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Hospital data breach results in an expensive lawsuit – Is yours next?

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Hospital data breaches have been rampant for quite some years now. Last year’s figures alone are quite frightening – one states that 41 million patient records were exposed, essentially making the patients potential victims of medical identity theft. Thus, both data breaches and medical identity theft has been in the limelight. These unwanted nuisances have turned the attention towards healthcare providers who are suffering from these events. One such provider is the University of Missouri Health Care (MU Health), who suffered a data breach of 14 thousand records and also were hit by a lawsuit by the impacted patients.

This happened back in 2019. The provider was sued by patients who were affected by the breach in question. The patients reasoned that the breach had made their sensitive records prone to medical identity theft – their fear was not irrational.

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The actual story

On the first day of May 2019, the healthcare provider found out that an outsider somehow accessed email accounts of two employees for more than a week. Following the incident, the concerned officials said that they took the necessary steps to secure both accounts. 

It was not disclosed how the hacker got access and whether it was a phishing incident or not. However, the healthcare provider revealed that the affected account had sensitive patient data stored, such as names, DOB, medical record numbers, insurance details, as well as treatment details. The hospital data breach even consisted of the Social Security Numbers of some unlucky patients.

The data breach, fortunately, did not affect all the patients of MU Health. However, it did affect around 14,400 patients, which is no small number. As soon as the provider’s inquiry ended regarding the breach on the twenty-seventh day of July, it started to inform the patients regarding the breach. Oddly, the organization notified the patients after the required timeframe of 60 days as per HIPAA regulations.

The aftermath

Within the same week of notifying the patients, one of them filed a lawsuit, followed by 19 others. Their reason was very simple – the data breach would likely result in medical identity theft and lead to lower-quality care. The patients also believed that they were paying quite an amount of money, and thus, MU Health should add stringent security with their services.

Hospital data breaches can arm hackers with enough information to obtain medical services assigned to the patients. The hackers could either expose the data, sell it, or use it for themselves. These could lead to the patients paying for healthcare services they did not avail. These could also become denied claims for healthcare providers. Whichever way one looks at it, data breaches and medical identity theft is extremely undesirable. 

How do hospitals prevent medical identity theft?

Although it is quite prevalent nowadays, medical identity theft can actually be prevented. One way to make sure that the medical records are safe is by locking them with a key that hackers cannot forge. That is exactly what RightPatient does. It is a biometric patient identification platform that locks the patient records with their biometric data. Once the platform attaches the medical record with the data during enrollment, a third party cannot come and claim that record, preventing medical identity theft and ensuring accurate patient identification. RightPatient has been preventing medical identity theft for leading hospitals such as University Health Care System and Grady Health System.

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Proper Patient Identification Can Help Fight the Opioid Crisis

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The opioid crisis has been a menace since it started. It spread like wildfire throughout the country, and everyone involved in healthcare is still struggling to keep the situation under control. PDMPs (prescription drug monitoring programs) have been set up in almost every state to monitor activities like prescribing, distributing, and using controlled substances such as opioids. These PDMPs help identify patients who might be prone to drug abuse and provides the hospitals with opportunities to prevent such scenarios.

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If that is true, then why is the opioid crisis still a thing?

PDMPs are dependent on the data they are given to work with. They receive patient data like logs, records, patient profiles, and even counseling records. Thus, if the data is clean, then the PDMPs will work perfectly, and vice versa. Here lies the challenge – most of the data can be incomplete or unreliable, to begin with.

According to Injury Facts, the odds of a person dying from opioids are greater than dying from a motor vehicle collision. This has made opioid overdoses to be the fifth largest cause of deaths in the country. Everyone is on edge regarding the issue, and it is paramount that the data needed by PDMPs are accurate, valid. And consistent with the patients. Accurate patient data at all times can drastically reduce the opioid overdoses and bring the whole situation under control.

The biggest challenges – data quality and patient matching errors

Hospitals and health systems have been adapting EHR systems quite rapidly for the past few decades, which has helped digitize medical records. Even after all these years, proper patient identification is still a significant challenge for many. Much of the patient data have errors or are incomplete. Many of these can be traced back to duplicate medical records or overlays. According to a survey conducted by PDMP Training and Technical Assistance Center, the majority of the states are facing problems with patient records – 53% said that there are data quality issues.

Can proper patient identification be the answer?

Accurate patient matching is the only solution – something which can identify the accurate patients within seconds. RightPatient is just that – a biometric patient identification platform. It locks the patients’ medical records with their biometric data such as fingerprints or irises. After enrollment, the patient needs only to scan their biometrics, and the platform identifies the accurate EHR within seconds. Several health systems such as University Health Care System are using it and are reporting enhanced patient safety, improved revenue cycle, and reduced medical identity thefts. No longer can drug abusers come in and claim someone else’s identity – the system flags them within seconds. Health systems that are using RightPatient have dramatically reduced opioid issues within their premises. Since accurate patient record matching is the key, RightPatient is the perfect solution for the problem. Proper patient identification has never been easier and safer!

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How Do Progressive Hospitals Prevent Medical Identity Theft?

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There are many things we need to be concerned about to avoid any identity theft and lose a significant amount of money. Social Security Numbers, bank accounts, credit cards, insurance, and even driver’s license need to be monitored continuously to make sure these are safe and sound. Another kind of theft has been increasing rapidly in numbers – medical identity theft. However, what are the problems associated with medical identity theft, and what can hospitals do to ensure that their patient data is safe and secure from such events? Let’s explore.

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What is medical identity theft?

As a refresher, medical identity theft occurs whenever an unauthorized person takes the credentials of a patient without the latter’s knowledge and uses it for personal gain. It can be used to obtain healthcare services such as prescription drugs, treatment, as well as medical equipment. Also, as we can see in the recent news, criminals are actively targeting medical data of patients, which has contributed to the meteoric rise of medical identity theft. These cause the patients to receive medical bills with shocking numbers – tens of thousands of dollars’ worth of services can be used or stolen by the criminals. One hundred seventy-one million patient records were exposed online, according to the Identity Theft Resource Center. On the other hand, the reputed Ponemon Institute estimates that patients pay around $13,500 either for the fixes or for the services used by the culprits.

How does it affect patients and hospitals?

Other than the previously mentioned financial impacts medical identity theft has on patients, it affects them in different ways as well. According to the Ponemon Institute, 3% of the patients were fired, 19% lost potential jobs. In contrast, a considerable number of patients faced embarrassment due to the exposure of sensitive healthcare data – all of which happened due to medical identity theft. It can also cause the medical data of the culprits to be embedded into the patient record. For instance, when a victim goes to their providers for healthcare services, the patient might be given treatment based on the culprit’s preferences, interfering with the preferences of the actual patient.

For hospitals, medical identity theft is equally damaging, if not worse. Half of the patients will switch their healthcare providers if their medical identities are stolen, according to the Ponemon Institute. Such an event would also impact their reputation, cause losses in millions due to denied claims, and so on. All in all, medical identity theft is a problem for everyone involved and can be very costly to fix.

How do hospitals prevent medical identity theft?

Many safeguards can prevent medical identity theft, but none are as effective as RightPatient. It is a biometric patient identification platform that ensures that the medical records are locked with the biometric data of the patients. The platform takes the biometric data such as fingerprints or irises of the patients and attaches them with the medical records. Without biometric verification, the records cannot be accessed by unauthorized parties, ensuring no medical identity theft takes place. RightPatient also ensures patient safety – the platform provides accurate medical records within seconds of scanning the patients’ biometric data. It reduces denied claims, improves revenue cycle, and saves hospitals and patients from unnecessary costs. Several pioneering healthcare providers like Terrebonne General Medical Center and Novant Health are using RightPatient. They are reducing denied claims, preventing medical identity theft, improving revenue cycle, and enhancing patient safety.

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Medical Identity Theft Prevention Enhances Patient Trust

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What is one of the crucial things a company needs to ensure so that it can thrive? Is it the employees, revenue, or size? While many may answer something along the lines of the previously mentioned characteristics, one of the most critical assets a company can have is the trust of its customers. The healthcare system is no different – various health systems and hospitals are successful today only because of their patients’ trust in their services. Since it is healthcare, patients put their lives in the hands of the hospitals – trust plays a huge role here. That trust can be enhanced with medical identity theft prevention.

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According to Morning Consult, in terms of trust from consumers, healthcare lies in the middle, while insurance, finance, and real state are underneath it, whereas airlines and technology are above it.

Morning Consult conducted a study which had several respondents about their perception regarding various US brands as well as firms. From these people, a meager 16% responded that they trust health systems a lot, whereas 36% said that they believe these organizations somewhat.

Also, while ranking the most trustworthy companies, people, ideas, among other things, the respondents ranked their physicians even above notable choices such as Google, police, and leaders.

Thankfully, the report went deeper and gave areas of improvement for hospitals and health systems to build up trust among patients. When the sample of the study was asked what the most crucial factor which helps build trust towards an organization is, three-fourth of the respondents said that protecting their sensitive data was extremely important for trust-building.

All of these are straight from the customers themselves, and these are even more applicable to the US healthcare system. The health systems and hospitals need to ensure that the sensitive patient data they keep are safeguarded, especially now. Breaches seem to be very common nowadays, which leads to exposure to the patients’ confidential medical data as well as documents like medical images, medication, and so on. It costs both patients and healthcare providers alike – patients become victims of medical identity theft, whereas healthcare providers’ reputations are dented. People question the security surrounding the medical records since HIPAA requires strict safeguarding of such sensitive information.

These lead to losses for both patients and health systems – patients may sue the hospitals, the culprits may use the identities to avail services illegally, costing the patients a significant amount of money for services that they never used. Medical identity theft may also occur if an individual steals a patient’s medical credentials and uses it for his/her gain. In such cases, the preferences of the culprit may get mixed up with that of the patients. For instance, the patient might be allergic to certain medications, and may still receive that after the culprit uses his/her ID.

Dynamic healthcare providers such as Novant Health, Terrebonne General Medical Center, and University Health Care System are preventing such issues by using RightPatient. It is a biometric patient identification platform that locks the medical records after attaching those with the biometric data of the patients. Once a patient enrolls with the biometric data, for instance, irises or fingerprints, the records can be accessed using only the same data, creating medical identity theft prevention. The hospital can also identify the accurate patient record within seconds after the patient scans his/her biometric data for verification. RightPatient not only aids in medical identity theft prevention, but also eliminates patient matching errors, ensuring accurate patient identification, enhancing patient safety, and improving the revenue cycle as well. It saves lives as well as millions for both patients and health systems, enhancing patient trust.

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Can Revenue Cycle Improvement Prevent Hospital Closures?

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So many hospitals are closing their doors that it is hard to keep count nowadays. These closures happen for several reasons which we will discuss later. One of the latest ones to join this unfortunate group is Nix Medical Center, located in San Antonio, Texas. 

The 208-bed hospital once owned by Prospect Medical Holdings was acquired in 2012 and operated by Nix Health as the Nix Medical Center for 89 years.  

In addition to closing its hospital’s doors, Nix Health also had to close its home health division as well as Nix Specialty Health Center & Nix Behavioral Health Center, generating an estimated layoff of over 970 employees. 

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But why are these hospitals being closed?

Hospitals are supposed to offer health care and save lives. Thus the most important institutions in any society. So why are they being closing down? 

Well, the largest and most common reason is the lack of revenue. 

In this instance, with fewer people visiting Nix Medical Center the hospital simply couldn’t generate enough revenue to sustain it’s operational costs thus resulting in its inability to provide effective health care and subsequently closing its doors.

What to take away from this example?

Hospitals need to learn from this scenario and focus their efforts on better financial management via reducing denied claims via revenue cycle improvement. 

Known to cost any health system an average of more than $5 million each year, denied claims often occur due to mistaken billing of patients. For example, a patient visiting the hospital for a routine checkup is billed the cost for a surgical procedure and vice-versa. While this may sound peculiar you would be surprised to know just how common it is. Although 63% of initially denied claims are recoverable, they can cost as much as $8.6 billion in appeals-related administrative costs and why hospitals must find ways to mitigate such losses.

How can hospitals achieve revenue cycle improvement?

One way health systems can achieve revenue cycle improvement and lessen denied claims is by ensuring patients are correctly billed for the healthcare provided. 

To achieve this many progressive health systems are using RightPatient – a biometric patient identification platform. By implementing RightPatient, medical records are locked to each patient’s biometric data thus preventing unauthorized identity theft. 

Health systems such as Terrebonne General Medical Center and University Health Care System are already using RightPatient and are preventing medical identity theft, patient mix-ups as well as denied claims. RightPatient effectively reduces loss in revenue by ensuring each patient is billed correctly for the healthcare provided. Using biometric data, patient misidentification is also prevented. Each patient is required to register only once after a health system deploys the platform – attaching the biometric data with the EHR of the patient. Afterward, whenever that patient visits the hospital, RightPatient uses their biometric data to access their respective medical records for the previous diagnosis and prescribe the necessary treatment.

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2583 hospitals hit with penalties due to readmission reduction program

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Medicare hit 2583 health systems with penalties by cutting payments to them. This has been happening for the last eight years and thanks to the ACA, it is an effort to reduce the readmission rates of hospitals. This specifically focuses on the patients who return within the same month after they are primarily discharged which helps the readmission reduction program.

This is not something new, as it is a recurrent theme for the last few years, where Medicare predicts that it’ll cost the hospitals a whopping $563 million per year. This effort to reduce readmissions is known as the Hospital Readmission Reduction Program and has about 3129 hospitals attached to it. Out of them, a staggering 83% could not reduce the readmission rate and thus, were slapped with the penalties. This penalty to each of these hospitals will be in the form of deductions from the payments Medicare will pay them for future patients over the next year, starting this October 1st.

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One thing has been repeatedly said that these efforts have been going on for quite some time, since 2012, to be precise. However, many are still unclear whether these fines are helping to reduce readmission rates and thus generating better patient safety. On the other hand, these efforts have been reinforcing hospitals and health systems to reimagine how the patients are receiving care and focus on their health after discharging them so that minimal readmissions occur. Conversely, many industry pundits have chimed in that a few healthcare providers may intentionally avoid readmitting patients who require critical post-discharge healthcare services solely because of these penalties, which is severely detrimental for the patient’s health as well the hospitals’ reputations. Others are saying the program itself is not that effective, although it has brought in small benefits. 

Some studies were conducted, and it was revealed that this HRRP caused an increase in fatal incidents regarding patients. However, it was refuted by a study conducted by the Medicare Payment Advisory Commission (MedPAC).

Sometime last month, MedPAC’s study was released to the public, and it showed that the number of readmissions of Medicare patients within a timeframe of 30 days decreased to 15.7% in 2017 from 16.7% in 2010. 

Going into specifics, the hospitals are penalized for these readmissions when the patients are provided with healthcare services for heart failure, pneumonia, heart attack, hip and knee replacement, chronic coronary artery bypass graft surgery, or lung disease. One good thing regarding HRRP is that inevitable readmissions, for instance, scheduled ones, are exempted from penalties. Delving deeper, HRRP dictates that if patients return within the 30 days timeframe, the hospital will be penalized. Also, if the Medicare-funded patients go to a different hospital, the primary hospital which provided the care will be penalized. 

According to KHN, about 1177 hospitals were penalized higher than they were compared to last year, whereas 1148 received lower penalties compared to the previous period. 64 providers were stable since they received the same amount of penalty compared to last year. 194 new hospitals were added to the list of penalized hospitals, whereas 372 exemplary hospitals received no penalties for two consecutive years. However, one thing must be noted – 2142 health systems and hospitals were exempted due to the lower number of cases, veterans, or children’s hospitals. 

So, the readmission reduction program is one of the biggest headaches of hospitals and health systems. How can they be reduced? Well, a lot of health systems are using RightPatient to address it. It is a biometric patient identification platform that locks the medical records of the patents with their biometric data and the records cannot be accessed without biometrics. Other than ensuring positive patient identification, it also ensures that the hospitals receive a notification when a patient enters their premises within the 30-day period so that they can be provided with better care and thus ensuring better patient experience, reducing the penalties as well as better patient outcomes and thus, minimizing losses while creating a win-win situation for all.

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Another industry expert in favor of an effective patient identifier

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It has been a long, continuous, and never-ending fight for the unique patient identifier which has not been without its own share of controversies. At the moment, Congress is thinking about whether it should give the green signal regarding the financing of a unique patient identifier to be used across the health systems and hospitals in the US. Now, Julie Dooling, another prominent healthcare expert of the American Healthcare Information Management Association (AHIMA), has given her views regarding how an effective patient identification platform can change the game. Such a solution can generate accurate patient identifications with the existing electronic health records within any hospital that aims at helping and improving patient safety as well as to eliminate any detected fraud in the process. Thankfully, such a solution exists – more on that later.

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Patient matching – how hard could it be. That’s what may come to the minds of many. However, the truth is precisely the opposite when it comes to matching patients to their actual records, let alone duplicates which may be exceptionally complicated and thereby, making the failure rate to be quite significant. Moreover, according to Ms. Dooling, 8-12% of errors exist due to the duplicate records created for the same patient. Here is where the patient identification solution will come into play and it will identify the correct records for the patients every time, according to her.

However, it is not only AHIMA – a lot of health systems, hospitals, as well as other prominent healthcare organizations have been clamoring for a solution and are thus demanding for the abolishment of the archaic ban on funding and researching for a unique patient identifier by the Department of Health and Human Services which could be used nationwide.

HIPAA came into effect in 1996 and had a prerequisite for making reliable patient identification systems so that meaningful health information could be generated. However, as said multiple times, privacy concerns were cited by many parties, which ultimately led to the restriction in the development and funding for a national patient identifier. The opposition reasoned that medical records would be exposed and cybercriminals could steal data.

However, that did ultimately happen, and we see news regarding such cybercrimes every day. Also, fraudulent activities are quite common regarding the health information of patients. Ms. Dooling says that the consequences of privacy concerns such as healthcare fraud, which were given as reasons for not opting for a UPI, are happening even without its existence. Ms. Dooling also added that if a UPI is to be made, as everyone is clamoring for it now, it will take a lot of effort since it has to be nationwide and also should have interoperability, which is the primary concern. She also stated her concern regarding privacy issues; they would not be collecting Social Security Numbers so that the people can heave a sigh of relief regarding this matter.

Funding, researching, and creating such a solution would take a lot of time and resources. However, what if such a solution exists? Wouldn’t it be that much more feasible? Fortunately, such an exact solution exists.

A lot of health systems are already using RightPatient, which was made with accurate patient identification in mind. It is a biometric patient identification platform that locks the patient records with the biometric data of the patients. Once a patient registers their biometric data using RightPatient, it gets attached to their EHRs, and they can be identified within seconds whenever they visit the hospital. Also, this reduces medical identity theft and the medical records cannot be accessed without the biometric data of the patients, which can be irises or fingerprints. Likewise, health systems are using RightPatient to reduce denied claims as well, since they are eliminating patient misidentifications within their premises. It improves patient safety, enhances revenue cycle, and reduces millions of losses while saving both lives and money in the process. It does fit the bill for being a UPI since it is a tried and tested solution for accurate patient identification.

Source: Making the Case for National Unique Patient ID

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Why should the Senate choose biometrics as a unique patient identifier?

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Unique patient identifiers have been talked about several times, not only in this space but also everywhere else in the US – especially quite recently. This is because there have been positive signs which might finally grant the health systems and hospitals alike with the mythical unique patient identifier, which is sorely needed in the healthcare industry for positive patient identification. But why is it so badly needed? What are the problems faced due to patient misidentification? What will be the benefits? What can be a viable unique patient identifier in healthcare? Let’s explore these questions.

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One does not need even to imagine losing someone close and dear due to patient misidentification – these stories have been all over the news for years, and there’s no stopping them, unfortunately. Whenever you turn on the television or watch healthcare-related news on your smartphone or tablet, you’ll see at least one problem which has been caused by patient misidentification. It might be medical ID theft, insurance fraud, patient mix-up, a denied claim, or in extreme cases, death. These are just some of the real-life examples which have occurred over the years and are also very valid reasons why a proper patient identification system should be in place for health systems all over the US. For instance, there was once a case where a patient was misidentified and was denied care due to the wrong medical record being pulled. Or, take the opioid crisis – an addictive medication can inadvertently be suggested to patients who are addicts. 

These are scenarios that could have easily been avoided if only the patients were identified accurately and matched with their appropriate records. Over one hundred health systems are already doing that, but more on that later. Thanks to the recent talks regarding UPIs, the US Senate has a unique chance to do something about it and save lives as well as healthcare costs. It has the opportunity to do that when the members get to vote on Senate Fiscal Year 2020 Labor, Health & Human Services, & Education & Related Agencies Appropriations bill. Back in June, positive news spread throughout the news portals that the House of Representatives passed an amendment regarding the removal of the old ban on the creation of an effective UPI that can be used across the health systems of the US. However, everything now rests on the US Senate to make this a reality by creating a UPI or adopting something across the lines which have been helping to identify patients accurately.

What happened previously?

It has been around twenty years since the previous talks regarding unique patient identifiers occurred, which have resulted in zero progress. This has caused major problems regarding patient misidentification like medical errors, as well as insurance fraud, medical ID theft, and in extreme cases, and deaths of unfortunate patients. Earlier, patient misidentifications were overlooked, but recently, everyone recognizes it as a serious threat to patient safety – even a prominent entity like the ECRI institute has listed patient misidentification as one of the biggest impediments to effective patient safety.

However, that’s not all. The absence of a proper patient identification system also causes problems for healthcare providers, as well. As previously mentioned, insurance frauds, as well as denied claims, and increased losses are quite common issues for health systems, hospitals, and physician practices, as well as ACOs. Conventional EHRs have also shown an absence of interoperability, due to which the healthcare providers cannot share the same information regarding the same patient who may need to go to different health systems for various ailments.

Some statistics

A study conducted in 2016 states that patient misidentification costs any given healthcare provider approximately $17.4 million yearly, as a result of denied claims, thus cutting down their revenue. According to the study, the more pressing issue is that these misidentifications not only cause losses but also hamper patient safety. The same survey states that 26% of the sample had witnessed a medical error firsthand or at least have known about it, which were generated by misidentifications.

What should be the unique patient identifier in healthcare?

Thus, it is seen how vital an effective patient identification system is for the healthcare industry. But what should the Senate choose as a unique patient identifier in healthcare and why? RightPatient is the answer. It is a biometric patient identification system that over one hundred respectable health systems are using, such as Novant Health, Duke Health, UMC, and TGMC. All of them are providing the same feedback – better patient experience, enhanced patient safety, and improved patient matching, all of which lead to reduced duplicate medical records as well as reduced insurance fraud. A patient only needs to register into RightPatient using their biometric data like their fingerprints or irises – afterward, they are identified within seconds, and their appropriate medical record is pulled from the EHR system. Thus, RightPatient seems like the perfect candidate to be a unique patient identifier in healthcare since it has the capability as well as the experience and proven track record to be one.

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Seven strategies ACOs use for better patient outcomes and lower costs

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According to recent studies, it is expected that Medicare’s projected spending will be well over $1.5 trillion by the year 2028 – that is more than double what the value was just two years ago! All Medicare asks from ACOs are better patient outcomes.

Many ACOs have already reduced costs and thus saved Medicare approximately $1 billion during 2013-2015. Not only did they reduce costs, but they also improved quality across the majority of the metrics required by Medicare. These exemplary ACOs depended on primary care visits, which they used to reduce ER visits and in turn, cut costs by around $700 per patient. 

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RightPatient enhances patient outcomes.

Some of the strategies which ACOs can follow to improve their healthcare spending patterns and generate better patient outcomes are: 

Collaborate with the physicians they work with

ACOs highlighted the fact that one of the ways to enhance the quality of healthcare as well as reduce the costs was to work closely with the assigned physicians. They also stated that these physicians are usually ordering services like lab tests for the patients or referring to other specialists without keeping the costs in check, and may inadvertently end up incurring more costs than necessary. However, if the physicians and ACOs collaborated frequently, the former can make informed decisions regarding the costs which will be beneficial for both the patients as well as the ACOs by reducing costs while keeping quality in check. Other than that, the physicians have to be busy with administrative issues, which can be quite hectic for them, which causes them to focus more on these tedious tasks rather than focusing on the patients. ACOs can collaborate with the physicians regarding these issues, as well, to reduce the time spent on such matters and focus more on the patients instead.

Encourage the patients to take initiatives regarding their health

A common yet effective strategy used not only by ACOs but by any health system is to encourage their patients to take charge of their health and adopt a better, more active lifestyle. However, ACOs are reporting that this can be quite challenging, especially if there are multiple physicians which is common in ACOs. What ACOs can do is adopt the strategy used by conventional health systems – use patient engagement apps like CircleCare. It has all the necessary features required for active patient engagement. Patients can track not only their steps but also keep track of their blood pressure, blood glucose level, schedule medicine reminders, and so on. It helps patients to maintain even the most complex medication routines as well as encourages them to lead a healthier lifestyle. However, these are not the only features of such apps, as will be explored further down the line.

Emphasize on patients requiring extra care

Care coordinators are professionals who are entrusted to make sure that the patients requiring extra care receive it, especially when they are discharged along with their proper medication as well as necessary materials. Nearly all the ACOs utilize such personnel who even help schedule follow-ups. However, ACOs can also use CircleCare in this context for better care, since these apps help patients and these caregivers to stay connected and exchange health information easily, perhaps about minor complications and so on. 

Reduce ER visits and readmission rates

Most ACOs face the problems of ER (emergency room) visits which in turn generate hospital readmissions, many of which are preventable. However, it is notably more of a concern for ACOs since they are fined based on the readmission rates. One strategy ACOs can use is providing digital solutions to patients such as patient engagement apps like CircleCare. Since these apps push the patients to be physically active, these can create better patient outcomes – the more active the patient, the healthier they will be. Also, since these apps have two-way communication facilities, they can contact their physicians regarding any minor health issues and resolve them outside the ACO premises, thus, reducing ER visits.

Enhance patient identification and data sharing

Patient identification is one of the major problems of the US healthcare system, and it is a massive concern for ACOs as well – they need to share patient data among themselves, and the data needs to be as immaculate and consistent as possible. Thus, ACOs can overcome the issues with conventional EHRs by using biometric patient identification solutions like RightPatient. It uses iris scanning to accurately identify the patients and match them with their appropriate records within seconds. This will improve the match rates as well as enhance the patient experience along with data sharing, which are all must-have features for any ACO as these lead to better patient outcomes.

Make sure medication adherence among patients is present

According to statistics, two-thirds of the prescribed patients are non-adherent regarding their medications. This generates 50% of treatment failures, causing up to 125,000 preventable deaths per year in the US. These could have been prevented if the patients were adherent to their medications, and for that, CircleCare is the perfect solution. Its medicine reminder makes medication adherence as easy as it gets – the patients using the app can set the type, color, look, frequency, dosage, starting/ending date, and duration through an intuitive yet simple interface. Even the most complex regimens become manageable due to CircleCare, ensuring medication adherence and thus fewer ER visits for ACOs.

Ensure patient education is provided

Patient education is another problem which generates frequent ER visits as well as hospital readmissions. Most patients have minimal knowledge regarding their health – 50% of them experience difficulty in understanding as well as using health information and 40% of them do not remember most of the information in the first place. CircleCare provides meaningful and easy to understand information for patients, customized according to their health conditions so that they can receive the latest knowledge regarding their health and make informed decisions if required. Moreover, it also provides general health tips regarding food and physical activities, which can help patients follow those tips for a better lifestyle and better patient outcomes.

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Unique identifiers will lead to a reduction of patient matching challenges

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Reduce-patient-matching-challenges-with-RightPatient

If you are a follower of this blog, then you will know how huge a problem patient matching challenges actually are for the whole healthcare industry. As the health systems are brainstorming workarounds to make sure patient matching is increased, they should also keep in mind some other factors. According to a report from Pew Charitable Trusts, if the industry wants to ensure that patient matching errors are eradicated or at least substantially reduced, they should focus on developing robust data standards and patient engagement alongside the search for an effective patient identification system.

Reduce-patient-matching-challenges-with-RightPatient

But why should it matter? According to the researchers, they have found positive correlations between patient matching errors and adverse effects. To put it simply, if a health system cannot match a patient correctly to his/her existing medical record, then problems like rising costs, medication errors, and adverse patient experiences will take place. Thus, patient matching is not an issue which can be underestimated. Concerns such as data integrity failures, lack of clean records, and patient mix-ups can all lead to patient identification errors and disrupt the patient experience as well as threaten patient safety. For example, if patient A has heart disease and patient B has kidney complications, and their records somehow got mixed up, then both of them will receive improper care, which could be fatal. Such mix-ups usually occur because of common names, demographics, addresses, as well as the format of the data stored within the EHRs of the patients. Formatting refers to how a health system saves the data and how many data fields it uses. For example, one health system may keep email addresses, whereas another one may not.

Another example can be a health system saving the full name of a patient in a single data field, whereas another may use three fields to save first, middle, and last names of the patients. Due to such errors, interoperability is generated as well. Other issues which cause patient matching errors can be incomplete or blank data. 

The research said that if common elements used by all the health systems were to be standardized, that is, the data is entered using a standard guideline rather than each health system doing so independently, these patient matching errors would decrease by a considerable amount. However, this may not reduce patient mix-ups between individuals with common characteristics like names and addresses, as these are still bound to happen. 

Another suggestion the research made was that active patient participation is needed to ensure that they are correctly identified and matched with their appropriate record. However, patients can sometimes absentmindedly or inadvertently choose a wrong record, while in other cases, the hospital staff may do it on their behalf and create a whole new record for the patient, known as a duplicate ID. 

The third and most effective suggestion the research made was to emphasize on using a unique patient identifier, something along the lines of RightPatient, that is, biometric patient identification systems. The study has shown that such a system helps in improving accurate patient identifications. The research further stated that biometric modalities are unique, cannot be counterfeited, and have excellent potential in the healthcare industry. They also found that hundreds of health systems have widely utilized some form of biometric patient identification system, and among them, one health system stated that over 90% of their patients accepted to use their biometrics to be identified since it is easy to use as well as accurate. Both the providers of healthcare as well as the receivers agreed that biometrics are helping to reduce patient matching challenges. 

RightPatient falls in line with the research’s suggestion. It is a biometric patient identification system which uses iris scanning to identify patients. Once a patient’s irises are registered into the system, the data is then integrated with the patient’s health record. All the patient needs to do is look at their camera – RightPatient then accurately matches him/her with the proper ID – it is that easy and convenient. Since it does not require any physical contact, there are no risks for contracting new diseases during the identification process. Even the health systems love RightPatient since, with its help, the physicians can focus more on the patient rather than spend time matching the patient with the correct record, enhancing the patient experience along the way. Over one hundred health systems are using it and have reported that it has reduced losses which they incurred due to patient matching challenges, saving millions of dollars in the process.