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Four Ways to Improve Protection of Patient Information Within Hospitals

RightPatient-improves-protection-of-patient-information

Healthcare in the US has been facing considerable challenges for the past few years. Data breaches, medical errors, patient safety issues, patient mix-ups, medical identity theft, the lack of interoperability, and detrimental patient outcomes are just some of the many problems that plague healthcare providers. However, one of the more crucial issues for healthcare providers is data breaches as they lead to a number of problems, especially compromising patient information. Unfortunately, these are becoming more common, even during the pandemic. Let’s take a look at why protection of patient information is crucial and four ways to improve its protection – leading to better quality and safety in healthcare facilities.

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Why the protection of patient information is crucial

The importance of patient information cannot be overstated – it is one of the most sensitive pieces of information for any given individual. Since it contains data such as names, medical history, medications, vitals, diagnoses, allergies, test results, demographics, etc., it should be protected at all times. Otherwise, external and internal data breaches can lead to the exposure of patient information to unauthorized individuals who might use it for nefarious purposes.

Medical identity theft is one of the most common outcomes of data breaches, and the former leads to patient data corruption. Patient data becomes unreliable, fragmented, and dangerous, causing detrimental healthcare outcomes down the line. This is exactly why HIPAA focuses on protecting sensitive information, known as PHI (protected health information).

After seeing why the protection of patient information is important, let’s take a look at how to improve it.

Four ways to improve the protection of patient information

Monitor access rights

Another way to enhance patient data protection is by monitoring access rights periodically, at the very least. This can be done by conducting internal audits to detect whether any unauthorized individuals have access to patient records. It’s crucial to remember that patient data protection requires preventing both internal and external breaches as well, and monitoring access rights prevents internal ones. After detecting the issues, simply revoking the access given to unauthorized users enhances protection.

Conduct risk assessments regularly

The best way to protect patient information is by taking the proactive approach – identifying issues within the system before the hackers do. Thus, healthcare providers need to conduct internal audits in order to detect existing security gaps, come up with effective solutions, and implement corrective actions.

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Utilize blockchain

Blockchain is something that has been trending in the past few years, and using it can significantly improve patient data protection. But how exactly can it help healthcare providers do so?

Well, hackers usually attack a single point. Since patient information is grouped in a single location, it’s easier to attack it and tamper with it however they please. Fortunately, blockchain enhances the protection of patient information. As the stored data is distributed over the network, hackers no longer can attack a single point – they need to access the data at all the blocks repeatedly. Moreover, any changes will be picked up by the officials and such changes require the approval of the majority of those in charge, making it virtually impossible for conventional hackers to hamper patient information.

Use solutions that focus on patient data protection

There are many solutions available for protecting patient data, but responsible caregivers need to think beyond data breaches as well. Data breaches have been far too common, and that’s because most healthcare providers have budgetary constraints leading to poor cybersecurity measures. While data breaches might be inevitable, providers can prevent medical identity theft in real-time with RightPatient.

RightPatient is a touchless biometric patient identification solution that locks EHRs with patients’ photos. Moreover, it’s versatile enough to be used at any touchpoint across the hospital, making it ideal for remote sessions such as telehealth and telemedicine.

After scheduling an appointment, the patients receive an SMS or email. They need to provide a selfie along with a photo of their driver’s license, after which the platform compares the photos for a positive match, ensuring remote authentication.

Patients coming to hospitals only need to look at the camera. The platform compares the photos – red-flagging fraudsters and preventing medical identity theft in real-time. This ensures the protection of patient information as it prevents incorporating the fraudsters’ medical information within the EHR. In many cases, medical identity theft can be life-threatening for the patients if it remains undetected and unaddressed, something that RightPatient prevents.

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Ensuring Safety in Healthcare Is Crucial as COVID-19 Cases Rise

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What a year this has been! While it’s almost the end of the unforgettable year of 2020, the effects of COVID-19 will be felt for many years to come, unfortunately. 2020 will be globally remembered as one of the worst years in recent times due to the pandemic and how it kept pushing everyone to their limits. Arguably, it hit the US healthcare system the worst – just take a look at the mindboggling statistics. COVID-19 has infected more than 15 million Americans while claiming just over 288,000 lives. That’s not all – cases are increasing rapidly every day, with healthcare providers being overwhelmed by the surge of COVID-19 patients. With all that’s going on, safety in healthcare providers’ facilities as well as accommodating patients is more important than ever.

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Let’s take a look at some of the recent moves taken in response to the pandemic, how they can improve healthcare outcomes and prevent hospital-acquired infections (HAIs), and how an effective patient identity management platform can help.

Recent moves to tackle COVID-19 challenges

Patients are being redirected to other facilities due to capacity limitations

Lifespan Health System of Providence, Rhode Island, is redirecting COVID-19 patients to a field hospital located at Rhode Island Convention Center, as the former reached its capacity and has no beds to spare. While it still has its ICU and ventilators available, its regular beds are full due to COVID-19 patients. Moreover, the field hospital, with a capacity for 600 patients, is accepting non-critical patients as well.

A similar case had occurred in Arizona’s Holy Cross Hospital. Instead of admitting the patient at a neighboring facility, the ambulance crew took the patient to the Nogales International Airport before transferring him to a different location (Flagstaff) due to capacity constraints.

COVID-19 surge forces Mayo Clinic to temporarily close clinics

The Mayo Clinic Health System closed one of its clinics temporarily and will do the same with its four other clinics. The affected clinics are its Mankato-Northridge, Belle Plaine, Le Sueur, Janesville, and Waterville clinics. The health system is doing so to reallocate its resources and prioritize critical care due to the COVID-19 surge. However, patients may still visit its other sites or use the online services they provide, such as virtual sessions, nurse line, etc.

A pediatric acute care hospital will accept adult cases

Cincinnati Children’s Hospital Medical Center will be accepting adults under 30, whenever possible, in order to help ease the pressure of COVID-19 on other hospitals. Many local healthcare providers that serve adult patients are almost nearing their capacities due to the overwhelming number of patients, which is why Cincinnati Children’s has made such a welcome decision.

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The existing practices aren’t enough to ensure safety in healthcare facilities

All of the healthcare providers have one priority right now – to ensure safety within their facilities. However, COVID-19 has been creating havoc in healthcare facilities for months now, leading to many of them shutting down, health systems suspending some of its facilities temporarily, or resorting to cost-cutting measures.

While a few might be benefitting from such measures, healthcare as a whole is suffering. Hospitals need to seek out ways to enhance patient safety, reduce HAIs, reduce response times, and improve patient outcomes to ensure survival during and after COVID-19. Thankfully, RightPatient can help.

RightPatient enhances safety in healthcare facilities

RightPatient is a touchless biometric patient identification platform that is extremely beneficial for healthcare providers, especially during the pandemic. Since it is touchless, it doesn’t have any infection control liabilities associated with it, leading to reduced hospital-acquired infections and improving safety in healthcare for everyone involved. Moreover, it maintains patient data integrity by associating correct medical records with the appropriate patients every time – it locks the medical records of the patients with their photos. Also, it is versatile enough to be used at any touchpoint in a healthcare facility, making it ideal for telehealth sessions.

After scheduling appointments, patients receive an SMS or email for verifying their identities. Patients are required to provide a selfie and a photo of their driver’s license or any other form of identification. RightPatient automatically compares the photos for a match, remotely authenticating patients. Biometric credentials are provided to the new patients. This helps ensure that the accurate patient is identified right from appointment scheduling.

At healthcare facilities, patients only need to look at the camera – the platform compares the photos for a match and provides accurate medical records within seconds, making it the most hygienic and feasible choice for patient identification. 

RightPatient improves safety in healthcare facilities not only by identifying patients accurately and ensuring patient data protection but by also reducing HAIs, something that is paramount right now. 

Be a responsible healthcare provider and use RightPatient now to improve healthcare outcomes, enhance patient safety, and protect patients.

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

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

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

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

Patient safety goals for next year

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

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

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

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

How patient identification ties in with other patient safety goals

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

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Improving staff communication

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

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

Safely use medicines

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

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

Prevent surgical mistakes

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

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

Reduce hospital-acquired infections

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

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

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

How RightPatient works – improving patient safety

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

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

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Protect Patient Information During Telehealth Visits by Addressing 7 Issues

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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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Infection Control in Hospitals is Imperative as COVID-19 Cases Increase

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COVID-19 is a phenomenon that has crippled almost the entire world. Even in those very rare countries where it didn’t infect many people, it did hurt their economies. The majority of developing countries are severely affected by the novel virus, leading to disruption in international businesses and global transactions. However, one can safely say that COVID-19 has affected America the worst – it is currently seeing huge spikes across the states, where officials are introducing new safety measures. Let’s take a look at the most recent record-breaking statistics of US COVID cases, some measures officials are implementing to mitigate its spread, and practices that will help ensure infection control in hospitals – improving patient safety and quality of care.

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US COVID-19 cases keep breaking records

Unfortunately, the US has the highest number of COVID-19 cases in the world – over 11.3 million! Moreover, it keeps on making new records: November 13 saw 184,514 new cases, according to John Hopkins University. This is in line with experts’ predictions – many stated that things will get worse during the fall. Ultimately, all of this will add to the huge amount of pressure healthcare providers are already facing – the COVID Tracking Project saw over 68,000 hospitalizations on November 13 where 6% of the patients were on ventilators and 19% in ICUs.

Needless to say, these numbers are frightening, with officials introducing measures to mitigate further spread. Let’s review some of the emergency measures introduced within some states.

Some recent measures to mitigate COVID-19’s spread

Oregon will see restrictions on gyms, restaurants, and retail stores. Virginia issued a mask mandate for anyone older than five starting on the 15th of November. New Mexico will be facing a two-week shutdown that consists of nonessential activities starting from 16th November.  Many other locations are seeing similar restrictions to ensure social distancing practices as a result of ever-increasing cases.

While these measures are in place to lower potential COVID-19 cases, infection control in hospitals must be ensured so that cases don’t spread within healthcare facilities. Let’s explore why this is important.

Why is infection control in hospitals important?

Of healthcare providers’ many responsibilities, preventing hospital-acquired infections (HAIs) has been a topmost priority for many of them. Hospitals are constantly looking to improve practices that enhance infection control and prevent HAIs. It is a crucial role of any hospital because, if not ensured, it will lead to compromised patient safety, undesirable healthcare outcomes, and create a chain of events that will jeopardize the entire healthcare facility. However, prior to the pandemic, HAIs used to be a headache of healthcare providers only; but now, contracting diseases is the concern of virtually everyone, especially those in hospitals.

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COVID-19 has shown how effective communication can be in this day and age – any new update regarding the novel virus can be shared and seen by anyone, thanks to the internet. Almost everyone has extensive knowledge about the do’s and don’ts, and they are quite reluctant to visit hospitals since they know that’s where the COVID-19 patients are going. Thus, healthcare providers need to ensure infection control in hospitals and enhance patient safety as well as the safety of the frontline staff members. Let’s take a look at how hospitals can reduce HAIs, some of which are according to WHO, and improve healthcare outcomes as a result.

Practices to ensure infection control in hospitals

Create an effective infection control policy

The foundation of having zero to minimal HAIs is to have an effective infection control policy at hand. Healthcare providers wanting strict infection control must plan for it in advance, and this plan should contain guidelines for dealing with HAIs, identifying affected patients, locations to place the patients in isolation, and the duration of such events.

Washing hands thoroughly and regularly

While this might seem obvious at this point, it is still one of the most important practices to ensure infection control in hospitals and save lives in the process. Washing hands regularly with liquids containing antimicrobial agents for twenty seconds is a must, especially after interacting with extractions, contaminated items, blood, secretions, etc. Keep sanitizers within a short distance of each other so that patients and caregivers both have access to them. If possible, use automatic dispensers to make it a touchless and safer experience for everyone involved.

Enforce PPE usage

PPE is a term that has been tossed around since the beginning of the pandemic, and for good reason. While healthcare professionals have been using it for decades to prevent HAIs, virtually everyone uses some form of PPE nowadays to protect themselves. Unfortunately, not everyone follows best practices, which will ultimately put others at risk.

Enforcing PPE usage for everyone within a healthcare facility is a good practice, regardless of their designation. Simply putting up signs saying “No PPE, No Service” will be quite effective for patients. For the healthcare staff members, surgical masks, face shields, gloves, gowns, etc., must always be present whenever they are within the facilities.

Keeping surfaces clean

Viruses linger on surfaces for days, and keeping them clean is the best solution to prevent HAIs. We can significantly reduce HAIs by monitoring the materials and environmental surfaces that are touched frequently and disinfecting them regularly and thoroughly, such as beds, handles, etc.

Using touchless solutions that ensure infection control

While many touchless solutions will be popping up within the next few years, there is one that is already being used by many healthcare providers to prevent infection control issues – RightPatient. It is a touchless patient identification platform that uses patients’ photos to lock medical records and verify their identities. Enrolled patients only need to look at the camera – the platform matches the live photo with the saved one, providing the appropriate medical record within seconds without requiring any physical contact, and ensuring patient safety and hygiene.

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Hospitals Can Reduce Denied Claims By Preventing 6 Issues

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The COVID-19 pandemic has caused arguably the worst financial strain the US healthcare system has ever experienced. While all healthcare systems around the world are facing similar challenges, the US is currently witnessing the highest number of cases in the world – over 10 million people! As the numbers continue to increase, so do the losses, and healthcare providers must reduce their costs to cope with these unprecedented numbers. That being said, reducing denied claims is more crucial than ever, as they cause caregivers to lose a significant portion of their revenue. Let’s take a look at denied claims, how they affect caregivers, and six errors caregivers must avoid to improve revenue cycle within their facilities, leading to improved bottom lines.

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What are denied claims?

While this is a common term heard within healthcare facilities, many still don’t understand how much loss can be incurred for any given healthcare provider. To put it into perspective, Change Healthcare stated that denied claims can cost around $4.9 million on average for any hospital. But what are claim denials?

Simply put, denied claims are those that are classified as unpayable by the payers (insurance companies) after they receive the process them. Claim denials often occur because there’s some form of error present within the claim that becomes apparent after processing. Issues such as missing information, sending the wrong information, and non-covered services are the common reasons why claims are denied. However, there’s another form known as a rejected claim.

When one or more issues are detected within a claim even before it was accepted or processed by the insurance company, it is classified as a rejected claim. Coding errors and mismatched procedures are the most likely causes that lead to such claims.

How do denied claims affect healthcare providers?

Claim denials are a massive pain point for healthcare providers as they decrease already razor-thin margins, significantly increase collection times and reimbursement, and consume valuable resources such as FTEs (full-time equivalent).

As we can see, claim denials significantly affect a hospital’s bottom line. Moreover, while 63% of claim denials can be recovered down the line, the administrative costs are a nightmare – $118 per claim. Thus, it’s better to avoid denied claims right from the beginning.

That being said, let’s take a look at the top six issues that lead to claims being denied.

6 issues to avoid that can help reduce denied claims

Absence of information

One of the most common mistakes that lead to claim denials is sending inadequate information to the insurance company. Even the smallest details such as date of surgery, date of onset, demographic information, etc., are liable to classify claims as unpayable.

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Issues with coding

Using an obsolete codebook or incorrect codes is a common mistake that leads to claim denials, as they cause revenue leakage.

Insufficient documentation occurs when there are missing elements required for the services billed, and it is extremely crucial to prevent them. Thus, immaculate documentation is critical to prevent legit claims from being converted to denied ones. If proper documentation is not present when coding and submitting claims, then insurance companies classify them as denied because they consider that the services were not performed.

Duplicate bills

Duplicate claims are quite common and are usually attributed to human errors. These occur when the revenue cycle staff forgets to remove a claim from the patient’s account after resubmitting the claim. However, as claims processing systems consist of tools that help detect duplicate ones, the systems flag and classify the anomalies as either suspect duplicates or exact duplicates. As the entire healthcare process is quite complex in nature, it might lead to original claims appearing as duplicate ones – resulting in a claim denial.

Simply preventing duplicate claims is not enough. Properly coding the billed service with required modifiers and documentation is crucial to help identify the bill as original and not as a duplicate.

Not filing claims at the right time

Various rules and regulations must be followed regarding claims and failing to do so will result in even legitimate claims being denied. For instance, the Affordable Care Act reduced the deadline window for submitting Medicare claims to 12 months from 15-27 months after the date of service.

Not verifying coverage eligibility for the services provided

Healthcare insurance is quite volatile, leading to constant changes. As a result, it is crucial to check eligibility every time services are provided to the patients. While this might seem like a tedious task, it will help save a significant amount of money down the line.

Whenever a patient comes in for healthcare services, it is essential to check whether the coverage is still in place (read: not terminated), the service provided is covered by the plan, and the cap has not yet been reached. However, a healthcare provider can cover its services using plans with a cap as long as it follows provided guidelines meticulously and provides the required documentation. 

Patient identification errors

One of the biggest problems that leads to claim denials is patient identification errors. Imagine this: if a patient is not accurately identified right from the start, the claim will be filed against the wrong medical record and the insurance company may ultimately classify it as denied. To ensure that claims are not denied and are processed smoothly, patient identification is a must. That’s where RightPatient can help.

RightPatient is a touchless biometric patient identification platform that locks patients’ records with their photos – protecting patent data. It can even remotely identify patients, making it ideal to be used across the care continuum and any touchpoint.

After scheduling an appointment, patients need to provide a personal photo and a photo of their driver’s license. RightPatient matches the photos to verify their identities, and when patients arrive at the hospital, all they need to do is look at the camera. The platform matches the saved photo with the live one, instantly eliminating any chances of the claims being denied.

Healthcare providers can reduce denied claims, optimize the revenue cycle, avoid duplicate medical records, improve healthcare outcomes, and even prevent medical identity theft with RightPatient – enhancing patient safety in the process.

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Improving Patient Safety Depends on Error-Free ADT E-Notifications

Improving-Patient-Safety-is-possible-with-RightPatient

While COVID-19 has been ravaging almost the entire world, healthcare industries have been facing an unprecedented number of patients and challenges. Arguably, the US healthcare system has been hit the worst. Just look at the numbers – over 10 million cases with a record of 100,000 new cases for seven consecutive days. Unfortunately, things will get worse, as spikes are seen across the states and experts predict far more cases during the fall. Healthcare providers are facing huge challenges while they deliver care, while keeping patient and provider safety as a top priority. That being said, CMS (the Centers for Medicare and Medicaid Services) has mandated that caregivers must support sending and receiving e-notifications during ADT (admission, discharge, and transfer) events, something that many believe will help with improving patient safety and quality of care. Let’s take a closer look at the rule, how it will enhance care coordination, and why it requires accurate patient identification.

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Interoperability has always been problematic

COVID-19 has already shown the importance of sharing patient data among caregivers. Most of the patients have multiple caregivers located at different sites, and for seamless care coordination and improved healthcare outcomes, their data needs to be shared accurately and in real-time with the appropriate parties. That’s exactly what CMS aims to achieve: improved interoperability between caregivers with patients in common.

Interoperability has been a massive issue within the healthcare space as caregivers fail to share patient data accurately, mostly because of patient identification issues – more on that later. In order to bolster interoperability, enhance coordinated care, and improve patient outcomes, CMS announced a new CoP (Condition of Participation) surrounding e-notifications as a part of their Interoperability and Patient Access Final Rule.

The new Condition of Participation (CoP) in a nutshell

This CoP requires applicable healthcare providers (critical access, psychiatric, and regular hospitals) that use digital medical records to share and receive alerts that are triggered in real-time due to ADT events – both inpatient and ED (emergency department) events. Applicable parties are PCPs (primary care physicians), post-acute care providers, and primary care practitioners, among others. The notifications should at the least include patient information, such as the patient’s name, the treating practitioner’s name, as well as the sending institution’s name. Caregivers can share more information if they deem it necessary.

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The applicable healthcare providers need to support e-notifications by May 1, 2021. This means they have around half a year to comply with the requirements.

Why it is critical for improving patient safety

By sharing critical patient information with other parties across the care continuum, all of them can make informed decisions using the most recent data, leading to seamless care coordination and better healthcare outcomes – improving patient safety along the way.

Healthcare in the US has become multifaceted and complex – gone are the days when a patient would go to a single caregiver for receiving care. Now, a single patient can have multiple doctors that are located at different healthcare facilities. E-notifications enable such caregivers to quickly send and receive information that can lead to faster outcomes and better decision-making. When you compare it to previous methods – fax, phone calls, etc. – you will understand how this is going to change patient data sharing and interoperability. In time-sensitive cases, for instance, these real-time alerts will save lives.

How healthcare providers are addressing this CoP

Caregivers are brainstorming to identify the best way to address this CoP. Many will develop e-notifications solutions in-house, whereas others will use third-party solutions. While healthcare providers do that, they might overlook a crucial aspect that will make or break their e-notifications solution: patient identification.

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To improve care coordination and interoperability efforts, e-notifications won’t be effective on their own – let’s see how.

Improving patient safety requires accurate patient identification

One serious but overlooked issue faced by healthcare providers is patient identification errors. Even during the pandemic, patient identification errors have been brought up a number of times, as they lead to delayed care, repeated lab tests, and can even hamper patient safety. But how exactly is this related to e-notifications? 

It’s quite simple – imagine a hospital that does not utilize an effective patient identity verification solution. It is bound to face a number of issues, such as duplicate medical records, overlays, medical record mix-ups, and so on. Now, imagine that a patient is misidentified during registration; the entire caregiving process will be dangerous and inaccurate as it will use the wrong medical record. This will also hamper interoperability – false alerts will be sent out, raising credibility concerns. It will wreak havoc in the facilities that are associated with the wrong medical record. Thus, accurate patient identification is crucial for improving patient safety as well as making e-notifications work. Fortunately, RightPatient can help with that.

RightPatient has been improving patient safety

Used by several caregivers, RightPatient is the leading biometric patient identification platform for a number of reasons. First, it ensures hygiene as it is a touchless solution, eliminating risks of hospital-acquired infections. Second, it has a vast amount of experience over the years, making it a trusted name within the healthcare space.

By using patients’ photos, RightPatient locks the medical records. Patients are asked for a personal photo and a driver’s license after they schedule appointments. The platform matches the photos to verify the identities remotely.

When patients arrive at the hospitals, all they need to do is look at the camera – the platform identifies them using the saved photo and provides the appropriate medical record within seconds. 

Use RightPatient now and eliminate misidentification, ensuring that you send out proper alerts to the correct caregivers, enhancing patient safety and care coordination in the process.

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4 Strategies to Optimize Revenue Cycle in Healthcare and Mitigate Losses

RightPatient-helps-optimize-revenue-cycle-in-healthcare-and-facilities

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

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Why is revenue cycle in healthcare important?

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

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

4 Strategies to optimize revenue cycle management

Improve front-end and back-end collaboration

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

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

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

Improve front-end activities

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

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

Adopt revenue cycle automation 

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

Identify patients accurately

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

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

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

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

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4 Strategies Hospitals Use to Prevent Medical Identity Theft Cases

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The US healthcare system has been plagued with several issues over the years. The lack of price transparency, interoperability issues, sky-high prices, and the lack of a standardized patient identifier are just some of them. One of the more concerning, and increasingly common, issues is medical identity, affecting more and more healthcare providers and patients. While providers are already facing huge losses due to the pandemic, they need to mitigate them by reducing preventable costs. One viable solution can be to reduce medical identity theft cases, and doing so will bring several benefits.

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Let’s take a look at how medical identity theft happens, how common it is, and some strategies that can prevent it and mitigate losses.

How do medical identity theft cases happen?

Medical identity theft can occur in many ways, but it can usually be traced back to stolen patient information or records – a consequence of healthcare data breaches. There’s a reason why medical identity theft cases are so common: hackers are focusing more on healthcare data breaches because stealing and selling patient information is quite lucrative.

After a hospital suffers a data breach, the hacker(s) then tries to sell the stolen patient information on the black market. Unfortunately, there are many buyers available for many reasons, and they are also willing to pay high prices – up to $1000 per record!

After buying the stolen patient data, the fraudster assumes the identity of the patient. This can happen within healthcare facilities as well as during telehealth sessions (which are surging in popularity right now).

The majority of hospitals have no effective patient identifier and therefore they fail to red flag the individual, leading to medical identity theft. The scammer then illegally uses the victim’s credentials to obtain prescription drugs, medical equipment, and healthcare services, charging the victim for the services. Not only that, but since the fraudster uses the medical record, their information will be recorded within the EHR (Electronic Health Record) and can lead to patient safety issues down the line.

While that was a simple example, many complex medical identity theft cases are occurring almost daily.

Is medical identity theft common?

The numbers don’t lie –more patient records were breached in 2019 compared to the prior three years combined! Moreover, 9.7 million patient records were affected by data breaches this September. There’s no doubt that the majority of these patient records will be used for medical identity theft, as experts are also predicting a sharp increase in the near future.

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Hospitals must ensure that they are preventing medical identity theft cases to guarantee patient safety and reduce associated litigation costs. Let’s take a look at some strategies that can help prevent medical identity theft and all of its consequences.

4 strategies hospitals can use to prevent medical identity theft cases

Follow the rules and regulations

First and foremost, the healthcare facility must ensure that they are properly following the rules. For instance, HIPAA mandates that there should be some technical, administrative, and physical safeguards present to protect patient information, known as PHI (Protected Health Information).

While this might seem like a straightforward strategy, a lot of healthcare providers fail to ensure HIPAA compliance. This not only leads to data breaches and medical identity theft down the line, but also incurs HIPAA penalties. HIPAA itself is a multi-layered and complex law that requires continuous effort to ensure compliance.

Fortunately, healthcare organizations can use HIPAA Ready, a robust HIPAA compliance software, to reduce the administrative burden. It streamlines HIPAA compliance, ensures training management, keeps all the HIPAA-related information in a centralized location, and also helps conduct internal audits. 

By ensuring HIPAA compliance, healthcare organizations can detect security gaps and address the vulnerabilities, mitigating data breaches and, in turn, medical identity theft.

Devise a policy to enhance security

As previously mentioned, HIPAA has several requirements and requires that networks and devices are secure at all times. To do that, hospitals must come up with and follow a strict device policy so that sensitive patient information is not leaked inadvertently. While a BYOD (bring your own device) practice might be more flexible, it will inevitably lead to data breaches and leakage of sensitive information.

Thus, the following tips will help enhance security:

  • Only allow official devices for storing sensitive information
  • Only allow logging into secure networks
  • Encourage usage of VPN
  • Ensure data encryption at all times
  • Keep logs of access requests to track any suspicious activity

Train employees regularly

Staff members such as registrars and nurses are the ones who regularly access patient data. Training them will provide them with the knowledge to avoid suspicious emails, as that is the primary weapon of hackers. Moreover, providing regular training – especially if it includes information on recent data breaches – can be beneficial. As previously mentioned, HIPAA Ready can help with training management.

Ensure accurate patient identification

Even if a data breach occurs, medical identity theft can be prevented if healthcare providers can red flag the fraudster during identity verification. That is exactly what RightPatient does.

 

RightPatient is the leading touchless patient identification platform used by several caregivers. It verifies identities by using patients’ photos. After scheduling appointments, patients need to provide a personal photo and a photo of their driver’s license. The platform matches them and verifies their identity remotely, red-flagging fraudsters. This system is ideal for telehealth sessions.

During inpatient visits, the scammer is red-flagged when the platform identifies that their face does not match the saved photo attached to the medical record, preventing medical identity theft in real-time.