RightPatient-enhances-patient-outcomes

Improving Patient Outcomes Relies on Identifying Patients Even During COVID-19

Healthcare in the US has always had its fair share of troubles. Price transparency issues, medical identity theft, data breaches, denied claims, and interoperability issues are just some of the many issues plaguing it. However, it is having arguably one of the worst times it has ever faced due to COVID-19. To date, over 14 million American citizens have been infected with the infamous virus, whereas over 270,000 people have lost their lives battling it. Due to the spike, hospitals are shutting down, health systems are closing their emergency departments, elective surgeries are being canceled, and healthcare staff members are being pushed to their limits once again. It feels like a particularly bad déjà vu. While healthcare providers are doing whatever they can to help with improving patient outcomes, many are facing a critical issue that has been an impediment to quality healthcare for years – patient identification errors.

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Having said all that, let’s focus on: 

  • why patient identification errors are a big deal even during the pandemic
  • what healthcare providers are doing to address it
  • how a tried and tested solution ensures patient safety and quality healthcare, improving patient outcomes in the process

Patient misidentification is nothing new

Anyone who knows anything about the US healthcare system has heard at least one story about patient misidentification or something related to it, such as duplicate medical records, patient mix-ups, incorrect surgeries, medical errors, etc. It has been occurring for years, leading to delayed patient care, detrimental patient outcomes, repeated lab tests, among other consequences. While many caregivers have been facing all these challenges for quite some time, a large number of them didn’t pay much attention to the problems. Everything changed with the pandemic – let’s see how.

Improving patient outcomes is difficult due to existing issues

COVID-19 pushed everything to its limits, especially the healthcare providers, and they were forced to face the issues that significantly hamper patient outcomes. One of the more prevalent issues was, and still is, patient misidentification.

HIMSS VP of Government Relations, Tom Leary, said that public health response efforts can be significantly impacted by inaccurate patient data, and that’s exactly what happened during the first wave. Since patient identification was erroneous in most healthcare facilities, this led to improper data sharing, delayed test results, sending results to the wrong patients, and more. Nurses even tried to google patients so that they could send them the test results!

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COVID-19 is an unprecedented situation that requires prompt responses that can help save lives, and issues such as patient identification errors significantly hamper the efforts put forth by frontline teams. So, what are healthcare providers doing to address it?

Healthcare providers are urging for the UPI

The US healthcare system was supposed to get a unique patient identifier (UPI) years ago, but a bill had restricted state funding to create one. Since then, most healthcare providers have been struggling to identify their patients accurately. Each year, experts come together and urge the ban’s abolishment, but their requests get rejected every time – for almost two decades. Even if the mythical UPI is made, it won’t be enough to solve such a huge problem by itself.

However, not every hospital is struggling with patient identification errors – many forward-thinking ones are using RightPatient.

Improving patient outcomes is possible with RightPatient 

RightPatient is a touchless biometric patient identification platform that is the most feasible solution currently, given the pandemic. It uses the characteristic that cannot be stolen, lost, or transferred, patients’ faces, to verify identities. However, the part that makes RightPatient ideal for the pandemic is that it is entirely touchless, ensuring infection control and reducing hospital-acquired infections.

By locking medical records with patients’ photos, RightPatient protects patient data and accurately identifies patients. Moreover, it is versatile enough to be used across any touchpoint within a healthcare facility, starting from appointment scheduling.

After scheduling an appointment successfully, patients receive an SMS or email, and they are required to provide selfies as well as a photo of their driver’s license. The platform compares the photos for a match, ensuring remote authentication. If these are new patients, RightPatient provides them with new biometric credentials – making it a hassle-free experience. 

Within healthcare facilities, patients only need to look at the camera – the platform compares the live photo with the saved one. After finding a positive match, RightPatient provides accurate medical records within seconds. This helps prevent patient mix-ups, duplicate medical records, medical errors, denied claims, and patient safety incidents – improving patient outcomes. Moreover, it can also prevent medical identity theft in real-time, as it red-flags fraudsters who try to assume patients’ identities. 

RightPatient can enhance healthcare outcomes, improve patient safety, and reduce significant costs – something which is extremely crucial for hospitals right now in order to survive.

Contact us now to learn how we can help you improve your bottom line.

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Protect Patient Information During Telehealth Visits by Addressing 7 Issues

The pandemic has been spreading like wildfire, and its effects on the US have been devastating – over 12 million people have been affected by it. Hospitals barely kept up with the pandemic’s effects when it first hit the country. Now that the winter has arrived, COVID-19 cases are increasing rapidly. One of the previously overlooked aspects of healthcare, known as telehealth, has gained much attention during this period. As it ensures that non-critical patients could receive healthcare services without the risk of contracting the virus, officials were quick to redirect such patients to telehealth. As a result, telehealth usage surged and it finally got the attention it deserved. However, like everything else, it also has pros and cons, and healthcare providers must address the risks associated with telehealth to protect patient information, improve healthcare outcomes, and enhance patient safety – let’s explore.

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7 issues healthcare providers must consider regarding telehealth

Cybersecurity risks

Since telehealth requires the internet, hackers are always working on new and innovative ways to steal patient data and sell it to unethical individuals, who will later assume the identities of the victims to use the healthcare services fraudulently.

Phishing attacks

One of the most common tools used by hackers is phishing, and while simple, it is quite effective. Hackers pose as officials and lead the unassuming healthcare employees to click on the links they provide. As a result, hackers gain access to the targets’ accounts and can access or steal information. 

While these attacks happened prior to the pandemic, telehealth is at huge risk as well now. Phishing tactics that are currently used rely on social networking, and it might lead to users being victims down the line. Moreover, there are many instances where hackers posed as credible organizations like Microsoft.

Hackers

Hackers have been constantly trying to access patient information to steal or use it for themselves, and the sudden growth of telehealth makes it much easier for them. If telehealth sessions are done using unsecured networks, hackers can just add themselves to the session and steal patient information. They are now targeting providers using obsolete systems that have security issues and vulnerabilities, as that will be much easier to gain access to.

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Uncertainty regarding rapidly changing rules

As the situation surrounding COVID-19  is evolving, the rules are being constantly updated. Thus, it is quite crucial to ensure that providers are up to date regarding the changes surrounding telehealth usage in order to ensure telehealth services are delivered in a manner that can protect patient information.

Fraudulent activities

There’s a much broader scope for fraud in telehealth than inpatient visits – such as kickbacks, charging for services that weren’t actually provided, misrepresentation, and so on. Even CMS is closely monitoring in order to reduce such risks. Providers must ensure that they are not being charged falsely by having all the required documentation on hand at all times.

Patient misidentification

An issue that can be commonly seen during inpatient visits, patient identification errors may very well bleed over to virtual sessions as well. The premise is just the same – misidentification at the front-end due to issues such as duplicate medical records, overlays, or human errors leading to medical record mix-ups. All of this ultimately leads to delayed care, detrimental outcomes, and compromised patient safety. Thus, accurate and secure patient identification is crucial.

Medical identity theft

One can safely assume that medical identity theft is the end result of most of the concerns listed above. Let’s explore why it is so prevalent and how it takes place.

Well, the hackers aim to steal patient information from healthcare providers, and the ones who are high-risk are the ones that have vulnerabilities such as keeping patient data unencrypted or using unsecured means to transmit or receive it. After stealing the information, they sell it to hackers for steep prices – up to $1000!

This information is available on the black market, and fraudsters buy it to pose as the victims. Armed with the credentials of the victims, they can easily pass themselves off as the patients and have access to healthcare services, expensive medical equipment, prescription drugs, and more. That’s not all – the victims will be fraudulently billed for the services used by the impostors.

Experts are predicting that such cases will transpire with telehealth visits too, and with the issues listed above, it won’t be that hard. Fortunately, RightPatient can prevent medical identity theft and protect patient information.

RightPatient can protect patients during telehealth visits

RightPatient is a touchless biometric patient identification platform that uses patients’ faces to verify their identities. While data breaches might seem inevitable, RightPatient can mitigate its losses by preventing medical identity theft in real-time.

Patients are required to take a selfie and submit a photo of their driver’s license after registration. The platform automatically compares the photos for a match and verifies patients’ identities remotely, making it ideal for telehealth sessions as well. Fraudsters are red-flagged whenever they try to use the platform and pass themselves off as the patient. RightPatient helps protect patient information, enhance patient safety, and accurately identify patients across the care continuum.

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Hospital Readmission Prevention is a Must as CMS Fines Half of Hospitals

The US healthcare system is in an unfortunate state – it just can’t seem to catch a break. While it was already coping with a number of issues – such as medical identity theft, the lack of price transparency, interoperability issues, and healthcare data breaches, among others – COVID-19 hit it hard. As a result, healthcare providers across the US are facing huge losses. With increasing COVID-19 cases across the States and with experts predicting even more during the fall, healthcare providers received yet another blow. CMS (Centers for Medicare & Medicaid Services) will fine about half of hospitals due to readmissions of Medicare patients, although this is for the pre-pandemic period and therefore COVID-19 cannot be held accountable for the lower payments. Let’s take a look at the numbers, how this will affect the hospitals further, and how hospital readmission prevention can be achieved with a proper patient identity verification platform.

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CMS will lower payments

While it’s already been quite a harsh year for healthcare providers, it’s about to get worse. Many caregivers are resorting to cost-cutting strategies by laying off employees, furloughing them, or even shutting down; however, the lowered payments will only add to the unprecedented costs.

Some numbers surrounding the penalties

During the fiscal year 2021, CMS will fine 2,545 hospitals due to increased Medicare patient readmissions that occurred within 30 days. The penalties were based on patient data ranging from July 2016 through June 2019. A staggering 83% of the hospitals received penalties, and they will be facing payment cuts as high as 3% per Medicare case during 2021. 39 caregivers will face the maximum penalty next year, which is an improvement over this year, when the number of hospitals hit with the maximum penalty was 56. However, with the pandemic disrupting everything, hospitals will lose more than ever. As a result, hospital readmission prevention becomes a topmost priority.

Why is the program important?

This is the ninth year of the Hospital Readmissions Reductions Program, and it has been created to improve patient care quality while lowering overall costs. As previously mentioned, it takes into account the readmissions of Medicare patients that occur within 30 days. While CMS is considering a suspension of the penalty program due to COVID-19, the penalties are still in effect this year.

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Some exceptions

Congress has exempted 2,176 hospitals out of the 5,267 from penalties due to a number of reasons. The hospitals exempted are either:

  • Critical access hospitals,
  • The only inpatient facility in the area,
  • Hospitals specializing in long-term care, children, veterans, or psychiatric patients.

What the industry thinks about hospital readmission prevention

While many participants within the US healthcare system have voiced disapproval regarding the penalty program, others have said that, while not perfect, the Hospital Readmissions Reductions Program is useful – it pushes caregivers to find innovative solutions to provide better quality care. 

The penalties will further increase hospital losses

Moreover, as healthcare providers are already facing huge losses due to the pandemic, they need to ensure hospital readmission prevention if they want to survive in the long run. Several hospitals are heavily relying on CMS reimbursements, and if they can reduce readmissions, it might help them survive the pandemic’s financial strain. By improving patient safety and quality of care, hospitals can significantly lower readmissions. Fortunately, RightPatient can help with that.

RightPatient enhances hospital readmission prevention

RightPatient has been helping leading healthcare providers with its touchless patient identification platform for years. It ensures improved healthcare outcomes by eliminating one of the most overlooked problems within hospitals: patient misidentification.

Patient misidentification leads to duplicate medical records and overlays, jeopardizing patient safety. Moreover, it provides the wrong medical records to caregivers, resulting in negative healthcare outcomes. Naturally, these are the patients who are readmitted within hospitals frequently. So, how does RightPatient help?

It locks the medical records of the patients using their photos during registration. Patients receive an SMS/email after they schedule appointments, and they are required to provide a personal photo and a photo of their driver’s license. RightPatient compares the photos for a proper match, eliminating any chance of misidentifications. All of this is done without requiring the patients to touch any foreign objects, eliminating infection control issues – something that is crucial during and after the pandemic.

Reduce patient readmissions, improve healthcare outcomes, and ensure patient safety with RightPatient – contact us now to learn how we can help you.

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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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3 Patient Safety Measures Hospitals Must Take in a Post-Pandemic World

COVID-19 has changed reality for us – it has changed the way we lead our lives. Sanitizers, masks, and social distancing have become quite integral parts of our daily lives now. Wherever we go, social distancing practices are encouraged for a safer environment. However, it has shaken the healthcare systems of the world to their core, especially that of the U.S. With the highest number of cases in the world (as of now), hospitals are slowly opening their doors for regular patients. Keeping that in mind, hospitals must take patient safety measures while they are opening to ensure that patients receive care in a safe and hygienic environment. Let’s take a look at some common steps hospitals can take to prevent patient safety issues.

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Some insightful statistics

According to a survey by Sage Growth Partners, 24% of the respondents (healthcare professionals) believe that issues such as disparate EHRs and lack of actionable data at the point of care lead to patient safety issues.

Improving patient safety is also among the top three priorities of the respondents, besides delivering high-quality care and increasing efficiency and reducing costs – all of which can be done by ensuring accurate patient identification (more on that later). 

Let’s explore what kind of patient safety measures will help hospitals enhance patient care.

Patient safety measures that can help enhance patient care

Planning everything well in advance

While many might think that everything is slowly returning to normal, it’s quite the opposite. Working from home is still being utilized by most organizations, social distancing is still being practiced, and wearing masks and sanitizing regularly are still highly encouraged.

Since hospitals are opening slowly, they should plan every step carefully along with contingencies while keeping worst-case scenarios in mind. Hospitals need to plan the opening days and rather than opening the whole facility at once, they should open in phases. This will help reduce the risk of any mass outbreaks of COVID-19 – managing a mass outbreak at a single location will be much easier than managing outbreaks at all the facilities.

Also, hospitals should decide at what capacity will they operate and the duration for that testing phase. If all goes well, they can slowly increase the capacity of patients they will be serving. 

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Finally, the inventory required for all of the above needs to be planned to ensure that the necessary materials are available at all times. For instance, PPE has become quite critical, and these should be ordered well in advance before the stock runs out within the facilities. Thus, instead of reordering the materials when they’re at 30%, they should be reordered at, say, 45% – these are essential materials, after all.

Enforce safety measures for everyone

It goes without saying that every individual must practice a minimum level of social distancing to help themselves and others stay safe from the novel coronavirus. Sadly, not everyone follows that. Thus, the hospitals must enforce that everyone within the facility must follow the social distancing rules to a T. Not only is this one of the most common patient safety measures, but it also enhances safety for the physicians, nurses, and every other healthcare staff. 

Keep brightly colored posters in places where they will catch everyone’s attention. Place stickers on the floor with six feet between them to show where patients or caregivers must stand, especially in busy places like registration desks. Make sure that everyone is wearing masks and that sanitizers are available everywhere. Keeping the facilities hygienic is crucial to enhance patient safety.

Ensure accurate patient data

One of the most crucial factors that make or break patient safety is patient data, as the former is heavily reliant on the accuracy of patient data. Imagine this, if the patient is treated based on inaccurate patient data, they will face delayed or incorrect medications, leading to poor healthcare outcomes. One of the most common ways patient data gets corrupted is via duplicate records. 

If a patient has multiple records, there are high chances that the registrar will select the one with inconsistent or fragmented data, leading to adverse outcomes. Thus, ensuring that patient data integrity is maintained at all times is crucial for improving patient safety. Fortunately, RightPatient does all that – and more.

RightPatient is the leading patient identification platform used by healthcare providers like Terrebonne General Medical Center, Grady Health, and Catholic Health of Long Island. With a robust photo-based engine, it ensures that the patients are identified accurately at all times across the care continuum, helping patient data integrity by avoiding duplicate medical records. Moreover, it ensures that the patients are who they say they are and not impostors, preventing medical identity theft in real-time.

Finally, a platform like RightPatient is critical in a post-pandemic world because it is entirely touchless. Thus, it helps caregivers and patients operate in a hygienic environment by preventing infection control issues.

Use RightPatient now and enhance patient safety at your facilities, prevent medical identity theft, and prevent duplicate medical records – enhancing patient data integrity along the way.

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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.

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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.