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Healthcare Data Breach Cases Lead to Medical Identity Theft – How Are You Protecting Patients?

Anyone who knows about the US healthcare system also knows that it has always been riddled with issues, even before the COVID-19 pandemic hit. Astronomical costs, the lack of price transparency, and the insurance system are not the only problems. Poor healthcare outcomes, preventable medical errors, medical identity theft, duplicate medical records, and lack of interoperability also plague healthcare facilities across all states. While we have covered many of these topics at one point or another, this time we will focus on healthcare data breach cases. Let’s take a closer look at recent healthcare data breaches, why providers are being targeted so frequently, how they generate medical identity theft, and how healthcare providers can protect patient data even after breaches.

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Healthcare data breaches are becoming increasingly common

When the pandemic hit the US healthcare system, many hackers had pledged that they won’t attack healthcare providers and steal patient information – something that was unprecedented. However, not all of the hackers shared the same mindset, and there have been many healthcare data breach cases over the past few months. As a result, healthcare providers are having to fight multiple battles at the same time. Let’s review two of the recent attacks.

UHS reportedly suffered a huge breach

Pennsylvania-based Universal Health Services, a health system that consists of 26 hospitals, suffered a breach. On the 30th of September, they stated that some of the systems had been recovered. While there are no specifics as to how many patients were affected, the health system was forced to go offline on all of its locations to reduce the risks. However, it is working tirelessly to restore the affected systems.

Ashtabula County Medical Center

The Ohio-based medical center also suffered a cybersecurity attack on the 27th of September which forced it to cancel procedures.

What are healthcare providers saying regarding data breaches?

Many are stating that healthcare data breach cases are becoming quite common and they need better cybersecurity measures to reduce these unwanted events. While cybersecurity has always been a concern of CIOs and IT leaders, the budgets don’t allow them to realize their visions of having breach-free health systems. Moreover, they are expecting even more data breaches in the future, as they don’t see data breaches going away anytime soon. Sadly, the problems do not end here.

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Healthcare data breaches generate medical identity theft

Data breaches are huge nightmares for any healthcare provider. The worst part is that they’re inevitable, and even the biggest health systems can be vulnerable – hackers are constantly uncovering new strategies to attack and steal patient information. 

After stealing the patient information, fraudsters buy it from the black market and they assume the identities of the patients. Not many healthcare providers have effective patient identity management systems, so scammers can easily pass themselves off as the patients, since they have their credentials. If providers use effective patient identification platforms, they can prevent medical identity theft in real-time. Thus, while data breaches are inevitable and, without proper cybersecurity measures, unavoidable, medical identity theft can be prevented.

RightPatient mitigates the losses associated with data breaches

Using a robust photo-based engine, RightPatient ensures accurate patient identification using the feature fraudsters or hackers cannot steal or imitate: patients’ faces. 

The platform can also identify patients right from appointment scheduling – patients are asked for a personal photo and a photo of their driver’s license after scheduling an appointment. After patients provide the photos, RightPatient matches the photos to verify the patient’s identity to see if they are who they say they are. If a fraudster is assuming the identity, RightPatient red-flags the anomaly, preventing medical identity theft in real-time. New patients are provided with biometric credentials, making it a seamless process.

If the patients are coming in person to the healthcare facilities, all they need to do is look at the camera. RightPatient matches the new photo with the saved one – if it’s a scammer, RightPatient red-flags the incident, preventing medical identity theft. It ensures a touchless and hygienic environment for everyone, something that is mandatory in a post-pandemic world.

RightPatient is enhancing patient safety, protecting patient data from being corrupted, and improving healthcare outcomes. Mitigate your losses, prevent medical identity theft, and enhance patient safety now with RightPatient.

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Medical Identity Theft Prevention Becomes Crucial as Telehealth Usage Rises

The novel coronavirus, infamously known as COVID-19, is a phenomenon that has changed our lives forever. Wearing masks, using sanitizers, and practicing social distancing has become a part of our daily lives, especially for those who need to leave their houses every day. It has disrupted business operations and even forced many into bankruptcy, causing businesses to shut down. One of the most affected industries is healthcare, and it is safe to say that the US healthcare system has been severely affected by the pandemic. Hospitals have shut down, and those that are open are facing unprecedented losses. However, telehealth has experienced a meteoric rise in both popularity and usage. While more patients and caregivers are adopting telehealth, healthcare providers need to ensure that such visits are not plagued with medical identity theft cases. Let’s take a look at the rapid rise of telehealth, how people are adapting to it, and how medical identity theft prevention can be ensured with RightPatient.

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Telehealth is becoming mainstream

Let’s take a look at a recent survey by Amwell. The research sheds light on the fact that patients and caregivers are far more open to using telehealth now compared to the pre-pandemic period. The numbers clearly illustrate this: in 2019, 8% of patients and 22% of caregivers had virtual sessions, whereas in 2020, the number is around 22% for patients and a whopping 80% for caregivers. This is predominantly because the pandemic forced hospitals to shift their focus to the COVID-19 patients, leaving others with the option to get treated via virtual sessions rather than inpatient visits.

Some of the key findings from the study regarding telehealth are:

More scheduled virtual visits compared to urgent care visits

According to the survey, patients leaned towards scheduled virtual visits compared to urgent care visits. 54% of patients had scheduled virtual visits with their physicians, whereas 21% of patients who had at least a virtual visit had an urgent care visit as well during 2020.

Virtual specialty care is growing rapidly

Unsurprisingly, telehealth is being used by more patients every day. 42% of patients had virtual visits with their regular specialists, and 13% had virtual visits with new specialists this year. Moreover, specialists such as cardiologists, surgeons, and others stated that they had seen more patients virtually compared to 2019. This led to specialists being more open to telehealth as well – it was the only way to treat some patients due to COVID-19.

More patients were opting for telehealth

2020 had three times the number of patients using telehealth compared to 2019. 59% of the patients who used telehealth stated that their first usage was during the pandemic, and an overwhelming 91% of the patients were “very” or “somewhat” satisfied with the visits.

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Healthcare providers, on the other hand, said that they saw almost four times more patients this year compared to 2019, and 84% of providers were “very” or “somewhat” satisfied with the platforms. 

Medical identity theft prevention must be ensured

While all of the above statistics show that telehealth has a promising future ahead, it also has to ensure patient safety. There are many risks associated with conventional inpatient visits such as medical identity theft, patient misidentification, medical errors, and so on. While not all of these issues will bleed over to telehealth, many experts are predicting that telehealth might witness medical identity theft cases. Thus, responsible caregivers should ensure medical identity theft prevention to secure safe, undisrupted healthcare visits – for both virtual and inpatient visits.

How data breaches, medical identity theft, and telehealth are related

Healthcare data breaches are becoming common because hackers can steal patient information and sell it for up to $1000. Data breaches are endless nightmares for healthcare providers – causing HIPAA compliance issues, loss of goodwill, unwanted publicity, and finally, medical identity theft. Fraudsters buy the information from the hackers to assume the identities of the patients and use the victims’ healthcare services illegally. Since many healthcare providers don’t have robust patient identity verification systems, they are unable to identify the scammers. These are the cases that occur within healthcare facilities. 

Telehealth has been largely ignored in the pre-pandemic world. People were debating about its pros and cons, and since it didn’t provide the same level of flexibility as conventional healthcare, its future was uncertain. However, the pandemic changed the public’s perception regarding telehealth. As the statistics above demonstrated telehealth’s acceptance, experts have predicted that hackers and fraudsters will focus on it as well. If they acquire the login credentials of patients, fraudsters can also impersonate the victims during telehealth sessions, committing medical identity theft virtually. Thus, medical identity theft prevention becomes crucial.

RightPatient ensures medical identity theft prevention

Thankfully, healthcare providers can prevent medical identity theft with RightPatient. It is a touchless biometric patient identification platform that uses the faces of the patients to prevent healthcare fraud and protect patient data. With a powerful photo-based engine, RightPatient ensures that the patients are who they say they are. After scheduling appointments, patients receive an SMS or email and they need to provide a personal photo and a photo of their driver’s license to verify their identity. The platform automatically matches the photos, ensuring remote identity verification.

RightPatient ensures accurate patient identification across the continuum of care, starting right from appointment scheduling. During hospital visits, all the patient needs to do is look at the camera – the platform matches the current photo with the one saved during registration, creating a touchless, easy, and hygienic experience. RightPatient is preventing duplicate medical records, reducing claim denials, preventing medical identity theft, and enhancing patient safety for leading healthcare providers. Be a responsible provider and protect patient data with RightPatient now.

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Patient Safety and Quality Improvement Can be Achieved with Positive Patient Identification

Among the several issues faced by the US healthcare system, one of the more prominent is patient misidentification. We know this to be true because even during the coronavirus pandemic, experts have stated that patient matching issues were continuing. Moreover, coalitions were formed to demand the fabled “unique patient identifier” once again. But why do healthcare providers demand patient identifiers time and again? Let’s take a look at some statistics that show how serious the issue is, some consequences caused by the absence of effective patient identification, and how patient safety and quality improvement are related to it.

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Patient identification issues are nothing new

The last decade has been a transition towards technology for the US healthcare system. Caregivers such as physician practices, hospitals, and health systems have made the jump from traditional paper medical records towards the more standard electronic health records (EHRs). However, as they did so, they saw the issues that occurred due to the absence of an effective patient identifier nationwide. One of the biggest challenges is matching patients to their accurate medical record whenever they arrive for healthcare services. Let’s review some recent statistics about how common misidentifications are. 

Some stats to back it up

According to a study conducted by eHealth Initiative, approximately 38% of the respondents have suffered from an unwanted event caused by patient misidentification within the last 2 years. Many of these events are caused by duplicate medical records, and an overwhelming 66% of the respondents blame data entry errors that lead to duplicates. Moreover, 80% of the providers have dedicated FTEs (full-time employees) or third-party contractors to solve these issues. The biggest barriers to reducing poor patient matching were the lack of prioritization and the lack of technology. 32% of the caregivers stated that they had around 3-10% duplicates within their EHR systems. All of these statistics show that patient misidentification is growing and needs to be addressed by caregivers. Fortunately, many hospitals and health systems are already using touchless patient identification platforms like RightPatient to solve these issues, but more on that later. Let’s see how patient misidentification is a barrier to patient safety and quality improvement.

Patient misidentification hampers patient safety and quality improvement

While patient misidentification causes a lot of problems for any given caregiver and patient, let’s take a look at how it impacts patient safety, and in turn, healthcare quality.

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Patient misidentification is closely related to duplicate medical records

Duplicates can lead to patient misidentification and vice versa. For instance, if a patient comes in and provides their nickname instead of the name on the medical record, the registrar won’t be able to accurately identify the medical record. Thus, after failing to find the record, a new one gets created, leading to another duplicate record within the EHR system.

Likewise, if there are many duplicates within the system against the same patient, there are high chances that all of them have incomplete and inconsistent information. This will lead to matching the patient to the improper medical record. Both of these scenarios will lead to incorrect procedures, adversely impacting patient safety.

Patient misidentification hampers patient data integrity

As previously stated, data entry errors are quite common during registration. Thus, if patients are associated with the wrong medical record, they will be treated based on someone else’s medical history, illnesses, allergies, and so on. One single pill can severely impact the patient’s health – one can imagine what would happen if the whole procedure was wrong! Such cases have led to delayed care, repeated lab tests, and compromised patient safety.

Patient misidentification leads to medical errors

Quite closely tied with the previous point, patient safety and quality improvement cannot be achieved if medical errors keep occurring. While medical errors happen for a variety of reasons, many are preventable, and as stated previously, 38% of the healthcare providers surveyed reported that they suffered from medical errors tied to patient misidentification. These errors could have easily been prevented had the caregivers used robust patient identity matching solutions.

Patient safety and quality improvement is achievable with RightPatient

Leading healthcare providers such as Catholic Health Services of Long Island, Terrebonne General Medical Center, Community Medical Centers, among others, have been using RightPatient and improving patient safety and quality of care. As the healthcare industry’s leading touchless patient identification platform, RightPatient has years of experience helping hospitals and health systems identify patients’ accurate medical records across the continuum of care. The platform uses patients’ photos to identify their accurate medical records, prevent medical identity theft, avoid duplicate records, and prevent medical errors – enhancing patient safety and ensuring a hygienic environment that will be crucial in a post-pandemic world.

Contact us right away to learn how we can help you achieve your goals.

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Patient Matching and Interoperability Are Ineffective Without Positive Patient Identification

The U.S. healthcare system has been inundated with several issues even before the pandemic. The lack of price transparency, medical identity theft, duplicate medical records, high costs, medical errors, and patient safety issues are just some of the issues plaguing providers. However, today’s focus is on another problem – the lack of interoperability. Many providers are thinking that interoperability will get a significant boost due to changes such as the 21st Century Cures Act and the CMS Interoperability and Patient Access Final Rule. While that might be true, many are overlooking the fact that it needs a particular component to work immaculately – patient matching. While some might believe that it is just a cog in the wheel, everything in healthcare heavily relies on accurate patient identification – without it, everything will go wrong.

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Let’s take a closer look at the rules, how they will boost interoperability, and why patient identification is crucial for interoperability to work.

The 21st Century Cures Act and Patient Matching

What it means

Several healthcare experts are quite content with the Cures Act, believing that it will usher in the era of true interoperability. In a nutshell, the implementation of certain provisions within the act will enhance interoperability and also support accessing, exchanging, and using electronic health information. What all this means is that patient data can be easily shared among caregivers, leading to better, more personalized care, as well as enhanced healthcare outcomes – but that’s only one side of the coin.

Interoperability requires more than the Cures Act

While the Act is a step in the right direction, interoperability won’t be successful solely because of it – other factors need to be considered. The most important factor is patient matching.

Imagine a scenario where a healthcare provider is abiding with the Act and has taken all the necessary measures to do so. However, due to issues like patient misidentification or duplicate medical records, matching patients to their proper EHRs will become nearly impossible. As a result, the wrong medical record will be sent to the wrong caregiver – jeopardizing patient safety and adversely affecting coordinated care efforts along the way. Thus, proper patient matching is an absolute must to make sure that the patient data exchanges are successful and error-free. Healthcare providers can do so by ensuring accurate patient identification across the care continuum by using solutions like RightPatient – more on that later.

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The Interoperability & Patient Access Final Rule

We’ve already talked at length about this rule and how it will enhance interoperability as well. In a nutshell, healthcare providers using EHR or EMR systems need to enable e-notifications support so that they can receive and send out real-time notifications during ADT (admission, discharge, and transfer) events with the patients’ other caregivers. While this rule has been established to boost interoperability and coordinated care efforts, this also requires proper patient matching. If a patient is misidentified, the caregiver will send out false alerts, jeopardizing the care coordination efforts. It will also put the provider’s CMS reimbursements at risk.

Thus, patient identity matching must be accurate at all times, if the providers want to ensure CMS compliance and abide by the 21st Century Cures Act. This is where RightPatient can help caregivers ensure accurate patient identification – and more.

RightPatient can improve patient matching 

RightPatient has years of experience with reputed healthcare providers such as Terrebonne General Medical Center, Community Medical Centers, and University Medical Center. It is a touchless patient identification platform that identifies patients with the element that cannot be copied or stolen – their face. Right from appointment scheduling, the platform ensures remote patient authentication – patients are asked for a selfie and a photo of their driver’s license. RightPatient matches the photos and ensures that patients are identified accurately – ensuring positive patient identification.

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3 Patient Safety Measures Hospitals Must Take in a Post-Pandemic World

COVID-19 has changed reality for us – it has changed the way we lead our lives. Sanitizers, masks, and social distancing have become quite integral parts of our daily lives now. Wherever we go, social distancing practices are encouraged for a safer environment. However, it has shaken the healthcare systems of the world to their core, especially that of the U.S. With the highest number of cases in the world (as of now), hospitals are slowly opening their doors for regular patients. Keeping that in mind, hospitals must take patient safety measures while they are opening to ensure that patients receive care in a safe and hygienic environment. Let’s take a look at some common steps hospitals can take to prevent patient safety issues.

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Some insightful statistics

According to a survey by Sage Growth Partners, 24% of the respondents (healthcare professionals) believe that issues such as disparate EHRs and lack of actionable data at the point of care lead to patient safety issues.

Improving patient safety is also among the top three priorities of the respondents, besides delivering high-quality care and increasing efficiency and reducing costs – all of which can be done by ensuring accurate patient identification (more on that later). 

Let’s explore what kind of patient safety measures will help hospitals enhance patient care.

Patient safety measures that can help enhance patient care

Planning everything well in advance

While many might think that everything is slowly returning to normal, it’s quite the opposite. Working from home is still being utilized by most organizations, social distancing is still being practiced, and wearing masks and sanitizing regularly are still highly encouraged.

Since hospitals are opening slowly, they should plan every step carefully along with contingencies while keeping worst-case scenarios in mind. Hospitals need to plan the opening days and rather than opening the whole facility at once, they should open in phases. This will help reduce the risk of any mass outbreaks of COVID-19 – managing a mass outbreak at a single location will be much easier than managing outbreaks at all the facilities.

Also, hospitals should decide at what capacity will they operate and the duration for that testing phase. If all goes well, they can slowly increase the capacity of patients they will be serving. 

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Finally, the inventory required for all of the above needs to be planned to ensure that the necessary materials are available at all times. For instance, PPE has become quite critical, and these should be ordered well in advance before the stock runs out within the facilities. Thus, instead of reordering the materials when they’re at 30%, they should be reordered at, say, 45% – these are essential materials, after all.

Enforce safety measures for everyone

It goes without saying that every individual must practice a minimum level of social distancing to help themselves and others stay safe from the novel coronavirus. Sadly, not everyone follows that. Thus, the hospitals must enforce that everyone within the facility must follow the social distancing rules to a T. Not only is this one of the most common patient safety measures, but it also enhances safety for the physicians, nurses, and every other healthcare staff. 

Keep brightly colored posters in places where they will catch everyone’s attention. Place stickers on the floor with six feet between them to show where patients or caregivers must stand, especially in busy places like registration desks. Make sure that everyone is wearing masks and that sanitizers are available everywhere. Keeping the facilities hygienic is crucial to enhance patient safety.

Ensure accurate patient data

One of the most crucial factors that make or break patient safety is patient data, as the former is heavily reliant on the accuracy of patient data. Imagine this, if the patient is treated based on inaccurate patient data, they will face delayed or incorrect medications, leading to poor healthcare outcomes. One of the most common ways patient data gets corrupted is via duplicate records. 

If a patient has multiple records, there are high chances that the registrar will select the one with inconsistent or fragmented data, leading to adverse outcomes. Thus, ensuring that patient data integrity is maintained at all times is crucial for improving patient safety. Fortunately, RightPatient does all that – and more.

RightPatient is the leading patient identification platform used by healthcare providers like Terrebonne General Medical Center, Grady Health, and Catholic Health of Long Island. With a robust photo-based engine, it ensures that the patients are identified accurately at all times across the care continuum, helping patient data integrity by avoiding duplicate medical records. Moreover, it ensures that the patients are who they say they are and not impostors, preventing medical identity theft in real-time.

Finally, a platform like RightPatient is critical in a post-pandemic world because it is entirely touchless. Thus, it helps caregivers and patients operate in a hygienic environment by preventing infection control issues.

Use RightPatient now and enhance patient safety at your facilities, prevent medical identity theft, and prevent duplicate medical records – enhancing patient data integrity along the way.

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

Patient safety is one of the more integral aspects of any given healthcare system. It ensures that patients are getting the required treatment without any medical errors or harm, healthcare outcomes are optimal, and healthcare services are delivered to the highest possible standard. While those are the common aims, the reality is quite different in the U.S. healthcare system. It has always been inundated with a number of serious issues – healthcare data breaches, medical identity theft, patient identification issues, lack of price transparency, and duplicate medical records are just some of them.  The root cause of many of the issues are duplicate medical records. While we already had a closer look at duplicate medical records and how it impacts revenue cycle optimization, let’s have a look at how preventing duplicates can lead to enhanced patient safety and quality, among other things.

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How duplicates impact patient safety and quality of healthcare

In a previous article, we’ve already seen how medical record errors like duplicates and overlays are created and how they cause claim denials. Let’s see how they impact patient safety and quality of healthcare as well.

AHIMA’s Shannon Harris and Shannon H. Houser stated in an issue of the Journal of AHIMA that duplicates and overlays don’t only cause financial woes, but lead the physicians and healthcare staff to inadvertently causing medical errors. For instance, imagine that a single patient has duplicate medical records in a hospital’s EHR system. While treating the patient, the physician will see the duplicates but chooses the one that has obsolete information. Since the information is not updated, the treatment or medication might very well cause adverse effects. Such cases might even lead to transferring the patients for emergency treatments, leading to jeopardized patient outcomes.

That’s not the only way duplicate medical records impact patient safety and quality of healthcare – let’s look at the latter. When you have fragmented information within duplicate records, issues such as repeated lab tests and delays in treatment are quite common. Since the majority of the healthcare providers’ registration systems have ineffective patient identity matching techniques, the number of duplicates keeps on increasing, leading to patient safety issues, patient data corruption, and financial troubles in the form of denied claims. 

How are hospitals addressing duplicates?

Sadly, rectifying duplicates and overlays are quite complex and a nightmare for any given healthcare provider. While most of the hospitals are trying to fix duplicates by reallocating their HIM resources and even dedicating some of their FTEs (full-time employees) to identify and rectify the erroneous records, unless they address the frontend issues (read: identify patients accurately), it will be a never-ending cycle. Patients will be misidentified, duplicates will be created, and FTEs will be assigned to fix them on the backend, taking up valuable time and resources.

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So, can hospitals address these issues and prevent duplicate medical records on the frontend?

RightPatient enhances patient safety and quality of healthcare

As previously mentioned, if the patients are accurately identified during the registration process, duplicates can be prevented right from the beginning. That’s what we do best with our industry-leading patient identification platform. RightPatient, with its touchless design, ensures that patients are identified across the care continuum, starting from appointment scheduling. Patients only need to provide their selfies and a photo of their driver’s license when they schedule appointments. RightPatient matches the photos and makes sure that the accurate patient record is identified every time the patient accesses healthcare services, remotely or otherwise.

When the patients arrive at the hospital, all they need to do is look at the camera – RightPatient matches the saved photo and the real-time photo during the check-in process, preventing duplicates, eliminating denied claims, and enhancing patient safety. The best part of RightPatient is that the entire identification process is touchless, creating a safe environment for all involved in a post-COVID-19 world.

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Revenue Cycle Optimization Efforts Are Hampered by Duplicate Medical Records

Medical record errors such as duplicate medical records and overlays are issues that keep resurfacing time and again, especially when they lead to patient identification errors. We’ve already taken a closer look at duplicate medical records, how they are created, and how they impact patient safety. However, these are not the only problems medical record errors create. Another prominent issue is that duplicates jeopardize your revenue cycle optimization efforts by creating denied claims. Let’s take a look at exactly how that happens, how denied claims can take up your valuable resources, and how RightPatient can help combat duplicates and overlays, and in turn, optimize revenue cycle management.

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How duplicates get created

To understand how duplicate medical records affect the revenue cycle, let’s take a brief look at how duplicates and overlays get created. These usually originate during the registration process, especially if the healthcare providers don’t have any effective patient identity verification system in place.

For instance, patients keep coming in and they need to be identified immediately so that they can be treated. This clearly shows that hospital registration desks are environments that are always hectic and staff is under pressure, more so for busy or larger hospitals. If you factor in outdated or ineffective patient identification platforms, duplicates are bound to occur, along with problems such as infection control issues that are associated with touch-based patient identification platforms.

Coming back to duplicates, the registrars have a very small window to identify the accurate medical records from an EHR system that might house thousands of records. Name changes, common names, misspellings, and nicknames only make matters worse. For instance, the medical record is saved under the name “Richard Grayson”, but the patient uses his nickname “Rick Grayson”. These are bound to create identification issues, and when the registrar can’t find the accurate record, they might end up creating a new one – leading to a duplicate record. Furthermore, existing duplicates will create more confusion for the registrars – AHIMA (The American Health Information Management Association) has stated that larger healthcare facilities have around 20% duplicates.

That’s how medical record errors usually begin, and while we’ve already talked about how it impacts patient safety, how exactly does it affect revenue cycle optimization and a hospital’s financial performance? Let’s analyze the issue.

How revenue cycle optimization is hampered by duplicates

According to a Black Book report, 33% of denied claims were caused by patient identification errors in 2017, costing the average healthcare provider $1.5 million and the entire U.S. healthcare system a whopping $6 billion per year. Let’s see how duplicates lead to denied claims that hamper the revenue cycle.

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It’s quite straightforward – as duplicate medical records consist of incorrect, obsolete, fragmented, or incomplete information, these lead to coding and billing errors. Moreover, as duplicates hamper patient care, litigation costs regarding such cases are not unheard of. Not only do healthcare providers lose money, but they also lose their goodwill – these stories spread like wildfire, whenever they occur.

Coming back to duplicate records and revenue cycle, let’s take a look at how they are related. One of the more common places where denied claims occur due to duplicates is during surgical procedures, according to an article from HIM Briefings. Let’s use the example provided by Letha Stewart from QuadraMed within the article.

During the presurgery phase, the patient comes in and is registered as “Richard Grayson” and has the medical record number 111. As previously mentioned, common names lead to confusion among the registrars, and thus, without an effective patient identifier, the registrar couldn’t find the accurate medical record on the day of the surgery. As a result, a new record gets created under “Rick Grayson” with a different number, for instance, 222. When the insurance provider verifies the claims regarding this surgical procedure, it will notice the glaring discrepancy – there are different medical records involved for a single procedure. Moreover, the insurer most likely will use the patient record available at their end, and seeing that the records don’t match, the claim will be denied. While this is a simple but illuminating scenario, this is how most of the claim denials that stem from duplicate medical records occur. To sum it up, incorrect, fragmented, or incomplete patient data and discrepancies lead to denied claims that impact revenue cycle optimization efforts.

Providers dedicate FTEs for fixing medical record errors

Duplicate records and overlays need to be identified and fixed to prevent impediments to revenue cycle optimization. Most providers do that by dedicating their full-time employees (FTEs) from their HIM departments. While these activities are necessary, they also consume a significant amount of resources and time. According to Stewart, many providers dedicate around five FTEs to solve these issues. However, if providers don’t have an effective patient identifier in place, they cannot take the load off their FTEs and they’ll need to continue fixing these errors for quite some time, leading to lower productivity and higher costs. Given the current pandemic, providers need to mitigate costs as much as possible. That’s where RightPatient can help them.

RightPatient enhances revenue cycle optimization

As we’ve mentioned several times, going to the root of the issue, patient identification, is the best strategy. If you avoid duplicates and overlays at the frontend, you won’t have to deal with them later and face consequences like denied claims, allocating FTEs for fixing the issues, and higher costs. But how can RightPatient help with that?

RightPatient is the leading touchless biometric patient identification platform used by many providers to prevent duplicates. With its photo-based search engine, RightPatient identifies patients from appointment scheduling and beyond. Be it remote patient validation or identification within the healthcare facility, RightPatient ensures that the correct medical record is provided every time within seconds. Reduce denied claims, prevent duplicates, and enhance patient safety with RightPatient now.

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CMS Interoperability and Patient Access Final Rule Requires a Robust Patient Identification Software

This has been quite a year for the U.S. healthcare system – nobody could’ve predicted all the series of events. While the novel coronavirus is still raging on, telehealth is experiencing unprecedented growth. On the other hand, hospitals are facing immense financial strain due to the pandemic’s consequences such as the cancellation of elective procedures and lower inpatient visits. However, despite all the recent developments healthcare providers need to work on something else as well – supporting e-notifications. CMS has made some additional changes to the Medicare Conditions of Participation (CoPs), and while providers will be busy brainstorming about how to best approach the requirements, many will overlook one critical factor that will either make or break their e-notifications – patient identification. Let’s take a look at what the rule specifically says about e-notifications, who is eligible, how it helps caregivers, and how a robust patient identification software like RightPatient is a must for ensuring proper e-notifications.

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The Interoperability and Patient Access Final Rule – in a Nutshell

While the rule itself is quite vast and detailed, we’ll cover the e-notifications part briefly. The basic meaning of the rule is clear from its name. For years, the U.S. healthcare system has been suffering from the lack of proper interoperability for a number of issues – patient misidentification being a major reason. However, with the “companion final rule”, as per CMS, things are about to change for the better, as it will introduce a certain level of interoperability that will ultimately boost coordinated healthcare efforts.

The “companion final rule” states that healthcare providers such as critical access providers, acute care, or psychiatric hospitals must send out real-time e-notifications during ADT (admission, discharge, or transfer) events to a patient’s caregivers such as established primary care practitioners, post-acute providers & suppliers,  primary care practice groups & entities, as well as any other practitioners, groups, or entities primarily responsible for the patient’s care. The information sent must contain the patient’s name, the treating practitioner’s name, and the sending institution’s name, at the very least. Finally, these are applicable during inpatient ADT events and ED admissions or discharges.

Any caregiver that uses digital medical records such as EHRs or EMRs must support e-notifications by May 1, 2021, to ensure CMS compliance.

With that out of the way, let’s look at how the rule requires accurate patient identification and how a robust patient identification software is critical for its success.

Why patient identification will make or break your CMS compliance

Healthcare providers are already busy working on e-notifications support, and while there are a lot of great solutions out there, providers shouldn’t forget the foundation upon which e-notifications depend on – proper patient identification.

The Interoperability and Patient Access Final Rule requires hospitals to identify their patients accurately across the care continuum, especially if they want to send out e-notifications to the proper caregivers. Sadly, patient identification has always been problematic – it is an overlooked but significant concern for the U.S. healthcare system. One might ask how are patient identification and e-notifications related – let’s learn more.

Imagine this – a hospital already has patient misidentification cases because they don’t use an effective patient identification software. If a patient comes in and is misidentified, not only will the treatment be affected, but the hospital will be sending out false alerts to the wrong caregivers. This will wreak havoc for all the caregivers involved with the patient. 

If such cases become common, then the patients, as well as the care coordination teams, will start questioning the credibility of the caregiver sending out false alerts. As a result, the hospital will lose goodwill and risk its CMS reimbursements. After COVID-19, not a single hospital can afford to make such mistakes – the pandemic has already caused the worst financial strain on hospitals and health systems in recent times. Thus, patient identification is a crucial component for the e-notifications to work. If caregivers don’t have a robust patient identity matching system in place, they need to upgrade it before the e-notifications support deadline.

RightPatient is the most robust patient identification software

RightPatient has been accurately identifying patients for years. With its touchless patient identification platform, RightPatient ensures that patients are identified accurately and safely right from the start.

After a patient schedules an appointment, they are sent an SMS or email and are required to provide a selfie and a photo of their driver’s license. The platform automatically matches the photos and remotely ensures patient identification. If it’s a new patient, the platform will automatically assign new biometric credentials for them. 

During hospital visits, patients only need to look at the camera – RightPatient matches the saved photo with the photo taken by the camera – ensuring accurate patient identification. Best of all, it’s an entirely touchless process, something that is mandatory in a post-pandemic world.

RightPatient is the leading patient identification software in the healthcare industry and is used by prominent caregivers such as Terrebonne General Medical Center, Community Medical Centers, and Catholic Health Services of Long Island. Be a responsible healthcare provider and upgrade your patient identification system now to prevent misidentification cases, medical identity theft, and ensure compliance with the Interoperability and Patient Access Final Rule.

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

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

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UPI’s history in a nutshell

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

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

Lack of effective patient identification is felt throughout healthcare

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

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

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How many patient identifiers should be used?

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

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

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

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

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

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5 Tips for Preventing Medical Identity Theft in Healthcare

Hospitals, medical centers, and physicians’ offices are not only places where patients should feel safe about getting the right medications, but it should be a place where they also feel safe with their sensitive information. Unfortunately, with the rise in the number of healthcare data breaches, the market is even riper for medical identity theft. Over 41 million patient records were breached in 2019 alone and the majority of them were associated with hacking or cyber attack-related incidents. 

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Preventing medical identity theft has been one of the top priorities, yet many organizations still rely on antiquated patient identity management solutions. Many leading hospitals, namely, Terrebonne General Medical Center and The University Healthcare System have been successful in preventing medical identity theft and benefitted in many other ways since using RightPatient. Other benefits include eliminating duplication of medical records, improving patient identity matching rates, clinical efficiency, and boosting the overall revenue cycle. But what about medical identity theft? How are patients affected by it? What are the ways for preventing medical identity theft? Let’s find out.

What is Medical Identity Theft?

Medical identity theft occurs when a fraudster uses someone else’s personally identifiable information (e.g. name, DOB, Social Security Number, health insurance number) to fraudulently receive medications or services, including attempts to falsify medical billings. The healthcare industry would have billions of dollars in surplus if all healthcare providers could prevent medical identity theft. This crime involves the fraudulent use of someone’s health insurance information to obtain reimbursement for healthcare-related services provided to a person not covered by the policy. This is one of the most common reasons for the rise in the numbers of claim denials. It affects revenue integrity and requires organizations to put in more strenuous efforts and resources to identify and resolve the problem throughout the revenue cycle management.

How are patients affected by medical identity theft?

Patients may not be able to afford the cost: Financial consequences for the victims of medical identity theft can exceed the cost of credit card fraud. According to a study conducted by the Ponemon Institute, medical identity theft can cost an average American $13,500 to resolve.

Victims may not be aware of their information being stolen: In most cases, insurers or healthcare providers rarely inform the patients about the crime. In general, victims are completely unaware of when they became a victim and learn about the theft of their credentials about three months after the crime has occurred.

Reputations can be on the line: Found in many studies, victims said that their reputation was affected because of medical identity theft due to disclosure of personal sensitive health information. Many respondents believe they missed out on good career opportunities due to identity theft. Some said it resulted in the loss of their job.

5 Tips for Preventing Medical Identity Theft

Invest in modern patient identity management technology and software

With the transition of paper-based patient’s records to electronic-based record-keeping systems, it is necessary to invest in modern technology and software for preventing medical identity theft. For better security and matching rates, many healthcare providers have adopted RightPatient – a leader in touchless biometric patient identity management solutions. With RightPatient, healthcare providers can verify patients’ identities and protect access to medical records. RightPatient does not only help in preventing medical identity theft but it also drastically improves patient matching rates and eliminates the creation of duplicate records.

Just as facial recognition or iris scanning techniques are used in smartphone devices today, this platform uses similar biometric techniques in a healthcare setting for authenticating and verifying an individual’s identity. RightPatient uses an individual’s iris pattern or photos of their face to lock their medical records. Each time a patient arrives at the continuum of care, the platform will scan their iris pattern or photos of their face to authenticate their identity and retrieve their correct medical records. With secure-log-in monitoring, fraudsters will be instantly denied when they try to gain access to medical records by assuming someone’s identity. 

Automating the patient registration and enrollment process

Automating the patient registration and enrollment process can eliminate the hassle of a long, complicated registration process, save valuable time and resources, and reduce errors at the same time. Criminals can easily obtain or use someone else’s common identifiers, such as names, SSNs, and DOB for fraudulent use. Many times common identifiers have also been the main cause of the creation of duplicate identities or record mismatching. Paper-based records are also vulnerable to how easily they can end up in the wrong hands. With RightPatient, transitioning to an automated patient enrollment system will be seamless. 

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Streamline workflow and maintain compliance

Protected health information (PHI) is like a treasure box for cybercriminals and thieves. PHI contains valuable sensitive information and can easily be worth more than credit card numbers on the black market. This is why the Health Insurance Portability and Accountability Act (HIPAA) was established to ensure confidentiality, integrity, and availability of PHI. HIPAA requires healthcare organizations to implement appropriate safeguards to better protect patients’ information so it doesn’t end up in the wrong hands. Maintaining compliance with HIPAA can be quite strenuous, but organizations can use HIPAA compliance software to streamline their compliance efforts and reduce administrative burden. Adopting the best security practices to limit unauthorized access or disclosure of patient information is crucial for preventing medical identity theft.

Robust bring your own device (BYOD) and network access policy

Personal devices should be secured before accessing a patient’s information across the network. A proper BYOD policy must be developed and maintained. For instance, is it safe for employees to bring company-issued devices back home? Many times, thieves get access to sensitive information when devices such as laptops, tablets, or smartphones get stolen from the office, home, or even from a car. Hospitals should also install a separate internet wi-fi network for visitors and patients to restrict access to the organization’s internal network. 

Educate your employees and patients and instill a culture of best privacy practice

Not all data breaches are malicious – human error is inevitable. From emailing sensitive data to the wrong person to accidentally posting on social media or leaving a laptop open, information can be disclosed in many ways. It is essential for healthcare providers to conduct proper training and educate their staff members, working in any capacity with medical information on how to handle and access PHI in an appropriate manner and identify suspicious behaviors for preventing medical identity theft. Training can be easily streamlined using applications.

Many hospitals always strive to do their best when it comes to securing patient information. The occurrence of medical identity theft is unfortunate but isn’t rare at all. Hospitals should also advise patients and encourage them to keep their sensitive information safe and be cautious when sharing sensitive information. 

Preventing Medical Identity Theft with RightPatient

Even during this COVID-19 national emergency crisis, medical identity theft is continuously becoming a great threat to the safety of patients and healthcare providers. Besides being the leader in patient identity management, RightPatient offers completely touchless biometric modules for patient identification. With RightPatient, healthcare providers can easily prevent medical identity theft and improve patient safety along with hygiene in a facility by removing physical contact, thus, limiting the spread of contagious diseases.