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It’s important to get things right from the start within the hospital setting. The moment a new patient walks through the door the hospital assumes a degree of responsibility for their health. Much attention is given to the quality of care, and the overall cost of medicine in the United States, but there is a fundamental consideration that many people don’t think of:

Proper identification. It’s important to accurately match patients with their medical records, both for the purposes of HIPAA-protected privacy and to provide them with the best possible care. Patient identification platforms are systems that provide healthcare providers with the resources they need to accurately identify patients. 

In this article, we take a look at why patient identification platforms play a vital role in the hospital admittance process. 

Enhancing Patient Safety and Quality of Care

Accurate patient identification is vital in ensuring that everyone who walks into the hospital is given care that is specific both to what brought them in and their overall health history. Proper medical intervention exists on a spectrum of continuity that begins the moment a person is born. 

Biometrics and other unique patient identifiers serve as a fingerprint of sorts, allowing hospitals to quickly identify everyone who comes through from there. 

Once identity has been established patients benefit from: 

• Reduced capacity for error: There are loads of things that can go wrong when a hospital doesn’t have the right background information on a patient. Improperly administered medication, and incorrectly applied procedures. When identity is established at the point of entry, hospitals can move forward with treatment strategies in full confidence. 
• Improved continuity of care: Again, it’s the idea that a person’s healthcare journey begins the moment they are born. In a practical sense, this continuity includes everything from patient allergies to pre-existing health conditions. In other words, vital information that hospitals need to coordinate their efforts and make informed decisions. 

Without this continuity, it would be all too easy for a hospital to accidentally give a patient a medication they are allergic to, or perhaps simply perform tests that are expensive and redundant. 

Improving Operational Efficiency and Workflow

Beyond the benefits that patients receive, there is also simply an administrative value to knowing exactly who is being treated. Hospitals rely on efficiency to deal with their workload and deliver the highest possible level of patient care. 

In a world where nurses are calling 911 to get assistance in an understaffed ER (an episode that took place not so long ago in the state of Washington), hospitals need every edge they can get to maximize their efficiency and streamline their processes. 

By automating and standardizing patient identification, hospitals:

• Save time and resources: Without the benefit of a patient identification platform, hospitals are beholden to manual processes of identity verification. This can take a significant amount of effort on the part of the hospital employee, and it is also just a process subject to human error. 
• Improve their workflow: Patient identification integrates with electronic record-keeping systems to establish a streamlined exchange of information. This eliminates the risk of data silos (information documented but inaccessible) and accelerates the workflow between hospital departments. 

When it comes to securing the best possible patient outcomes, every second counts. Patient identification platforms quantifiably streamlined efforts and make it easier for hospital employees to do their jobs quickly and accurately. 

Securing Patient Data and Protecting Privacy

Patient identification platforms have a robust set of HIPAA-compliant safety features that are designed to protect patients and their private information. 

Encryption plays an important role in restricting access to sensitive information while still ensuring that people who need the data (the patient, doctors, nurses, administrators) can access it. 

Data security within the world of healthcare is important for many reasons. For one thing, digital technology, though convenient, creates unique points of vulnerability that didn’t exist twenty years ago. It used to be that patient information existed only in a physical form and could be locked away, out of reach to those who weren’t supposed to have it. 

In the abstract world of cloud-based technology, information is literally everywhere. HIPAA-compliant software helps to marry convenience with safety. 

It also just helps to foster trust between patients and the hospitals that serve them. While this bond is hard to quantify it is a vital element in ensuring that people continue feeling comfortable using the hospitals that are there to serve them. 

Patient identification platforms like RightPatient, in that sense, are the right form of innovation. They make things easier for hospitals while protecting, and indeed, enhancing, the rights of patients. For instance, RightPatient uses patient photos and attaches them to patients’ medical records during registration. Whenever a patient returns, the platform scans their photo, runs a biometric search, and provides the accurate EHR shortly – it’s that easy!

There are different types of fraud and abuse in healthcare, but the most prevalent ones are those committed by health insurance and healthcare facilities. These two types of malpractice in the healthcare system are not propagated by the organizations only. Rather, even customers can commit healthcare fraud. 

What is fraud in healthcare? This is a crime committed by patients/customers, medical providers, medical insurance providers, and other parties to get financial or other benefits not due to them from the healthcare system. 

The common types of abuse in the system include claims for services not given, for instance, a service provider charging for employee mental health while knowing they did not offer any.

It also includes giving false information in the medical records, giving false information for one to be eligible for some services. 

While there are many areas of healthcare fraud and abuse, the ones elaborated below are the most common:

1. Billing for services not rendered

Also referred to as upcoding, this is the most common medical malpractice all over the world. This type of fraud is targeted at the government, to make money illegally for services not rendered. 

It can also be a case of billing for a costlier service whereas a cheap[er cost was provided. Unless the patients recognize this kind of fraud and report it, it might be hard for the concerned authorities to know. 

As the customer, you should peruse your bill keenly looking for anomalies such as services listed, which you are sure you never received. 

If you notice such, ask about it immediately. Sometimes, genuine mistakes do happen. However, if they do not rectify the bill, you should escalate, and report the matter. 

Ignoring such mistakes can have a big ripple effect because you can be charged high health insurance premiums. 

Precisely, to upcode is to submit codes for more serious illnesses, while in actual sense, the illness treated was lesser. This creates a heavy strain on the medical systems as resources are going where they are not needed. 

2. Billing for medically unnecessary services

The doctor might provide certain services and bill for them. However, if they were medically unnecessary, that is fraud. The government is billed for a cost that should not have been there in the first place. 

The healthcare provider acts as the bridge between the federal systems such as Medicare, Medicaid, and the patients. 

The two will only pay for medically necessary services, but as suggested by the provider. Therefore, hospitals commit fraud by recommending tests and services that are hardly related to the condition you are suffering from. 

A hospital or a doctor may commit fraud by recommending medical products or services that a patient does not need. 

Perhaps they do this because a pharmaceutical company has promised them a kickback, or some other form of reimbursement. This is against federal healthcare rules and regulations. 

3. Doctor receiving kickbacks

It is illegal for a doctor to refer patients for a certain service when they know they do not need it, for a certain payment. 

To cite a case example, in 2021, National Medical Care, Inc. was charged with paying doctors and nurses kickbacks to recommend intravenous nutrition to dialysis patients under Medicare. In fact, the successor to NMC, Inc. (Fresenius Medical Care), had to pay $385 million to settle claims out of court. 

On the other hand, it is also illegal for doctors or healthcare facilities to pay others to refer Medicare patients to them. 

In Texas, the Anti-Kickback Statute imposes a criminal penalty on any person or facility that offers anything of value to solicit a referral under the government healthcare program. 

If patients discover such underhand matters taking place, or they suspect that Medicare or Medicaid is being billed for a service that was not necessary, they should blow the whistle on their healthcare provider. 

When the doctor receives a gift, cash, equity, or any other benefit in order to use a certain medical device on a patient or make any decision about the patient, that is considered a kickback. 

If it caused the doctor to act in the interests of the giver rather than of the patient, they would have to prove that it wasn’t a kickback. 

Despite many prosecutions being instigated against such schemes, kickbacks are so rampant in the medical industry and most pass undetected. 

4. Not charging patients properly for prescriptions

Many times, many healthcare providers have been found culpable of giving patients who were not under Medicare or Medicaid discounts. 

It was found that such patients would pay lower amounts for prescriptions after getting in-house discounts. At the same time, the same healthcare facility would not extend the same discounted rates for patients under Medicare and Medicaid systems. 

It is against the rules to charge patients anything above market rates for medication. It is also against the healthcare rules to charge patients under Medicaid and Medicare a higher rate than other patients. In such cases, a False Claims Act case might be instituted against the pharmacy in question. 

If found guilty, such a facility or person will be liable to pay a fine that is three times the government damages and a penalty that’s related to inflation. 

5. Nurses doing examinations yet billing the government for doctor services

Today, it has become almost routine for nurses to handle many outpatient examinations. However, this is against the federal healthcare rules to bill the government for doctor services when it was actually a nurse or other staff that did the work. 

This does not mean that it is okay for a nurse to do a physician’s work if the government is not being billed for it. It could lead to misdiagnosis as patients are more likely to be handled by under-trained staff. 

Patients are encouraged to whistle-blow on such providers if they find out that the person taking them through certain procedures is not a physician. 

6. Medical identity theft

Medical identity theft means the use of a patient’s medical identifiable information to obtain prescriptions that are not due to them. 

The identity thief then bills the government for the services rendered, pretending to be the patient whose medical ID they have stolen. 

Medical identity theft is not only about the fraudulent use of patient data. It is also a misuse of physician identifiers to write prescriptions for services and drugs. Such can also be used to falsely refer patients for procedures, or even bill for services not rendered. 

It is the mandate of the healthcare provider to keep all of their healthcare workers’ and patients’ data safe. 

Several healthcare providers are utilizing touchless biometric patient identification platforms like RightPatient. By identifying patients accurately, hospitals and health systems can red-flag fraudsters and stop them from accessing patient services – preventing medical identity theft. 

7. Unbundling

This is another type of fraud that is rampant in the medical industry. When a doctor offers several procedures and bills them separately rather than under one qualifiable code, that is called unbundling. 

Usually, this happens when the payment for the procedures is higher if they are billed separately than when they are billed under the “group code.” In that way, the healthcare provider makes more money than necessary. It is against the federal healthcare rules. 

Unbundling is also rampant in the laboratories that fail to bill for panels of tests in a bundle. Instead, they bill them separately to make more money. 

Conclusion

So much for fraud in healthcare, but what is abuse in healthcare? Abuse is any action that goes against the values of healthcare practice. 

It includes things like not keeping proper records, claims for services not rendered or rendered but not medically necessary, bad billing habits, and many others. 

Abuse and fraud in the medical and healthcare industries do tend to overlap at times. But the common denominator is that someone is benefiting financially. 

Over the last several decades, technology in the healthcare space has steadily been evolving. In recent years, however, this evolution has seemingly exploded with incredible technology now enabling medical professionals to aid patients in profound ways.

One demographic of American patients that is in dire need of increased healthcare resources is those in rural areas. Gaining perspective on how new technology in healthcare can help provide rural residents with the care they need can give one a more nuanced perspective on the way technology is impacting healthcare.

Here is how technology will transform patient care in rural areas.

Telehealth is Making Rural Healthcare More Accessible

In rural areas, there are a number of barriers standing between residents and healthcare. One of the most difficult challenges is a lack of medical facilities and medical professionals located in rural areas. Oftentimes, this means that rural residents will have to travel for several hours just to see a doctor.

As one can imagine, the resources needed to build new medical facilities are immense. To make matters worse, not many medical professionals are keen on living in rural areas, and it could take years to build new facilities even if the proper funds were secured.

Thankfully, telehealth has presented itself as a potent and effective solution that can help solve the issue of a lack of rural healthcare facilities. Essentially, telehealth is the practice of providing healthcare through the use of electronic technology. 

In its most common forms, telehealth involves patients communicating with medical professionals remotely through phone calls or video calls. This alleviates some of the need for rural residents to travel significant distances to see medical professionals.

Unfortunately, telehealth is not yet at an advanced stage that completely dissolves the need for rural residents to see their medical providers in person. However, as technology evolves and new ways of engaging in telehealth become normalized, this may one day change. 

Hopefully, new technology will be able to solve the problem of remote healthcare and provide rural residents with a way to receive robust care and experience better health outcomes. 

Robots Can Help Medical Professionals Perform Procedures More Successfully

As has been noted, many rural areas across America lack key medical resources. Even when there are clinics and medical facilities in these areas, they may not have the proper equipment and professionals to perform specific types of procedures. For rural residents, this means having no other option than having to travel significant distances to have procedures performed. 

Robots, however, are beginning to play a more important role in healthcare. What may have once seemed like an idea out of a science fiction movie has now started to become reality as robots are helping medical professionals perform surgeries and procedures. 

For rural residents, this means that more types of procedures may be offered in local clinics as a result of an influx of new medical robots. This can help medical providers ensure that they’re providing amazing care to rural residents in need of surgery and procedures. As such, the next decade will likely see a great boost in rural healthcare offerings as more healthcare organizations take advantage of medical robots that can help perform procedures. 

Remote Patient Monitoring is Providing Rural Residents with More Convenience

Traditionally, treating patients remotely posed some key challenges for medical providers. Specifically, medical providers had to trust that patients were being consistent in their self-care and were unable to know if patient vitals were off in real-time. This could often result in poor health outcomes for patients who weren’t stringent in their self-care duties. 

Today, however, technology has evolved to the point where medical professionals have the opportunity to monitor patients remotely in real-time. This form of technology has impacted nursing and other medical fields profoundly by making remote care a more viable option. 

For rural residents, this can have a number of benefits. Rather than noticing declines in health when it’s too late, medical professionals can notify rural residents immediately if their vitals become irregular or worrisome. 

One technology that is helping to make this possible is a form of AI called machine learning. Essentially, this form of AI learns over time by studying masses of patient data. As a result, machines powered by machine learning software can alert medical providers if a rural resident’s health is taking a negative turn. 

As time goes on, many are hopeful that technology will continue to make remote monitoring of patients more effective. In this way, technology can help rural residents experience better health outcomes with increased regularity despite a lack of rural medical facilities. 

Technology is Helping Rural Residents Achieve Optimal Health Outcomes

While rural residents have faced a number of healthcare obstacles over the last decades, technology is presenting itself as a powerful tool to overcome these challenges. From making remote monitoring more effective to utilizing robots to help with medical procedures, medical technology is transforming the way that rural residents receive care. 

As time goes on, many are hopeful that technology in healthcare will continue to evolve and provide rural residents with more amazing care options that can potentially transform their lives.

When people hear nurse, their mind typically jumps to bedside nursing. And while this is a noble, common manifestation of the profession, it’s also just the tip of the iceberg. There are many different types of nurses, each providing a unique kind of care and expertise.

Understanding the different types of nurses can help you make important career choices, or simply just understand the healthcare system better. In this article, we take a look at several of the many different types of nurses and describe what they do on the job. 

In-Patient Versus Outpatient Nursing

Most people will have interactions with in-patient nurses at some point in their life. If you are ever admitted to the hospital, this is the person who will take care of you. They perform a wide range of duties, including performing tests and helping to ensure your comfort. 

Out-patient nurses often work in the hospital setting as well, but with patients that don’t need to be admitted. For example, if you are getting ongoing blood work, or if you find yourself in the emergency room, you will probably be involved in outpatient care. The hospital treats you and then sends you home that same day. 

However, there are situations in which outpatient nurses may travel to the patient’s house. This is typically done in situations where the patient would not otherwise be able to access care. 

School Nurse

School nursing is often a frequent first job for newly minted nurses. School nurses work in educational environments to assess student health and provide basic care to people who are deemed to need it throughout the school day. 

Nutrition Nurse

You can hire a nutrition nurse if you are trying to optimize your food intake to achieve a specific health goal (weight loss, lower blood pressure, better overall nutrition, etc). Nutrition nurses can help their patients come up with food plans, and monitor their progress with said food plans over time. 

Sometimes nutrition nurses are brought in after a specific incident. For example, if a person has a cardiac event, they may be referred to a nutrition nurse as a way of helping them make the lifestyle changes required for continued health. 

In other situations, people may hire nutrition nurses to help them meet their own goals. 

Nurse Educators

Nurse educators work in schools, teaching the next generation of nurses. They usually will have several years of experience on the job, and will most likely need to at least have a master’s degree to be eligible for the job.

Because they have real-life experience, they are well-positioned to guide students through the hands-on elements of nursing education. 

Hospice Nurse

Hospice nurses are brought in toward the end of life to help improve the patient’s comfort level. Once hospice begins, most patients are no longer looking for a cure for their condition. Instead, the hospice nurse works to reduce pain and help the patient achieve at least some degree of normalcy with their eating and sleeping habits. 

Hospice nurses continue to advocate for their patients right up until the end, modifying their care as much as possible to suit their needs while also working with their families to facilitate visits and ensure that the patient’s final wishes are being honored. 

Informatics Nurses

Informatics nursing is a relatively recent development that combines the responsibilities of a hospital nurse with those of a data analyst. Informatics nurses may look both at individual patient data, and analytics for an entire community to help improve the hospital’s ability to provide high-quality care. 

In addition to getting an RN certification, informatics nurses also need to be licensed specifically for data analysis. Because this is a relatively new profession, not all regions of the country have access to informatics nurses. 

Nurse Ethicist

Nurse ethicists work to advise hospitals on policies relating to healthcare ethics. They may also be brought in to advise in situations where the ethics of a choice made at the hospital are in question. They may work directly with other nurses to educate and remind them about the ethical elements of their job.

You may interact with a nurse ethicist as a layperson if your loved one is unable to make medical decisions for themselves. When a decision needs to be made about withdrawing life support, nurse ethicists are brought in to work with members to make the best possible decision. 

Homecare Nurses

Homecare nurses provide patients who can no longer take care of themselves with long-term care. If you come to the conclusion that an aged family member can no longer live on their own, you may look for the services of a home care nurse. 

That said, there are various forms of ongoing care. In certain cases, when the person requiring care is in good health, they may just need someone to help them with a simple task. Running errands. Performing light housework. Helping them with personal hygiene, etc. 

These tasks do not require the services of a home care nurse. However, if the patient has extenuating health conditions that require constant supervision the services of a home care nurse may be required. 

Flight Nurse

Flight nurses work out of airplanes, providing care in situations where someone becomes sick on a plane, or when they need to be transported by air to another hospital. They may perform the same duties as an ER nurse, but within a very unique environment that takes years of experience to master. 

Flight nurses usually need to have at least several years of experience on the job. They are also required to get a special certification to be eligible for the job. 

Conclusion

Navigating the healthcare system on your own is hard. If you are trying to secure care for yourself or someone that you care about, it helps to know what questions to ask. Above we have described some of the many different types of nursing jobs out there. However, there are many other types of nursing as well. 

To secure the right kind of care, begin by researching the symptoms or conditions that need treatment. From there, it is easier to find the appropriate specialties.