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

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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

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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

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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.

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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

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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.

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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.

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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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Upgrading the Patient Identification Process Can Help Combat the Opioid Crisis

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Opioid abuse has been a constant problem for the U.S. healthcare system for years now. When opioid medications were introduced, it was said that they would help caregivers and patients by improving healthcare outcomes. However, many didn’t count on the fact that it might create problems such as opioid addictions, leading to medical identity theft, overdoses, and even deaths of the addicts as well as their newborns. Even during the COVID-19 pandemic, there has been a sharp rise in opioid abuse cases. Let’s review some statistics associated with opioid abuse, where cases are happening now, why they usually happen, and how a proper patient identification process can help combat the opioid epidemic for healthcare providers.

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The opioid epidemic is just one of the many problems

We’ve stated this more times than we can count – the U.S. healthcare system just doesn’t seem to catch a break. It has always been plagued with a number of serious problems. Expensive healthcare, lack of price transparency, lack of proper patient identification process, medical identity theft cases, healthcare data breaches, duplicate medical records – these are just some of the many issues faced by patients and caregivers. However, the opioid crisis is another significant issue that needs to be addressed – even during the pandemic, it’s getting worse. Thus, healthcare providers are not only facing the issues above, but they’re also fighting a pandemic as well as an epidemic. However, before getting into the current situation, let’s take a look at some stats.

The numbers show how serious the opioid epidemic is

According to the U.S. Department of Health and Human Services (HHS), 130+ people died every day due to opioid overdoses, 10.3 million Americans misused prescribed opioids in 2018, and 2 million patients misused prescribed opioids the first time they received them from their doctor. 

However, the numbers have jumped significantly this year compared to 2019 in approximately 21 of the largest U.S. counties, according to The Wall Street Journal. Counties in California, Indiana, Michigan, Minnesota, Nevada, and Ohio saw an increase in deaths caused by opioid overdoses. Moreover, Los Angeles County suffered an increase in overdoses by 48% within the first 6 weeks of the novel coronavirus pandemic when compared to the same period from last year. But why are the opioid cases considered an epidemic? 

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The opioid crisis in a nutshell

In the late 90s, opioids were pushed by pharmaceutical companies – ensuring that they were either less addictive or nonaddictive compared to other drugs available at that time – morphine, for instance. They stated that even the less addictive ones had no dangerous side-effects. This instilled doctors and physicians with confidence and they started prescribing them to patients. It created an epidemic that the U.S. healthcare system has been battling for decades now – and the rates are only increasing. But how do addicted patients get their hands on these drugs from hospitals?

Lack of a proper patient identification process leads to more cases

Patient identification, as previously mentioned, has been problematic for years now. The addicted patients can simply go back to their caregivers and demand more of the dangerous drugs, stating that this is the first time they’re requesting them – abusing their prescriptions. Since the caregivers don’t have a proper way to verify such statements (as an effect of the lack of patient identification), they have no other choice.

Also, addicts might lie regarding their information and present themselves as a different patient in order to get access to the drugs. One way they can do that is by committing medical identity theft – they assume the identities of others to receive the drugs. Thus, hospitals can better battle the opioid crisis if they make the patients go through a proper patient identification process.

RightPatient can enhance your patient identification process

RightPatient has already been helping leading healthcare providers ensure positive patient identification for years now. With its photo-based search engine, RightPatient can prevent medical identity theft in real-time, ensure that patients are who they say they are, and track their last visits to the facilities to verify that they’re getting the prescribed medicine and nothing more.

RightPatient can also ensure accurate patient identification from appointment scheduling. After booking an appointment, the patient receives an SMS or email to verify their identity. A patient only needs to provide their selfie and a photo of their driver’s license. RightPatient matches the photos and remotely validates the patient’s identity. If it’s a new patient, the platform assigns biometric credentials for them, making it a seamless process.

RightPatient has several benefits – not only can it help curb the opioid abuse cases, but it can also prevent medical identity theft, avoid duplicate medical records, and help in improving patient safety and quality of care.

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Patient Safety and Quality Healthcare Require Patient Identification During the Pandemic

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Another day, another new initiative by healthcare leaders regarding patient identification. One might wonder that given the pandemic and its ongoing effects on healthcare, why is that a top priority right now? Well, that’s what the healthcare experts have been demanding as inaccurate patient data negatively impacts patient outcomes during this crisis. The U.S. healthcare system has been suffering due to the absence of a patient identifier for decades now – the ban is still in effect on a UPI. Let’s look at what industry experts are saying and how positive patient identification can ensure patient safety and quality healthcare.

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The importance of patient identification according to experts

This isn’t the first time leaders have talked about the need for accurate patient identification and it won’t be the last time. Healthcare providers have been struggling with patient identification for decades now, leading to compromised patient safety, inaccurate patient data, and unwanted healthcare outcomes. Add the pandemic to the equation, and identifying patients accurately becomes more important than ever as accurate data sharing is a topmost priority.

Recently, a session organized by the ONC (Office of the National Coordinator) for Health IT brought up the topic. According to Tom Leary, HIMSS VP of Government Relations, incorrect patient data leads to adverse impacts on public health response initiatives. He further elaborated on that – patient identification errors during the ongoing crisis led to several issues like improper data sharing, delays in sharing test results, and inaccuracies within longitudinal patient records. According to Mr. Leary, some nurses even tried to Google patients to identify them and contact them regarding their test results!

Preparing for COVID-19 vaccines, whenever they’re created, will require accurate patient identification during large-scale immunizations to identify the infected ones, the ones who got the shots, and to identify the outcomes of the cases, stated Mr. Leary. Not having any proper patient identity verification system in place is just worsening the health outcomes and adding fuel to the ongoing fires during the pandemic. Thus, to ensure patient safety and quality healthcare, proper patient identification is an absolute must.

Patient safety and quality healthcare depend on identifying patients

As previously mentioned, many might think that with the pandemic still impacting healthcare significantly, patient misidentification is the last thing we need to worry about. However, Mr. Leary, as well as other healthcare industry experts, thinks otherwise. During the ONC session, they have already demonstrated how patient misidentification is affecting healthcare outcomes. But even before the pandemic, patient identification errors were notorious for adversely impacting patient safety and quality healthcare.

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Let’s go back to the time before the pandemic struck the U.S. Even then, the healthcare system had a plethora of issues, one of which was duplicate medical records and overlays. Imagine – a patient came to the hospital and they were assigned a duplicate record, based on which the whole treatment will be provided – so many things could go wrong!

An incomplete or inaccurate EHR leads to repeated lab tests, improper treatment, and even deaths due to a single misidentification. As a result, patient safety is severely impacted as well as healthcare outcomes. Patient misidentification cases are associated with unwanted incidents that can haunt caregivers – loss of goodwill and litigation costs are just some of the consequences.

Even before the pandemic, patient misidentification was a significant issue within the healthcare system. However, the COVID-19 crisis demonstrates how patient identification errors impact patient outcomes during a time when accurate patient information is of the essence. 

Experts are urging for the UPI once again

It’s been around two decades since the ban was imposed on a state-funded UPI (unique patient identifier), but industry experts are once again rallying to remove the ban this year. Even if the UPI is finally mandated, responsible healthcare providers will combine it with an effective patient identifier. Such a patient identification policy will encompass several benefits such as enhanced interoperability, reliable patient matching, and improved healthcare outcomes. So, out of all the different patient identification solutions out there, which one is the best match?

Patient safety and quality healthcare require RightPatient

RightPatient has been ensuring accurate patient identification for years now, but why is it the best solution? Well, it can be seamlessly integrated with EHRs to become part of the workflow, making it perfect to be used alongside the UPI, should the latter get approval. Moreover, RightPatient eliminates the biggest headache of providers currently – infection control issues, as it is a touchless solution. With its photo-based search engine for identifying patients during appointment scheduling and beyond, RightPatient is the most feasible choice for positive patient identification post-COVID-19.

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Data Breaches are Occurring During the Pandemic – Prevent Healthcare Identity Theft Now

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Despite the relaxed rules and the U.S. slowly opening up, the COVID-19 crisis is still going strong. With no treatment found (as of yet), everyone is still feeling the effects of the coronavirus. However, there’s no doubt that the U.S. healthcare system has been affected more significantly than systems in other countries. For starters, the number of patients is overwhelming, the financial strain is unprecedented, not to mention the existing issues such as data breaches. When faced with so many impediments from all sides, how can providers prevent healthcare identity theft? Let’s explore some of the recent data breaches, how they lead to medical identity theft, and how a solution like RightPatient can protect patients and providers.

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Some recent cases

It’s not only healthcare providers – all types of healthcare organizations are being targeted by hackers.  Let’s review the healthcare organizations who became recent victims of data breaches.

Dynasplint Systems suffered a data breach that might have resulted in stolen health information. After an investigation, they identified that names, addresses, social security numbers, and other information might have been accessed or stolen. Over 102,800 people were affected.

Another healthcare organization, Pinnacle Clinical Research specializing in clinical trials, suffered a phishing attack. The breach consisted of clinical trial participants’ information. 

Mental Health Partners suffered a phishing attack as well – names, DOBs, social security numbers, among other information was potentially stolen.

How data breaches lead to healthcare identity theft

There are many other recent cases like the ones above. However, they have one thing in common – the hackers were after patient information. Any healthcare organization is a potential target for hackers. But why do hackers target them, especially for their patient information?

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After stealing the patient information, the data is sold on the black market for high prices. Since healthcare in the U.S. is quite expensive, the demand is high for the stolen information – those why buy the data believe that it’s worth buying, as opposed to getting healthcare coverage for themselves. When these fraudsters use the victims’ information, they get access to healthcare services, expensive medical devices, and treatments, whereas the victims get fraudulently charged with the costs.

That’s not all – patient safety is jeopardized as well. When the fraudsters use the victims’ medical information, the patient data gets corrupted as the fraudsters’ information and preferences are recorded in the victims’ medical records. Unless such healthcare identity theft cases are rectified, the patient will be receiving improper treatment based on a medical record consisting of corrupted patient data. These cases lead to repeated lab tests, delays in treatment, as well as negative patient outcomes. Healthcare providers also face litigation costs due to medical identity theft cases. 

With the pandemic still raging across the world, one would think that medical identity theft would be the last thing caregivers are worried about. While data breaches are quite inevitable, steps can be taken by healthcare providers to ensure patient safety.

How to prevent healthcare identity theft cases

Ensure HIPAA compliance and safeguard PHI

One way of protecting patient information is by getting back to the source – data breaches. Anyone familiar with healthcare in the U.S. has heard of HIPAA. The law basically sets the groundwork for protecting patient information known as PHI (protected health information). However, it’s quite a comprehensive and multilayered law – even the biggest healthcare providers have a hard time ensuring compliance as the rules and regulations change frequently. 

Even during the start of the pandemic, some rules were relaxed to ensure faster healthcare delivery. The bottom line is that if providers ensure HIPAA compliance, put enough safeguards in place, detect security vulnerabilities using internal audits, and are well versed about data breaches, they can protect themselves better against cybersecurity attacks. That’s what HIPAA Ready does – it is a simple but powerful HIPAA compliance software that keeps all the HIPAA related information centralized, helps you conduct internal audits to detect vulnerabilities, and helps you set up HIPAA training sessions to keep your employees up to date on the latest changes.

Ensure patient identification

Responsible healthcare providers can go the extra mile and add an extra security measure that no fraudster can pass through – even in the cases of data breaches. That’s where RightPatient comes in.

It is a touchless patient identification platform that uses a photo-based search engine to ensure that the patients are who they say they are and not some fraudster. During hospital visits, the platform takes a photo of a patient during enrollment and locks the medical record with it. If a fraudster attempts to commit healthcare identity theft, the platform will red flag the individual, preventing medical identity theft in real-time.

RightPatient has been helping leading healthcare providers for years now, and with its touchless platform, it is the only sensible option in a post-COVID-19 world.

Try RightPatient now and be a responsible healthcare provider.

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How Many Patient Identifiers Should be Used to Ensure Patient Safety?

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The US healthcare system has always been plagued by a number of issues. One very common but often overlooked issue is that of patient identification errors. Misidentification cases continue to be quite prevalent while there continues to be a ban on the creation of a state-funded Universal Patient Identifier (UPI). While debate continues around the risks and rewards involved with a UPI, one should also be asking about its efficacy. How many patient identifiers should be used to prevent patient safety issues? Will a UPI be enough to solve this colossal challenge?

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UPI’s history in a nutshell

Since the idea for a unique patient identifier was formed, it’s seen constant criticism and opposition, resulting in a ban that’s lasted for around two decades. Last year, healthcare organizations came pretty close to finally having the ban removed when the US House of Representatives voted to repeal the ban. However, the ban is still in effect with the legislation failing to gain approval in the Senate.

As for the future of the UPI, let’s look at its past. It has not been funded for around two decades due to issues like privacy concerns and growing data breach incidents that could seriously jeopardize patient safety and privacy. Thus, chances are high that the future may not be kind to the creation of a state-funded UPI.

Lack of effective patient identification is felt throughout healthcare

The absence of reliable patient identification is widely felt throughout hospitals and health systems. Patient safety issues and patient data integrity failures are just some of the many issues associated with patient misidentification. However, a crisis like the COVID-19 pandemic clearly highlighted the importance of proper patient identification, impeding the ability of caregivers to provide healthcare services quickly and effectively without access to holistic patient information. Since the pandemic started, healthcare staff on the frontlines have been learning that the hard way.

Many experts are even thinking that this might be the time the UPI will finally be realized. But will it be enough? How many patient identifiers should be used to make sure it’s safe for patients and effective for providers? Fortunately, our Co-Founder, Michael Trader, has a comprehensive answer.

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How many patient identifiers should be used?

Mr. Trader has stated that it’s crucial to find balance regarding a UPI and it’s equally important to establish an infrastructure that can house the UPI securely – only identifying patients accurately is not enough. Furthermore, the creation of duplicate medical records and overlays need to be prevented – they are some of the many issues that significantly hinder patient matching.

Mr. Trader adds that while the UPI will have benefits such as better interoperability as providers can share patient data more reliably, it will not mitigate issues such as duplicates, overlays, and medical identity theft. How many patient identifiers should be used, then?

Mr. Trader stated that instead of relying solely on the UPI, responsible providers will pair it with another identification system, and preferably one that is tried and tested. Linking the UPI to a photo-based biometric patient identification platform comes to mind. This touchless solution can be scaled across all encounter touch points, even enabling patients to utilize their own smartphones, making it the ideal solution in our post-pandemic world. With such a combination, patient misidentifications can be eliminated.

For years, patient misidentification has been a persistent problem for patients and caregivers alike. Providers need to eliminate misidentification as soon as possible, with or without the UPI. After all, it’s a single mistake that can cause severe consequences for both providers and patients. Fortunately, RightPatient can help providers avoid such unwanted cases. 

With its photo-based patient identification platform, RightPatient has been identifying patients accurately for years. Leading and responsible providers have chosen RightPatient instead of waiting for the UPI – they know the effects of patient identification errors better than anyone else. Thus, if the UPI is created, responsible leaders will be coupling it with the leading patient identification platform, ensuring interoperability, accurate patient identification, and reliable patient data exchanges.

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Dirty Patient Data Can Have Severe Consequences for Healthcare Providers

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The US healthcare system has always been facing problems that stopped it from realizing its full potential. These issues are longstanding barriers to providing immaculate healthcare services to patients, and thus affect healthcare outcomes for all involved. One of these issues has been the “dirty” patient data accumulating within EHR systems over the years. With the COVID-19 pandemic causing even more issues like the unprecedented financial strain, layoffs, restructuring and so on, providers need to ensure that the patient information within their facilities is accurate, consistent and relevant. Let’s look at what unclean patient data is, how it affects patients and providers and how RightPatient can ensure the cleanest patient data with accurate patient identification.

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Patient data

A brief definition

In the simplest terms, patient data refers to a single patient’s medical information – medications, medical history, vitals, illnesses and so on. Such data is critical in making informed decisions regarding the patient in question. What should be the current or future course of action and how to best handle the needs of the patient are some common examples.

From the explanation, it is clear why clean patient data is important for both caregivers and their recipients. Let’s look at the other side of the coin: dirty data.

“Dirty” patient information

By now, it should be quite clear what dirty data means. Whenever the data is inaccurate, incomplete, inconsistent, obsolete or corrupt, it is considered “dirty”. Unclean patient data can lead to a lot of problems for any given healthcare provider. It impacts everyday operations, makes effective data sharing difficult and impacts healthcare outcomes, among other issues. Let’s have a more detailed look at the common ones.

Effects of unclean patient data

Inaccuracy and inefficient operations

Imagine if a patient goes to their healthcare provider for a checkup. The registrar types in the patient’s name: several medical records pop up on the screen, all pertaining to the same patient. Understandably, this can confuse the registrar. They are faced with a difficult choice: either go through all the patient records and find out the accurate one or create a new one entirely. The former case will take up a lot of time, while the latter will just create another duplicate medical record within the system. Both of these are consequences of having unclean data within the system.

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Huge losses

According to Gartner, unclean data can cost an organization anywhere from $9.7 to $14.2 million. For US healthcare providers, however, it’s an entirely different figure. AHIMA stated that duplicate medical records can cost up to $40 million for any given provider, while a health system having several facilities can house up to 20% duplicate records.

Imagine if a patient is treated with another patient’s medical information. When the record holder gets the bill for services they did not use, they’ll simply contact their insurance provider regarding the matter. This will lead to a denied claim. Thus, inaccurate data can lead to denied claims as well – costing around $4.9 million on average for the average health system.

Patient safety is compromised

One of the biggest issues of unclean data is that it impacts patient safety. One patient will receive inaccurate and even dangerous treatment because they are being treated based on an entirely different patient’s medical record. Even if it is the same patient, if there are multiple records under their name, each record will have inconsistent and incomplete information about the patient, leading to improper care, medications and procedures. All in all, healthcare outcomes will not be as expected as patient safety and quality of care is jeopardized severely. This can affect a provider’s ratings as well. Patients will not be happy if they are not receiving unreliable healthcare services. Thus, clean data is critical to improving quality and safety in healthcare.

Non-compliance issues

This one is quite new. However, most healthcare providers know this and are working on it: e-notifications support.

The CMS rule mandates that all caregivers having EHR systems must ensure they support e-notifications by May 1st, 2021. During any ADT event, the provider needs to send e-notifications to the patient’s caregivers, whether they be established primary care practitioners, post-acute providers & suppliers or any other entity primarily responsible for the patient’s care. This is done to boost positive healthcare outcomes and improve care coordination. If the data is unclean, providers will end up sending false alerts either to the wrong provider or the wrong patient.

In any case, unclean data will cause non-compliance issues, penalties and might even jeopardize CMS provider agreements.

Lower ROI

Health systems and hospitals have been investing significantly in population health management, big data, analytics and similar projects they find promising. The efficacy of these systems depends on high-quality data being fed into them. When data is corrupted due to duplicate and overlay records, those investments are diluted, leading to lower ROI. 

Keep patient data clean with RightPatient

One of the best ways to ensure that patient data integrity is maintained is by identifying the accurate patient record from the get-go. That’s where we can help.

RightPatient is the leading patient identification platform that ensures data integrity is maintained within EHRs. It is a touchless, photo-based platform used by leading healthcare providers. 

By making sure that you identify your patients accurately every time, you can avoid duplicate medical records, prevent medical identity theft, eliminate financial issues related to dirty data, improve patient safety and quality of care. Also, you can send out proper e-notifications to the accurate caregivers, eliminating any non-compliance penalties.

By ensuring accurate and consistent data that can be used by the aforementioned investments (population health management, big data, analytics, etc.), RightPatient improves ROI for healthcare providers, creating a win-win scenario for everyone.

Contact us now to know how RightPatient works and how we can help you ensure the cleanest data via positive patient identification.

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

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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!