Duplicate records decentralize the healthcare process that providers initially intended to provide to patients. For instance, due to duplicate records, a patient’s complete medical history could be impossible to find. In essence, different diagnoses are stored in various records, which leads to serious medical errors like mistreatment, repetitive lab tests, wrong medication, unintentional injuries, and in extreme cases, deaths.  

Patient misidentification, wrong patient identification, and mismatched patient records are used interchangeably but mean the same thing. Patient misidentification occurs when a healthcare provider mixes up medical records of different patients. This happens when the patients share similar characteristics – name, date of birth, medical history, are just a few examples. This can cause severe issues like mistreatment, financial loss for patients, longer recovery time, and has also proven to take the lives of unfortunate ones. 

How are hospitals affected?

Not only patients but healthcare providers are also affected profoundly. Claim denials can lead to losses in millions and occur when bills are sent to the wrong patients as a result of patient misidentification. Patients can also hit hospitals with lawsuits because of mistreatments. 

Thus, accurate patient identification is critical for hospitals to operate smoothly and without any unwanted incidents. Fortunately, RightPatient has a proven track record of helping out hospitals with patient identification issues. It is a biometric patient identification platform that locks the medical records of patients with their biometric data. During enrollment, the platform takes a photo of the patient and his/her biometric data, such as a scan of the irises, and attaches it to the medical record. Later on, whenever the patient returns, all he/she needs to do is look at the camera. RightPatient accurately identifies the medical record within seconds, ensuring accurate patient identification as well as preventing the creation of duplicate records. 

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Wrong Patient Identification Causes Kidney Transplant Fiasco at a Hospital

Another day, another wrong patient identification. It just goes to show how common patient misidentification is in the US healthcare system. It has been plaguing the industry for several years and looks like there is no stopping it. However, what did it cause this time? Where did it happen? Who was affected? Was it fatal? Let’s dive deep.

The patient misidentification took place in Lourdes Hospital Transplant Center, located in New Jersey. This time, it was the case of a kidney transplant – the patient who had the surgery and got another patient’s required kidney. However, nobody at the hospital noticed that such a mix-up took place.

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Why did this mix-up happen?

Once again, it is because of the similar characteristics of the patients. This time, the patients had a similar name as well as age. Both of them needed kidneys, that’s why they were on the same list. However, the one who was supposed to get a kidney later got it first – this was found out by a hospital official while checking the organ donor list. It was quite lucky for the patient that the kidney was a perfect match, as the other scenario could have had dire consequences.

The good thing is that the hospital reported the incident on their own, according to Virtua Health (which owns the Lourdes Health System). Thus, it is quite transparent about the issue. Had this been some other hospital, it might have denied it or kept the matter under wraps.

Virtua Health’s Executive Vice President and Chief Clinical Officer said that this is a rare case occurring in its forty-years-old program and that they are ensuring they take the steps necessary to ensure that this unwanted incident does not happen again.

Later on, the patient who was supposed to get the kidney first got the surgery a week later, and both the patients are doing fine now.

This is not an isolated incident. It might be one of the very few cases where the patients were unscathed due to wrong patient identification, which did not cause any significant harm to them. Several patients get misidentified every day, almost due to medical record mix-ups, duplicate medical records, data overlays, and so on. This affects patients as they receive the wrong bills, medication, and even surgeries, like in this case. Hospitals are also affected – denied claims, lower ratings, data overlays, and medical identity theft all lead to huge losses.

How can hospitals avoid wrong patient identification?

The problem here is medical record mix-up and wrong patient identification. That is eliminated by using RightPatient – several progressive health systems and hospitals are using this biometric patient identification platform. It seamlessly integrates with existing EHR systems and keeps the biometric data of the patients. Once a patient registers with it, the biometric data such as irises or fingerprints are used to identify the accurate medical record within seconds and pulls it from the EHR system for use. RightPatient also locks the medical record with the patient’s biometric data so that unauthorized access is prevented – eliminating medical identity theft in the process. Had RightPatient been used in this case, this mix-up could have been prevented, just how health systems like Novant Health and Terrebonne General Medical Center are avoiding it. 

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Seven strategies ACOs use for better patient outcomes and lower costs

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

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

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

Collaborate with the physicians they work with

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

Encourage the patients to take initiatives regarding their health

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

Emphasize on patients requiring extra care

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

Reduce ER visits and readmission rates

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

Enhance patient identification and data sharing

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

Make sure medication adherence among patients is present

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

Ensure patient education is provided

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