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5 Tips for Preventing Medical Identity Theft in Healthcare

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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. 

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Verifying Patient Identity – Top 3 Benefits

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

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

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

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Verifying patient identity to prevent medical identity theft

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

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

Reduces information discrepancies in medical records

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

Verifying patient identity for compliance

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

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

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

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

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

RightPatient – touchless biometric patient identity management platform

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

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

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Patient Identity Matching – Solving an unsolved crisis with RightPatient

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

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

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

How costly are patient identity matching errors?

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

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

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

The problem with common identifiers

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

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

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

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

Accurate Patient Identity Matching with RightPatient

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

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

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

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

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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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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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Strategies which help ACOs to improve patient outcomes

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The individual entities in any Accountable Care Organization (ACO) are always under the pressure to reduce their costs as well as strengthen their healthcare strategies to improve patient outcomes and maximize the benefits of being a part of the ACO. Thus, they are familiar with the fact that they need to develop strategies for accomplishing these targets – reduce costs, improve patient data sharing, care coordination, and improve patient outcomes as well, with an emphasis on post-discharge patients via reduced hospital readmission rates.

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RightPatient enhances patient outcomes.

Take post-acute care networks as an example – north of 40% of Medicare patients receive post-acute care after they are discharged from the hospital, costing more than a whopping $60 billion back in 2015. Variation in post-acute care also caused Medicare spending variance by more than 73% – these variances were tied to healthcare costs, outcomes, and quality – the better the quality, the lower the costs, and vice versa.

If these standards are not satisfied, then the ACO receives penalties in the form of lower payments or fines. Thus, any given ACO needs to generate an exceptional patient experience via better healthcare, improving the coordination among the organizations regarding data sharing, reducing the readmission rates and minimizing the costs incurred. 

Here are some strategies which will help the ACOs to achieve these targets: 

Use biometrics for patient identification for improving patient outcomes

Biometric patient identification systems are being used by over one hundred health systems and are reported to increase patient matching significantly – something which is sorely needed within the healthcare industry currently. In the case of ACOs, a single patient’s data is shared by all the systems within them, such as health systems, hospitals, physician groups, and insurers. Thus, interoperability is a must-have feature. EHRs are already known to cause identification errors and have unintuitive interfaces, inherently low patient match rates, and lack of interoperability, which is why health systems are using add-ons like RightPatient to accurately match the patient with his/her appropriate medical record. EHRs are supposed to cause physician burnouts as well, as they need to click through the interface thousands of times. Thus, adopting a solution like RightPatient will not only improve the match rates but also improve the patient experience as well as reduce physician burnouts, generating improved coordination. Patients only need to get their irises scanned to retrieve their accurate medical record for usage. Thus, faster matching creates better coordination and sharing of uniform and clean data among the organizations funded by Medicare. 

Ensure proper medication adherence 

One of the biggest problems for ACOs is ER (emergency room) visits, which generate hospital readmission rates – occurring due to the unhealthy population under their care. According to a study, two-thirds of the patients who are supposed to take medications are non-adherent; that is, they do not take their medications properly. This non-adherence creates around 50% of treatment failures among those patients and causes up to 125,000 deaths per year. The fact is that these deaths could have been prevented if the patients were adherent to their medications. All these generate up to an unbelievable $300 billion in costs. Apps like CircleCare have a feature which could have ensured medication adherence – Medicine Box – a medicine reminder where patients can easily set reminders for their medications.

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Thus, even if the medication regimen is complex, CircleCare makes it easier than ever for the patients to take the right medicine at the right time.

Provide patient education to improve patient outcomes

Another challenge for ACOs is that their patients are not adequately educated regarding their medical conditions. Research shows that over 50% of adult patients experience difficulty in using and understanding their health-related information, whereas around 40% forget most of the data. CircleCare provides health-related information which is customized according to the patient’s disease(s) – this helps to keep the patient up to date with the latest information regarding his/her medical condition so that informed decisions can be made. This ensures effective patient education, leading to better patient outcomes. Once an ACO registers with CircleCare’s service, all it needs to do is direct the patient to download it. Afterward, the patients can schedule their medicine, track steps, record blood glucose levels, record blood pressure, and communicate with their healthcare provider – all of which helps to improve patient outcomes, lower readmission rates, and reduced costs as well as higher quality healthcare. 

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Patient engagement apps are reducing hospital readmission rates

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According to a recent study, patient engagement technologies like patient retention apps are more likely to lead towards better healthcare outcomes. Patients who used these apps contributed to reducing hospital readmission rates compared to those patients who did not use engagement apps.

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Patient engagement technologies like CircleCare, a patient retention app, have shown that they aid patients having chronic diseases to visit their healthcare providers more prudently. Rather than going to the EDs (emergency departments of their hospitals and spending a significant amount of money which could be preventable, they used these patient engagement technologies to take care of themselves and also contact their physicians whenever required, regarding their health updates and asking for assistance directly within the app. The latter is much more desirable as it saves money from a preventable hospitalization and where the patients have tools provided by their healthcare providers, thus, reducing hospital readmission rates. 

According to the study, patients suffering from chronic conditions face some challenges getting a cohesive healthcare service- they need to go through several primary and supporting facilities for the full experience, thus are bombarded with different data points and care sites, which result in a disrupted and broken healthcare experience.

The research also showed that tools which provide the patients with facilities like access to their health information, tracking their activities, are helping to deliver superior quality healthcare and help the patients to stay on track regarding their post-discharge guidelines, all of which leads to only better patient outcomes.

Patient engagement tools and better patient outcomes are positively correlated- the more the use of these tools like CircleCare, the more active participation is seen from the patients, and thus, the better are the patient outcomes as hospital readmissions are fewer for these engaged patients. Even if the patients had multiple diseases, as long as they had access to the tools and were using them actively, the research showed these patients contributed to reducing hospital readmission rates. 

The research was carried out by grouping patients by their chronic conditions, hypertension, diabetes, asthma, and so on. As previously mentioned, patients with chronic or complicated cases who had access to patient engagement tools were readmitted fewer times compared to those who did not have access or did not use it. 

These results show that patients are becoming health conscious than ever and are opening up to useful patient engagement tools. It is a positive outcome overall, as the patients are choosing to pursue an active and healthy lifestyle and not resort to hospital readmissions, which can be expensive and inconvenient. The study also demonstrated that unless it is too severe, the patients choose to communicate with their physicians via the engagement tools instead of opting for readmissions or similar actions. This way, they can talk about any discomfort or situations they are facing and get instant advice, which helps them save a trip to the ED. Thus, patient engagement tools are taking healthcare out of hospitals and making it accessible via mobile devices, which is very much convenient for the patients themselves. 

So, what are these patient engagement tools that are pushing healthcare to better heights? One of the prime examples is CircleCare, a patient retention app which doubles as a patient engagement app. It has all the features of a perfect patient engagement tool. CircleCare can track steps, schedule medicines reminders, record glucose level, blood pressure, and also provide a community where the patients can engage with one another for exchanging health tips- a social media for patients. Moreover, it is also a means for patients to communicate with their healthcare providers; thus, they can contact them whenever necessary, without any hassle. Once a hospital registers to the service, they direct their patients to download the app to their smartphones/tablets and register as their patients, and that’s it! Patient engagement tools like CircleCare not only help the patients to communicate with their physicians but also help them lead and maintain a healthy and active lifestyle, which in turn generates improved patient outcomes and results in reducing hospital readmission rates, making it a must-have engagement tool.

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Patient engagement is the key to improved patient outcomes

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Why might any healthcare provider contact their patients after their discharge? It’s simple – to encourage patient engagement so that the patients can be proactive and thus healthier, which in turn causes improved patient outcomes and lowers readmission rates, simultaneously reducing costs

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There’s a catch to this – if it’s so easy, why is effective patient engagement still out of reach for most healthcare providers? Let’s analyze.

A recent survey consisting of several healthcare systems sheds light on some interesting facts – 70% of the participants stated that less than half of their patients are involved in engagement activities, whereas a mere 9% said that they observe more than 75% effective patient engagement. 

Why are some successful and some unfortunate? It mostly reflects the fact that many are still confused by what patient engagement means. Many think that patient engagement refers to just giving a patient a scheduled time and making sure they know the patient’s name, and that’s all – but that is a far cry from what patient engagement entails.

Patient engagement refers to the healthcare provider learning about the patient’s interests, medical records, background, and anything relevant that is there to know about the patient as much as possible. What do the healthcare systems do with such data? They provide customizable tools to the patients which can be used for active patient engagement – to ensure improved patient outcomes and experience. There are many tools already available at the disposal of the healthcare providers to use for active patient engagement like CircleCare. Thus, patient engagement means providing a patient with tools and facilities which the patient can then use or participate in, if he/she chooses, to ensure better health and lead a healthier lifestyle, with its primary goal being improved patient outcomes and better patient retention rates.

Even large and reputed healthcare systems sometimes need the assistance of such tools for patient engagement, which is reflected in the survey’s findings. There are many examples that tell the same story repeatedly – a reputed healthcare system thinking that it was providing entirely satisfactory patient engagement until it started looking at the results and then teaming up with an external party who understands patient engagement better, and later on, the healthcare system actually seeing marked improvements because of using the new tools.

With the extensive knowledge and technical know-how of such third parties regarding patient engagement technologies, these healthcare providers saw that instead of using conventional facilities like patient portals, which can be clunky, unresponsive, and tedious to use, the patients used tools like apps which are available for both tablets and smartphones. The patients not only use it for better health and checking their records, but they also use it to communicate with their providers, exchanging crucial information, if required.

According to a healthcare official, patient engagement is very integral to their services, and they need it to ensure they have a healthy, mutually beneficial relationship with their patients. Such tools like CircleCare provide the window to ensure active engagement. Using CircleCare, patients can easily communicate with their doctors to let them know of any discomfort or updates in real-time. 

CircleCare is a patient retention app which doubles as a patient engagement app. It ensures maximum patient engagement, as it has features like tracking steps, recording blood glucose level, recording blood pressure, and also scheduling and reminding one about medicine. Not only that, it has all the features previously mentioned above, like communicating with physicians, exchanging information in real-time, and so on. Best of all, if the patient maintains an active, healthy lifestyle, which is shown as the patient completes “goals” and earns points within the app, they can also win exciting prizes which they can exchange with the coins. Once a healthcare provider subscribes to the app, they can direct the patient to download and use them for active patient engagement, ensuring lower patient readmission rates due to positive outcomes. 

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Can hospitals achieve better patient outcomes through patient engagement tools?

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Let’s face it – no patient thinks about going home and logging into a web portal. It is ancient at this point. During a recent event focusing on all things related to healthcare improvement, that was the opinion shared by a respected healthcare official. The rest of the executives from different healthcare systems who were participating with him nodded in agreement. On the contrary, they laughed, because they are accepting the fact that patient portals are just not practical. Not only for this small group of officials but by now, it is common knowledge that such patient portals did not turn out to be one of the effective patient engagement tools as they were once hoped to be. Where did it go wrong? What’s next? If this didn’t push patient engagement, what kind of patient engagement tool will? These are the questions on the minds making up the healthcare system.

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During the event, the group sat down and had a lengthy discussion regarding healthcare and patient engagement tools, and the following are some of the critical things that were revealed.

Patient engagement is of utmost importance

This was stated by all of the executives present. Patient engagement is one of the top three organizational objectives for them. They also believe the fact that their organization’s value patient engagement as they see patients who are more participative to have better health outcomes than those who don’t, along with increased satisfaction, retention, and revenue.

Priorities are not reflected in the results

Another notable finding during this discussion was that there is a massive difference between the amount of importance healthcare systems place on patient engagement and the level of results they deem successful – they interpret 15% as a good number. One may then ask, how can such a vast difference between objectives and results be possible? One official from a healthcare system said that they need to be completely digital regarding everything being done in their hospital – from the moment the patient decides to use their services until the follow-ups are complete. Naturally, they require a patient portal which the healthcare providers have, and they observe approximately 15% of patient engagement through it, which they believe is more than an acceptable number.

Even though considering such a small number as success is very peculiar, it is not uncommon. The Office of the National Coordinator for Health Information Technology states that less than one-third of the patients who had access to portals used it only one or two times per year. The ones who did not use the portals had a variety of reasons – they wanted to speak with their healthcare providers directly, did not deem it necessary enough to view their records online, were worried about the safety and privacy of the portals, or could not use them due to various issues.

Not enough advancements in patient engagement tools

The healthcare officials who were present in the event think that the motivation for effective patient engagement needs to come from the patients themselves. However, as the findings specified already, it is not always in the hands of the patients themselves, but in the hands of the healthcare providers – the latter are the ones who develop the patient engagement tools, strategies, and technologies to support them. For instance, no matter how participative a patient is willing to be, he/she will not be able to effectively engage with the healthcare provider if the patient portal is complex, faulty, or inefficient. Another drawback the officials stated was the perception of patients regarding the portals’ contents and features – if they were inconsistent and irrelevant, patients would not use them.

 Another official added that even though patient engagement is a top priority for any healthcare system, the ones running them do not utilize the tools available to make better use of technology and come up with something more innovative and productive than patient portals. They do not invest in the necessary places and do not hire the people who can bring about a change to patient engagement tools.

Is patient engagement actually possible?

Yes, of course. Patient portals may be clunky, complicated, and the fact that people use their browsers less nowadays does not help the matter. No, the solution lies somewhere else. People are always on their phones using apps, and this is the key – a patient engagement app like CircleCare. The patients do not need to go to browsers and sign in; all they need to do is unlock their phones and tap on the app – they are in! CircleCare is an app which helps the patient stay fit – it can track their steps, schedule alerts for their medicine, and record their blood glucose level as well as their blood pressure, thus, helping them to stay proactive and maintain a healthy lifestyle. Not only that, but the app also connects the patients with their physicians so that they can communicate with each other whenever required – to share critical information, updates, tips, and additional information regarding their health can be exchanged. Once the hospital subscribes to the app, all the patients need to do is download it and use it, which will not only help them maintain a healthy lifestyle, but also ensure active patient engagement, and as a result, hospital readmission rates will go down due to better patient outcomes and active patient engagement.

Process Improvement Methodologies are used for Patient Experience Improvement

Process Improvement Methodologies are used for Patient Experience Improvement

Process Improvement Methodologies are used for Patient Experience Improvement

Healthcare organizations are continually pursuing ways to improve their processes to enhance the patient experience they provide. However, the biggest problem is that they need to measure patient experience improvement, and there is no specific way to do so. The challenge is to gain access to timely and relevant data. Nevertheless, in spite of this roadblock, they have found another way to measure their success.

According to a survey, the participating healthcare systems have stated that the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) or similar CMS surveys are their most preferred tools to track the patient experience provided. These are followed by phone calls made before a patient’s discharge and assistance from third-parties, or non-CMS surveys.

These healthcare providers have also increased their use of social media monitoring because of their needs for accurate and timely patient experience data, which is why using these methodologies do not seem that surprising. The number of healthcare systems utilizing process improvement methodologies is higher than the ones who do not use it, and the former ones stated that HCAHPS or CMS surveys are their preferred way of both tracking and measuring their organization’s success or failure regarding the patient experience they provide.

Moreover, the number of respondents who said they use tracking and are using it for process improvement methodologies is higher compared to those respondents who do not, with in-house surveys being an exception. This shows the amount of emphasis placed on performance measurement by process improvement, which no doubt the respondents believe leads to patient experience improvement.

They may have used several process improvements, like enhancing the patient identification system, since patient identification is a recurring problem in most healthcare systems, as 8% of the medical records are duplicates on average. Some hospitals are utilizing biometric patient identification like RightPatient, which does enhance the whole process, as physicians can focus on more critical tasks rather than take time identifying the patients. All of this ultimately leads to the healthcare systems providing a personalized patient experience.

These healthcare systems are correct in placing their trust in process improvement methodologies, and the report reflects that. It is favorable for patients and healthcare providers alike, as 87% of the respondents stated that their organizations had experienced significant improvements in the HCAHPS scores or similar measurements, which is a clear indicator of the efforts they have made to enhance the patient experience in response to their previous scores.

The report’s breakdown is as follows: 13% of respondents have observed significant improvements, 44% have noticed moderate gains, and 30% have experienced minor improvements, while 5% saw no increase.

However, the results reveal another aspect – there is a positive correlation between patient experience improvement and the use of such process improvement methodologies. A large number of respondents (16%) have stated that they experienced significantly improved HCAHPS scores after using the methods compared to those who did not use them (6%). Likewise, moderate improvements were noticed by a large number of respondents (47%) who used the process improvement methodologies compared to those who did not (36%). Accordingly, the respondents who did not use such methods are far higher in number (10%) than those who used it (3%) and reported that they did not see any improvements.

How are the healthcare systems improving their patient experience significantly? Other than process improvements, they can also utilize technology to enhance the patient experience further. They can use apps like CircleCare. It is a patient retention app used by hospitals for active patient engagement. Once a hospital subscribes, they can instruct the patient to use it for various purposes like communication with the hospital, keeping track of their steps, recording their glucose levels, scheduling their medicine, and receiving valuable health tips within the app. All these activities not only help to improve patient engagement but also cause patient experience improvement, resulting in an increase in patient retention rates due to better patient outcomes.