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Identifying Patients Accurately is Critical for Ensuring CMS Compliance

The US healthcare system has been going through a very challenging phase due to the coronavirus pandemic. However, it looks like healthcare providers are going to have their hands full – they have another rule to comply with and must plan accordingly to ensure compliance by May 1, 2021. The fact that there have been additional changes to the Medicare Conditions of Participation (CoPs) is already well known among healthcare leaders. However, while many providers are already thinking about how they can ensure compliance, they might leave out one significant factor that can make or break the entire effort – are they identifying patients accurately? Why is this important? How does patient identification fit in with the new changes? How can providers ensure accurate patient identification? Let’s explore in detail.

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CMS Interoperability & Patient Access Final Rule

While the entire healthcare system has been suffering from the lack of interoperability, the Centers for Medicare and Medicaid Services (CMS) have made some changes to the CoPs to ensure that there is some degree of interoperability, believing that it will have positive effects on care coordination as well.

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The “companion final rule”, as per CMS, mandates that healthcare providers like acute care, psychiatric, and critical access hospitals send out e-notifications during every patient admission, discharge, or transfer (ADT) to the designated recipients (read: providers and other entities primarily responsible for patient’s care). This is applicable for both inpatient admissions and patients registered in the emergency departments (EDs).

Moreover, the providers obligated to follow the ADT requirements must make enough effort to ensure that they have sent out the notifications to the applicable parties (suppliers, entities, practitioners, etc.) in real-time.

Any given healthcare provider that uses digital medical records like EMRs or EHRs needs to ensure compliance with the updated CoPs for e-notifications. COVID-19 has extended the deadline – healthcare providers now have until May 1, 2021 to ensure compliance with the recent changes. 

Why are the CoPs important?

What is the biggest reason to ensure CMS compliance? Financial factors like CMS reimbursements and avoiding non-compliance penalties are more than ample motivators. Healthcare providers need to be compliant in order to safeguard their CMS provider agreement – it determines whether the providers are able to receive reimbursements or not, which can be quite significant in some cases. If providers do not ensure compliance, not only will their agreements be in jeopardy, restricting them from receiving reimbursements, but they might also face penalties. Given the current healthcare crisis that has crippled almost every caregiver, more financial woes are something any provider would want to avoid. 

What the healthcare providers are doing

Since the deadline has been extended to May 1, 2021, leading figures of healthcare providers are brainstorming about how to comply with the change – should they build an in-house e-notification system themselves, or should they buy from experienced vendors? Whatever option providers go with, they are not addressing the elephant in the room – are they identifying patients accurately?

How identifying patients accurately is related to e-notifications

Think of it this way – patient identification in hospitals is already inaccurate. In fact, many healthcare providers face patient identification errors due to duplicate medical records, medical record overlays, and patient mix-ups, among other problems. These lead to issues like compromised patient safety, unwanted patient outcomes, avoidable medical errors, and even deaths.

So, it has already been established that if a hospital does not have an accurate patient identity management system, then it causes a lot of problems for the facility. Can you imagine what will happen if the hospital goes for an e-notification platform without identifying patients correctly first?

Issues like common names and characteristics shared by patients are already quite prevalent and cause patient mix-ups. If such a case occurs while sending out e-notifications, then the wrong patient’s data will be provided to the subsequent caregiver. Thus, patient mix-ups and incorrect patient identification cases during ADT notifications will wreak havoc – delays in treatments, medical errors, and lawsuits are just some of the consequences of such scenarios. It will be a nightmare for any given provider. Hospitals and health systems that are not identifying patients accurately at their facilities need to eliminate these errors to ensure CMS compliance and avoid any unwanted consequences. They need to ensure patient data integrity by ensuring positive patient identification every time a patient comes in. That’s where we can help.

Identifying patients accurately with RightPatient

CMS-compliance-requires-proper-patient-identification-for-e-notificationsRightPatient is the healthcare industry’s leading photo-based biometric patient identification platform. It seamlessly integrates with the major EHR systems and becomes part of the workflow. Patients are registered by locking their medical records with their photos. After enrollment, incoming patients only need to look at the camera and the platform matches the photos and provides accurate medical records within seconds. This ensures a safe, easy, touchless, and hygienic patient identification experience for everyone.

RightPatient ensures that the correct patient is identified every time across the care continuum, helping you maintain patient data integrity. With RightPatient, you can send out the correct patient’s notification every time, ensuring CMS compliance and safeguarding your patients and, in turn, your business.

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Verifying Patient Identity – Top 3 Benefits

The failure to accurately identify patients throughout the healthcare industry continues to result in medication and diagnosis errors, procedures on the wrong person, duplicate medical records, and health insurance fraud. Therefore, healthcare providers should properly collect and manage information for verifying patient identity to prevent medical identity theft, improve medical record accuracy, and comply with HIPAA.

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The amount of information flow in healthcare is greater than any other industry, but it all means nothing if a patient’s identity is compromised, or cannot be matched with their records. Verifying patient identity before starting a medical treatment or service is vital for ensuring a positive patient experience. The inability of healthcare providers to accurately identify their patients during the COVID-19 pandemic has resulted in slow procedures, incorrect treatments, and even encouraged insurance fraudsters to take advantage of this chaotic situation. 

That being said, RightPatient has been helping healthcare providers keep accurate records connected with the correct identity for years now, ensuring effective health treatment and recovery. The coronavirus pandemic has also been a prime catalyst for the consideration of futureproof biometric identity management solutions, such as RightPatient, for verifying patient identity. The reason for this is that our solution helps providers maintain a hygienic environment and limit the spread of contagious diseases. Here’s what else RightPatient can do for your organization:

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Verifying patient identity to prevent medical identity theft

Even during this pandemic, security experts warn that the threat of medical identity theft is far from over, because attackers know they can take advantage of this situation. Healthcare providers, as well as patients, suffer from medical identity theft: the illegal access of a patient’s personally identifiable information and using this information to fraudulently obtain medical treatment, goods, or services. 

The cost of proper medical treatment is exorbitant, especially if not covered by health insurance. It results in claim denials and negatively affects a health system’s bottom line. That is why verifying an individual identity is crucial before providing any kind of service. Health care providers, such as Terrebonne General Medical Center (TGMC) and the University Health Care System have successfully prevented many potential medical identity theft occurrences since using RightPatient. 

Reduces information discrepancies in medical records

Arguably, the most damaging concern for healthcare providers is incorrect and potentially life-altering information being put on someone’s medical record. Inaccurate records have been the root cause of incorrect treatments, delays in procedures, and even the creation of duplicate records and overlays. Medical records are very difficult to change as they are meant to be a permanent and comprehensive account of an individual’s healthcare history. Thus, verifying a patient’s identity and accurately matching their information with their medical records can help providers to avoid financial losses due to fraudulent claims and improve data integrity.

Verifying patient identity for compliance

In the U.S., various state, federal, and industry-specific compliance regulations such as HIPAA and HITECH have been established for verifying patient identity. Not complying with these Acts can lead to hefty financial penalties being issued, and in worst-case scenarios, criminal charges being filed. 

HIPAA, which stands for the Health Insurance Portability and Accountability Act of 1996, is a federal law that provides security provisions and data privacy, to protect a patient’s medical information. It enables smooth transitions of electronic records and requires appropriate controls over the use and disclosure of medical records.

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Any organization that deals with protected health information (PHI) is required to comply with HIPAA’s rules and regulations. The law consists of several standard verification requirements for the disclosure of PHI. Under this subpart:

(i) Except with respect to disclosures under §164.510, verify the identity of a person requesting protected health information and the authority of any such person to have access to protected health information under this subpart, if the identity of any such authority of such person is not known to the covered entity;

Numerous stipulations suggest that it is lawful for organizations to take reasonable steps, such as using HIPAA compliance software and using platforms like RightPatient for verifying patient identity, to ensure compliance. HIPAA compliance also ensures that there are appropriate safeguards in place to protect PHI from unauthorized disclosure or breaches. 

RightPatient – touchless biometric patient identity management platform

RightPatient is the healthcare industry leader in biometric patient identification. RightPatient also offers remote identity validation and appointment scheduling solutions for telehealth practitioners to ensure positive clinical outcomes during this pandemic. The platform verifies patient identities by comparing their selfie photos and ID (e.g. driver’s license). It helps healthcare providers save money on more costly identity-proofing solutions through credit agencies.

Even without this pandemic, exercising due diligence is vital. With the threat of medical identity theft looming even greater than before, healthcare providers need to have the most risk-conscious and thorough procedures in place to mitigate fraud. With RightPatient, healthcare providers can confidently stand under the near-perpetual spotlight of public scrutiny.

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Patient Identity Matching – Solving an unsolved crisis with RightPatient

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

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

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

How costly are patient identity matching errors?

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

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

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

The problem with common identifiers

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

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

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

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

Accurate Patient Identity Matching with RightPatient

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

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

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

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

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5 Strategies to Ensure Revenue Integrity in Healthcare

Many healthcare providers were struggling financially before the pandemic. But now, the U.S healthcare industry is on the verge of financial disaster. According to the American Hospital Association, hospitals are bleeding approximately $50 billion per month due to canceled elective procedures and costs associated with treating COVID-19 patients. Many non-COVID patients have also stopped seeking primary care visits, including patients with life-threatening conditions, because they are worried about exposures. In addition, claim errors, denials, and payment delays that result from inaccurate patient identification, duplicate medical records, and medical identity theft still persist, all of which affects revenue integrity. 

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Adopting Value-Based Reimbursement (VBR) models has shown to have economic advantages but poses a real challenge for healthcare providers alongside ever-changing healthcare compliance regulations. Siloed workflows, data proliferation, and disparate systems make it difficult to achieve the collaboration that is needed for VBR to yield optimal results. However, intelligent revenue cycle management can be the key to achieving financial stability and revenue integrity. 

Identify the problem

Today’s environment requires automating workflows and considering the whole revenue cycle process to ensure revenue integrity. Healthcare providers want an easy, seamless way to manage revenue cycle without errors, such as those caused by patient identification issues. Considering the lack of electronic medical record (EMR) system capabilities to adequately address the critical need for accurate patient identification, it is vital to leverage complementary technologies with core-specific competencies that can improve the overall revenue cycle. For example, improving patient identification and matching processes at the front-end of the revenue cycle process can significantly reduce costs. 

As an industry-leader in touchless patient authentication, RightPatient has been helping many healthcare organizations reduce claim errors and denied claims by ensuring accurate patient identification. By eliminating denied claims linked to identification errors, healthcare providers can reduce the burden of back-end activities in the revenue cycle and simplify the reimbursement process to ensure revenue integrity.

Rely on technology

Adopting technology is also essential to ensure that clinical teams across the healthcare ecosystem are accessing high quality shared data to produce the best outcomes. Augmenting the organization’s core systems with complementary technologies on a single, integrated platform enhances internal collaboration with other teams or departments. For instance, RightPatient crosses departmental silos and brings transparency to patient healthcare data across disparate domains. Transparency across teams is critical. RightPatient will ensure that a holistic and accurate medical record of each patient can be accessed by clinical and operational staff members no matter where the patient is authenticated. By automating the patient identification and authentication process, RightPatient improves clinical outcomes and enables staff to proactively focus on other areas where their expertise has the most impact.

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Ensure compliance

According to the National Association of Healthcare Revenue Integrity (NAHRI), the goal of revenue integrity is to prevent issues that lead to revenue leakage or compliance risks through effective, efficient, and internal controls across the care continuum, supported by strong documentation and sound financial practices that can withstand audits at any time. 

Violation of healthcare compliance is a major contributing factor to financial losses. For instance, HIPAA violations are becoming more common across the U.S healthcare system. HIPAA compliance software, on the other hand, can help address this issue. Such software allows healthcare providers to simplify their compliance efforts and manage training through an effective communication system. Ensuring HIPAA compliance prevents privacy issues that can impact proper revenue cycle management and helps to avoid costly financial losses.

Accurate documentation and coding

Unfortunately, as long as healthcare providers do not address the issue of front-end data validation, claim denials will continue to wreak havoc. Inaccurate patient identification and medical identity theft still remain a major contributing factor to denied claims and payment delays. However, through accurate patient identification, RightPatient enables healthcare providers to bill and code each patients’ information accurately. By ensuring accurate and clinical documentation, this platform significantly reduces inefficiencies of denials and rework, thereby strengthening revenue integrity. 

Improve hygiene and foster patient trust with RightPatient

Healthcare providers are witnessing a reduction in non-infected patient activity due to the fear of COVID-19. Visits for general check-ups or other routine procedures have decreased to the obvious financial detriment of healthcare providers. These providers need to reassure their patients that they are taking all precautionary steps to maintain hygiene and control this contagious disease. Adopting RightPatient is a sensible part of this strategy. 

RightPatient is a completely touchless biometric patient identification platform that can accurately identify patients throughout the continuum of care. After capturing a photo from a smartphone, tablet, or webcam, RightPatient instantly identifies patients and retrieves their correct medical record. By securing unauthorized access to medical records, hospitals are able to prevent medical identity theft, reduce denied claims, and duplicate records – all of which are vital to a high-performing revenue cycle. 

RightPatient also offers remote patient authentication, which is becoming increasingly necessary as people are maintaining social distance by staying at home and getting treatment through telehealth practices. During this process, RightPatient validates patient identities by comparing their ID (e.g. driver’s license) and selfie photos. This process can also help healthcare providers to save money on more expensive identity proofing solutions through credit agencies. 

As patient care becomes more complex, so does the management of the revenue cycle. RightPatient can help to simplify and manage the complexity by ensuring safe, ubiquitous patient authentication from various patient encounter points. Full financial recovery from this pandemic may take years, but adopting RightPatient will ensure that you are on a faster path to success.

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Impact of Duplicate Medical Records in Healthcare can be Mitigated

The novel coronavirus is probably one of the biggest challenges the U.S. healthcare system has ever faced. However, the healthcare industry is not new to problems – it has constantly been plagued with issues, although, not of the same magnitude as COVID-19. One of the biggest challenges it faces is patient identification errors and this is a direct impact of duplicate medical records in healthcare, among other factors. Let’s see why it happens and how it can be reduced.

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Duplicate records in a nutshell

Duplicate medical records are where there are multiple patient records referring to the same patient stored in an EHR (Electronic Health Record) system. Multiple records are usually created due to human errors. For instance, if William Johnson goes to the hospital, the EHR user will search by his name, ask some questions, and go through the standard procedure for identifying the patient. Now, there might be quite a few medical records named William Johnson and the EHR user may get confused, leaving two choices – searching until finding the most appropriate record or making a new one. Many hospitals house millions of records, and there is also a high probability that there may be quite a lot of “William Johnsons” sharing the same information as the actual patient. Thus, if the EHR user cannot find the appropriate record from this vast sea of EHRs for William Johnson, and a duplicate medical record gets created. 

Impact of duplicate medical records in healthcare – some findings

According to a study conducted by Black Book Research, the impact of duplicate records includes patient identification errors, repeated care, redundant medical tests, and denied claims – all of which lead to increased costs. Overall, these problems cost the healthcare system billions of dollars each year.

But why is the cost so high? Well, on average, duplicate records occupy almost 20% of the EHR system of any given healthcare provider. 

Another problem of medical records similar to duplicates is overlays. The latter is caused when records of patients are merged into a single one – generating inconsistent information such as a fragmented medical history. 

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Both duplicate medical records and record overlays have serious consequences – not only for a hospital where financials and revenue cycles are impacted, but patient safety is also jeopardized. Duplicate medical records often contain inaccurate or incomplete medical history and can lead to wrong treatments due to factors like medication, lab test results, and allergies not being mentioned. These can even cost a patient their lives. Thus, the impact of duplicate medical records in healthcare is significant and needs to be addressed effectively.

Leading hospitals are mitigating effects of duplicates

Even though the majority of hospitals are suffering from the impact of duplicate medical records in healthcare, many pioneering providers have taken steps to mitigate the costs associated with duplicate records.

They went to the root of the problem – why are duplicates and overlays being created in the first place? It is because the EHR users are not able to identify the patients accurately. If an EHR system houses millions of patient records, who can blame them? Common names and information lead to the creation of duplicates and generate patient identification errors. This is exactly what RightPatient prevents. 

RightPatient is a contactless biometric patient identification platform that can seamlessly be integrated with EHR systems. It locks the medical records of the patients with their biometric data upon enrollment. When they return, all they need to do is look at the camera and the platform identifies their accurate medical record within seconds, creating a contactless and hygienic experience without hospitals having to think about infection control issues. Since it accurately identifies the patients, it prevents the creation of duplicate medical records. Pioneers like Grady Health, Terrebonne General Medical Center, and University Health Care System are using RightPatient and preventing duplicate records, improving revenue cycle, and saving millions in the process, all the while improving patient safety. 

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Correct Patient Identification is Crucial for Vaccine Administration

With over 1.6 million confirmed coronavirus cases in the United States as of 22nd May 2020 and surrounding talks about reopening society, it remains a firm fact that without widespread contact tracing and safe vaccine administration, there is no getting back to the life we once knew as normal. Nevertheless, there is one major and longstanding hurdle to overcome for achieving either of both widespread contact tracing or safe vaccine administration goals, and that is correct patient identification.

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The importance of correct patient identification

The Pew Charitable Trusts, a non-profit, non-governmental organization along with several other organizations have been looking for ways to improve patient matching through correct patient identification. Most importantly, they have stressed the fact that biometric technology is the key, including in a recent HIMSS20 Digital Presentation

PEW has again stressed that Congress should act to improve patient identification and patient matching. They sent a letter this week to House Speaker Nancy Pelosi, D-California, Minority Leader Kevin McCarthy, R-California, Senate Majority Leader Mitch McConnel, R-Kentucky, and Senate Minority Leader Chuck Schumer, D-New York. According to the letter, thorough contact tracing in the short-term and nationwide vaccination administration in the long-term relies on having accurate patient demographic data, but the current flaws with correct patient identification and matching of patient records hinder the nation’s ability to achieve either of those goals.

Drawbacks of patient identification errors

Ben Moscovitch, Project Director for Health Information Technology at the Pew Charitable Trusts says “Matching is a problem today”. He says, according to research, half of the patient records may not match when transferred from one healthcare facility to another, thereby imposing unnecessary risk and potential harm to the patient. 

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Not having a correct patient identification technique in hospitals can cause discrepancies in data when hospitals try to match an individual’s record, and it may lead to the creation of another electronic health record (EHR) for the same patient (this is commonly known as creating a duplicate medical record in the system). Duplicate medical records drive up costs. Research has shown that duplicate medical records can cost hospitals $96 to fix each record, adding up to $1,000 to remove the data of two patients whose records have been merged together.

Key factors that can hinder the immunization process

A variety of factors can affect correct patient identification. When common identifiers such as name, DOB, and address are used, a simple typo or variation in how these identifiers are recorded during registration can lead to poor match rates. 

Another major problem with patient matching is the fact that many people have similar names, including the same date of birth. In a nation where nearly 48,000 people are named John Smith, correct patient identification is absolutely critical for an effective widespread vaccination program.

An effective large-scale nationwide vaccination program and immunization registry would depend on reliable and robust patient data, and successful administration of this program hinges on the ability of healthcare providers to locate the right patient record. Biometric technology has consistently proven effective in matching patient records through correct patient identification.

Why should you use biometric technology in a post-coronavirus society?

Contactless biometric technology is a hygienic way to ensure correct patient identification, limiting infection control risk during the identification process. As a pioneer in touchless biometric patient identification, the RightPatient platform offers iris and facial recognition for correct patient identification to ensure that patients can be identified without having to touch a common biometric device. 

RightPatient uses the biometric characteristics of a patient to prevent medical identity theft and duplicate medical records. Through the platform, patient identities can be validated remotely through their own personal devices (e.g. smartphones, tablets, and PCs) after they schedule appointments. During in-person or telehealth visits, patients can be subsequently authenticated by simply capturing their photo. The solution significantly increases patient matching rates. 

Needless to say, contactless biometric technology for correct patient identification is the key to an effective nationwide vaccination program. Errors from common patient names, lack of demographic data standards, and human mistakes can be avoided with RightPaitent to strengthen the integrity of data related to vaccinations and COVID diagnoses. This will help to reduce costs and improve patient safety. 

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Duplicate Medical Records and Patient Misidentification Frequently Affects Hospitals

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

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A study regarding patient misidentification 

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

Patient matching and duplicate records explained

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

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

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

How are hospitals affected?

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

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

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Leading Hospitals Understand the Importance of Proper Patient Identification

The importance of proper patient identification can be felt by hospitals, patients, and everyone else involved in the caregiving process. Positive, or proper patient identification refers to hospitals successfully matching patients with their appropriate medical records. However, in practice, this is very tricky. In fact, according to a study, 38% of healthcare providers stated that they had encountered at least one incident which directly ties in with patient misidentification in the past two years.  

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Why patient misidentification happens

Patient identification errors occur due to multiple reasons – duplicate medical records and overlays are just two of the many reasons. Duplicate medical records are created when a patient has more than one electronic health record to his/her name, whereas overlays referring to two different medical records belonging to different patients are merged. Both situations cause fatal harm to patients and cause irreparable damage to healthcare providers with their financials and goodwill on the line. Thus, the importance of proper patient identification is understood quite well by health systems.  

Strategies used by leading hospitals

Choosing the required number of personnel to handle a large amount of data is a must. A large provider can house up to 10 million medical records. If your one is such a health system, are you employ enough personnel to keep that humongous amount of data in check? A responsible provider not only need to ensure that the data is clean but also must maintain this state at all time. Entering clean data is one thing, but keeping it is another challenge entirely.

The selection of the software which fits your needs is the first and most important strategy. Do not opt for outdated software – these not only pose a security risk but may also be incompatible with your other software. Thus, choosing a method that enhances patient matching can save lives, for instance, a biometric patient identification platform. But more on that later. 

Obeying all laws and regulations may go a long way. In unfortunate circumstances, you can ensure your safety by letting the authorities know about the incident and your compliance with all rules to ensure the safety of patient data. 

Understanding the importance of proper patient identification

The last and most important thing – use a solution that ensures that patients are always positively identified. This is precisely where RightPatient can help you. It is a biometric patient identification platform that locks medical records with patients’ biometric data upon registration. After the registration, the platform can detect the medical record matched with the patient’s biometric data accurately within seconds. Leading healthcare providers such as Community Medical Centers and Terrebonne General Medical Center are protecting millions of patient records with RightPatient, thus ensuring positive patient identification and saving millions of dollars in the process. 

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Duplicate Medical Records Impact Patient Safety in Hospitals

Ensuring patient safety is one of the top priorities for any hospital. Experts suggest that the mismatch and duplication of patient data have damaged the U.S. medical system and caused potentially fatal consequences. Let’s see how duplicates hamper patient safety in hospitals.

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Duplicate medical records may occur in different ways. The most common repetitive error occurs during the patient registration process. This situation also occurs when the unconscious patient cannot be identified. Sometimes, duplicates are created based on the patient’s demographic changes; the registrar may fail to find the patient’s last name and decide to create a new record. Patients must be identified reliably and consistently so that healthcare providers can have a complete view and make the best decisions.

Duplicate records are costly for E.D.

According to a report from 2019, approximately 18% of patient records within organizations are duplicates. Such duplicate records cost an average of over $1,950 per hospitalization, while the medical system spends more than the USD 800 per emergency (E.D.) visit.

Duplicate records cause delay and improper treatment

One-fifth of the patients have incomplete health records due to duplicate data, so they cannot fully view the patient’s medical records. This also leads to delays, unnecessary tests, or improper treatment of the patients. 

There are bad examples of duplicate medical records

Duplicate records pose a remarkable level of threats to the provision of proper care and patient safety in hospitals while carrying some significant consequences. In one incident, a woman’s mammogram was mistakenly assigned to another lady’s chart. As a result, her diagnosis was postponed, and the clinician was unable to start her treatment until the diagnosis was confirmed.

Patients might end up with the wrong drugs

Duplicate medical records also harm prescription drugs. If a patient receives medications according to the wrong prescription and the clinician does not acknowledge the patient’s drug history, then the probability of a fatal outcome is high.

Duplicate medical records add unnecessary expenses to hospitals  

A survey from 2018 revealed that duplicate patient EHRs cost hospitals an average of $1,950 per patient. 33% of all denied claims were caused by mismatched or incorrect patient information – as found by the survey. Such denied claims caused an average of $1.5 million to the health care system in 2017 and $6 billion annually as a whole. Data sharing continues to grow and poses challenges to the safety of virtual medical records; hence, resolving the issue regarding patient records has become an increasingly urgent and complicated task. 

The challenge of patient identification can be solved if patient records are accurately identified against a patient’s unique feature, and RightPatient does just that. It creates a closed-loop patient record that can only be accessed through biometric identification – ensuring that the patient data is locked and irreversible. Once the inscription is done, patients only need to scan their biometrics – RightPatient to identify the accurate medical record within seconds and submit it to the hospital staff. The duplicate medical records of health systems such as Community Medical Centers and University Health Care System have been significantly reduced, which can help improve emergency medical response and ensure patient data safety.

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Patient safety issues occur due to patient misidentifications

When electronic health records (EHRs) were introduced, people lauded it as the next big thing in the technological landscape of the healthcare industry. There were many reasons – it was entirely digital as the name suggests, could be accessed quickly and whenever required, reduced paperwork, among many other reasons. However, once it was widely implemented, the reality was drastically different. Instead of solving these problems, EHRs added additional ones along the way – patient safety issues.

Patient safety issues occur due to patient misidentifications

EHRs have created many problems for patients and healthcare providers alike. They have created risks which were unpredicted at the time of their implementation, which can potentially generate the chance to make grave errors in the treatment processes for patients, specifically if the treatment involves medicines. If this seems terrible, it gets even worse. These problems associated with EHRs are much more catastrophic for children and younger patients since their prescribed drugs are age-based. A study has found that EHRs do not take age into account; thus, it does not tackle the problems associated in a pediatric environment. Other than that, patient safety issues like matching errors are synonymous with EHRs. This is where biometric patient identification systems like RightPatient come into play.

The problems healthcare providers face while using EHRs lead to misidentifications mostly. Some of the challenges EHR users face are:

  • Problems associated with displaying patient information, or incomplete/corrupt patient data
  • Issues related to patient data entries which cause delays
  • Problems with EHRs regarding feedback or notifications
  • Disruption in the workflow if data needs to be shared 

So what are the actual problems associated with patient safety issues caused by EHRs? 

Restricted information results in wrong medications

EHRs usually provide the hospitals with blank data fields which the latter can fill in, if required, regarding making notes making it easier for colleagues. However, they do not know whether their colleagues have access to those specific fields, which can create many problems. For example, if a doctor had made a note within the EHR regarding the medical condition of a patient, say glucose level, the nurse who will administer the medication may not be able to view this note because her access is restricted, not taking into account the medical condition. Such problems lead to a lot of medical complications. Likewise, if required fields are not available to be viewed by everyone in the hospital, the staff may get confused between patients with common characteristics like name, address, etc., causing patient matching errors.

A patient is provided with excess or wrong medication due to an entry error

This is the primary cause of confusing units – between imperial units and metric units. Thus, as it is common in the US to use pounds, and if the weight is entered in pounds, but the EHR accepts only kilograms, this will hamper with the medication. Medications are sometimes dependant on the weight, especially in the cases of children, and they may, unfortunately, receive larger doses of medicine than required, which can be fatal. Other than that, if a patient is misidentified, then this will cause the patient to receive the wrong medication as well.

Missed doses of medications occur due to problematic information displays

EHRs can usually list all the medicines that have been scheduled for patients, along with the time and dosage required. However, sometimes due to patient matching errors, they may end up with the medicines planned for some other patient, and this can be fatal for both the patients involved if someone is not cautious enough while administering the medications.

Duplicate patient IDs are created

By far, one of the most significant flaws of EHRs is consistent to this very day. News regarding patient matching errors are very common, and at least one person you know has faced it. How does it happen? Very simply – once a patient comes in and a hospital representative does not find the individual’s record in the EHR, the employee tries to save time by creating a new ID instead of searching more in-depth for the correct record. The staff thinks that this is the way to save time and effort but generates another source for losses by the employer. Sometimes even the patients are to be blamed – if they are not attentive enough while verification, the hospital staff may pick the wrong record for them. Its effects can range from being financial losses to even life-threatening. Due to this single issue, everyone involved with healthcare has suffered – patients, healthcare providers, insurance companies, and so on. Healthcare companies are now clamoring for a unique patient ID solution to eliminate these errors. 

Medical ID thefts take place

Another consequence of patient safety issues via EHRs – fraudulent activities. Addicts and professional thieves can very easily misuse others’ IDs and gain access to healthcare benefits or drugs which are entitled to the actual patients, resulting in financial losses incurred by the unfortunate patients. All this happens because there was no sure way to identify whether the medical record belonged to the perpetrator, until now.

What can be the solution to patient safety issues?

As seen from the problems, all of them point in one direction – patient matching errors. From all of this, patient identification error is seen as a disease in itself of the healthcare industry. Everyone involved is affected and suffers due to it in various ways and degrees. It is a multibillion-dollar problem in the US, where fixing a single entry costs from $1000-5000.

However, its days are numbered, it seems, as biometric patient identification systems like RightPatient are successfully eliminating it from the healthcare providers who use it. It uses iris scanning, which is easy and convenient for patients – all they need to do is look into the camera, and they are identified accurately. Another benefit of this biometric modality is that it also correctly identifies the irises of the younger patients as irises are formed within ten months of birth and remain unchanged. Patients also love it because there is no chance of getting any contagious diseases as it does not require physical touch. Over a hundred healthcare providers are using it, and they are reiterating the same thing – patient experience has improved along with patient safety due to the reduction of errors and the speed of the process.