Blog Posts on Patient Identification in Healthcare

Preventing Medical ID Theft Can Combat the Effects of Healthcare Data Breaches

September 14, 2021/6862 views / 0 Comments/in BLOG, Data Breach, Data Integrity, EHR, healthcare, Medical Identity Theft, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

We talk about a lot of healthcare topics regularly on our blog but the most common one is healthcare data breaches. That’s because hackers are targeting healthcare providers every day to steal patient information – leading to much too frequent data breaches. Unfortunately, today is no different as we take a look at some recent data breaches and how some of the hospitals are responding. However, the consequences of most data breaches, medical ID theft, CAN be mitigated with accurate patient identification, ensuring safety in healthcare facilities – more on that later.

Healthcare data breaches update

Over 3 million patients’ information was exposed this August

It’s frightening how both the number of data breaches and patients at risk from them keep on increasing. Just last month, over 3.3 million patients’ confidential and sensitive information was exposed due to data breaches at hospitals and health systems, as per HHS’ breach portal.

Out of them, St. Joseph’s/Candler Health System identified around 1.4 million patients’ information at risk, University Medical Center of Southern Nevada saw 1.3 million, and over 637,000 patients’ information was compromised at UNM Health.

Over 600,000 patients’ information exposed

DuPage Medical Group identified unauthorized activity on its computer network – resulting in shutting down access to it. However, around 600,000 patients’ information was put at risk due to unauthorized activity. Information such as names, dates of birth, addresses, Social Security numbers, and diagnosis codes was exposed. As is standard with healthcare providers, the group is providing complimentary services to the affected patients.

More than 171,000 patients at risk of being medical ID theft victims

Metro Infectious Disease Consultants, a physician group of over 100 physicians, identified that over 171,000 patients’ data was exposed due to hacker(s) breaching employee email accounts. After a thorough investigation, the physician group came up with the aforementioned number, secured the employee email accounts, and saw that names, date of birth, Social Security numbers, and medical information was exposed. It also announced that the affected patients will be offered complimentary services.

Around 12,000 patients’ information exposed due to a phishing attack

One of the most common methods used by hackers is phishing, and that’s how one of them hacked Revere Health and got access to around 12,000 patients’ information. To prevent it from happening further, Revere Health is sending “phishing” emails to test their employees and provide the ones who click on it with training – quite an innovative approach.

Medical ID theft is the common consequence of data breaches

Hackers can sell stolen patient information for up to $1000 in the black market, which is why it’s so lucrative for them and the reason for so many healthcare data breaches we read about every day.

Fraudsters buy these stolen patient records from the hackers and then get healthcare services using the victims’ information, but there’s more to it.

Since the fraudsters are being “treated” using the medical records of the victims, the EHRs contain someone else’s information, rendering them corrupt, dangerous, and unusable. If these corrupt records are not prevented or detected immediately, then the actual patient will be receiving the wrong medical care – making it extremely dangerous for them. Moreover, the patients will be receiving bills for healthcare services they never got.

Healthcare providers, on the other hand, might get hit with lawsuits, not receive the payment, and face patient safety incidents.

While data breaches seem inevitable, the most common consequence (medical ID theft) can be mitigated with RightPatient – improving patient safety in the process.

RightPatient prevents medical ID theft in real-time

One of the biggest reasons why fraudsters get away with committing medical identity theft is because most hospitals and health systems cannot ensure accurate patient identification. Fortunately, RightPatient is a touchless patient ID platform that has a vast amount of experience identifying patients accurately and can prevent medical identity theft in real-time.

During the registration process, patients only need to look at the camera – RightPatient attaches a photo of the patient with their EHR. When the fraudster arrives to access services, they’ll need to go through the same process, and since they are not the actual patient of the hospital, their EHR will not be verified. The platform will alert the registration team that the fraudster actually isn’t the patient – preventing medical identity theft in real-time.

RightPatient has been successfully preventing medical identity theft, protecting millions of patient records across different hospitals, and ensuring patient safety for years. If you want to do the same at your healthcare facility, contact us now to learn more about how we can help you.

Electronic Medical Record Errors Are Preventable with Positive Patient Identification

September 13, 2021/6621 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

We’ve been talking about several topics such as medical identity theft, duplicate medical records, COVID-19, revenue cycle management, data breaches, and more. However, the one point we keep coming back to is electronic medical record errors. This has been a cause of concern among healthcare providers and patients, but it doesn’t end there. The consequences of medical record errors extend to insurance providers, healthcare staff members, physicians, and even the patients’ family members!

What many fail to grasp is that most of these errors are not caused by the EHR systems themselves, but are caused by external factors. One of the foremost reasons is that there’s no effective, standardized patient identifier present. This alone leads to medical record mix-ups, duplicates, and other errors – more on that later.

Let’s take a look at EHR error statistics, the consequences caused by them, and how positive patient identification can mitigate them.

Statistics regarding electronic medical record errors

A recent study focused on the frequency and types of EHR issues perceived by patients which shed light on a number of insightful statistics. Over 136,000 patients received the invitation to participate, and over 29,000 patients responded. 22,889 viewed 1 or more notes within one year. Out of these 22,889 patients, 21% (4,830) of them witnessed mistakes. Out of these 4,830 patients, 43% said that the mistakes were serious, 32.4% said that it was somewhat serious, and 9.9% said that it was very serious.

When asked about what kind of issues they saw within their EHRs, the most common response was diagnosis errors. For instance, many saw that a disease they didn’t have was listed in the EHR! Can you imagine the consequences of this?

Others witnessed wrong medical history, medication errors, and so on.

Most of these issues, if not all of them, can be traced back to the lack of accurate patient identification – let’s see how.

How patient misidentification creates electronic medical record errors

It’s quite simple – since there’s no effective and standardized patient identifier present in the U.S. healthcare system, EHR issues are bound to occur. An EHR system houses thousands and can even hold millions of medical records. It’s quite natural to have many patients with the same name, especially if it’s a common one.

Now, if a patient named “James Smith” turns up, the EHR user will see that there are several medical records associated with the same name. Moreover, there’s no guarantee that the patient’s record is under the same name – it might be saved as “Jim Smith”.

Also, most EHRs provide basic search functionality, and with the registration area being a high-pressure environment, the EHR user needs to select the appropriate medical record quickly. If the hospital isn’t using an effective patient identifier, the registrar either creates an entirely new medical record or chooses the wrong one – creating the potential for medical record errors.

While that’s how patient misidentification and electronic medical record errors are related, let’s take a look at some of the consequences.

Consequences of EHR errors and patient misidentification

EHR errors, bolstered by inaccurate patient identification:

Increase duplicates and overlays within the EHR system
Jeopardize patient safety
Hamper patient data integrity
Lead to patient record mix-ups
Create medication administration errors
Increase denied claims
Cause patients to go through repeated lab tests
Increase hospital readmissions
Create detrimental patient outcomes

It’s not very surprising that patient identification errors have been occurring for a long time, and only a handful of healthcare providers have been proactive regarding preventing such issues within their facilities. These responsible healthcare providers have been using RightPatient to prevent such issues by ensuring accurate patient identification.

RightPatient ensures positive patient identification

RightPatient is the number one choice of leading healthcare providers – they’ve been using our touchless biometric patient identification platform to protect millions of patient records.

RightPatient is easy to use and becomes a part of the EHR workflow. During registration, the platform requires patients to simply look at the camera – the platform takes a photo of the patient and essentially “locks” the EHR with it. Already registered patients then only need to look at the camera – RightPatient runs a search to match the live photo with the saved one – it’s that easy!

RightPatient has a vast amount of experience with several diverse hospitals, making it a clear choice to ensure accurate patient identification, prevent medical record errors, and more.

Are YOU preventing medical record errors successfully at your healthcare facility?

Protection of Medical Records is Critical as Data Breaches Appear Unstoppable

September 2, 2021/6674 views / 0 Comments/in BLOG, EHR, healthcare, HIM, Medical Identity Theft, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Healthcare data breaches are nothing new, especially in the U.S. Even before the pandemic, data breaches were common among hospitals, and why wouldn’t they be? With hackers selling one stolen medical record for up to $1000, medical records can be a lucrative business. However, since the pandemic, data breaches have become significantly more common. But there are some factors to consider in this context. For instance, because of the pandemic, healthcare providers understandably had a lot on their hands – a surge of COVID-19 patients, adapting to the rapidly changing environment, setting up virtual healthcare, and so on. Hackers took advantage of this situation and focused their attacks on healthcare facilities. Let’s look at the problem, explore why it is still occurring, and determine how the protection of medical records IS possible with positive patient identification.

Recent data breaches show the importance of protecting medical records

Cyberattack forces a hospital to go back to analog methods!

That’s not a piece of news we hear every day, is it? Well, the information of a whopping 1.4 million patients was exposed due to an incident back in June at St. Joseph’s/Candler. After detecting suspicious activity, the health system decided to shut down the IT systems, using paper documentation to mitigate the effects of the attack. However, things are better now, as their IT systems have been mostly restored.

Information of more than 637,000 patients exposed

The attack led to unauthorized individual(s) accessing New Mexico Health’s network, compromising information for more than 637,000 patients. Names, addresses, birthdates, health insurance information, medical record numbers, were among the data accessed by the unauthorized party. The health system has been providing complimentary services to the affected patients after notifying them of the attack.

All of this goes to show how important the protection of medical records is, especially if hospitals want to avoid huge losses in addition to those caused by the pandemic. Fortunately, RightPatient can prevent fraudsters from tampering with EHRs and even prevent medical identity theft in real-time – more on that later. For now, let’s see why data breaches are still occurring.

Why do hospitals fail with the protection of medical records?

There are quite a few reasons why data breaches still wreak havoc across healthcare facilities.

Firstly, most healthcare facilities have extremely backdated security solutions or very basic (not robust) modern solutions.

Secondly, their IT infrastructure is outdated – and security relies on good IT infrastructure.

Thirdly, most facilities have not updated their systems in view of the recent data breaches. In other words, they don’t learn from the mistakes of others.

There are, however, other external factors that limit the effectiveness of cybersecurity teams. The biggest issue they face is budgetary – generally, cybersecurity receives a very meager portion of the hospital’s budget. Thus, even if they wanted to, they couldn’t ramp up their cybersecurity measures.

Moreover, hackers are coming up with new and innovative ways to steal patient information and disrupt hospital operations. As previously mentioned, hospitals and health systems are prime targets because hackers get significant amounts of money by stealing patient information and selling it on the black market.

All in all, healthcare providers cannot be blamed entirely for becoming targets of data breaches – there are both external and internal forces that make them inevitable.

However, while data breaches are inevitable and seemingly unstoppable, their most common consequence, medical identity theft, IS preventable.

RightPatient ensures the protection of medical records

There are several reasons why RightPatient is the leading touchless biometric patient identification platform. It ensures accurate identification of registered patients at all times. The platform is extremely easy to use for both patients and hospital employees – it becomes part of the EHR workflow. RightPatient is also safe, hygienic, and prevents HAIs (hospital-acquired infections), as it is touchless. However, it also prevents medical identity theft in real-time.

When fraudsters attempt to pass themselves off as patients, RightPatient will establish that the fraudster does not match any saved medical records, simply by using the face – thus preventing medical identity theft.

Several healthcare providers have added millions to their bottom line thanks to RightPatient. When will YOU make the move to the leading touchless patient ID platform?

Patient Verification Helps Hospitals Deal with Decreasing Revenue as COVID-19 Cases Rise

August 31, 2021/7739 views / 0 Comments/in BLOG, COVID-19, Data Integrity, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Hospitals and health systems are constantly being challenged by the pandemic. Sure, COVID-19 has affected virtually every business – many organizations have declared bankruptcy while others have shuttered their doors. However, most, if not all of these organizations, had their employees work from home. Healthcare providers, on the other hand, had to face unprecedented challenges head-on, such as frontline healthcare teams risking their lives, losing billions of dollars, patient verification issues, data breaches, and more.

Unfortunately, it looks like the battle with COVID-19 is far from over for healthcare providers. With the Delta variant once again wreaking havoc, caregivers are experiencing razor-thin margins. That being said, accurate patient verification CAN prevent many issues, helping hospitals survive this challenging period. Let’s take a look at a few stats that show how concerning the new variant is and how positive patient identification can help caregivers.

Some recent statistics that show a rise in margins and expenses

While things were definitely getting better with millions being vaccinated across the U.S. and businesses slowly opening up, the Delta variant of COVID-19 has struck back with full force. While healthcare providers have been facing lower losses and improved margins when compared to the first half of 2020, a new report sheds light on many facts. While many indicators show that things are going in the right direction, some show that the effects of COVID-19 are far from over.

The “median operating margin index” in June was 2.8%, excluding funding from the CARES (Coronavirus Aid, Relied, and Economic Security) Act. When taking funding into account, it was 4.3%.

What do these numbers mean for hospitals and health systems? Well, it’s an increase of almost 90% (excluding CARES Act Funding) or 48.7% (including the funding) when compared to the first half of 2020. All of these numbers are based on 900 hospitals that have participated monthly for the last three years.

When it comes to patient volumes, it’s a mixed bag. Patient volumes were higher when compared to 2020, but lower than they were before the pandemic. For those who want specifics, discharges between January and June of 2021 were 10.1% higher than in the first half of 2020, but when compared to the first half of 2019, patient volumes are down 4.4%. A similar trend can be seen for ER visits in hospitals, i.e. higher than in the first half of 2020 but lower than in the first half of 2019.

Fortunately, the revenue of hospitals and health systems has increased compared to both 2020 and 2019! According to the same report mentioned above, this is because of outpatient visits. “Gross operating revenue,” excluding CARES Act funding for January to June of this year, was 18.2% higher than the same period of 2020 and 7.9% higher than the same period of 2019.

But all of these statistics look good for hospitals, right?

Well, while all of these do look good, expenses have also increased – affecting margins significantly. The first half of 2021 saw an 8.5% rise in expenses when compared to the first half of last year, and an increase of almost 10% when compared to the first half of 2019.

While margins are increasing, expenses are increasing as well

Unfortunately, the COVID-19 pandemic is far from over – the Delta variant has reached the U.S. and has been in the news for the past few weeks. While healthcare providers have opened their doors to regular patients, COVID-19 cases are spiking once again, and this might be detrimental to hospital margins according to an official associated with the study mentioned above.

Hospitals need to identify ways to reduce losses, improve patient safety, and avoid unwanted incidents that hurt the bottom line. But how can patient verification help?

How patient verification helps improve hospital margins

Accurate patient identification has been a topic of discussion for several years now, and identification errors have also given rise to a number of studies.

Accurate patient identification helps

Prevent medical record errors such as duplicate medical records and overlays
Prevent medical identity theft in real-time
Protect patient data integrity
Reduce denied claims by ensuring accurate, consistent information within medical records
Prevent medical errors that might lead to patient safety incidents
Avoid dangerous patient mix-ups, including transplant mix-ups
Ensure CMS compliance by sending out proper e-notifications to appropriate caregivers
Improve patient outcomes
Reduce hospital readmissions

All of the above, when considered together, can drastically reduce losses and improve a hospital’s margin. We know this because our leading patient identification platform has been helping several healthcare providers for years.

Patient verification made easy with RightPatient

A number of healthcare providers have chosen RightPatient to manage their patients’ medical records. In a post-pandemic world, RightPatient’s touchless patient ID platform makes the most sense, as it keeps everyone safe by preventing physical contact (when compared to other methods of identification).

RightPatient reduces denied claims, improves patient safety, prevents duplicates and overlays, and prevents patient identity theft – boosting the bottom line of hospitals.

How are YOU planning to reduce losses and improve margins at your healthcare facility?

Improving Patient Safety in Virtual & In-Person Visits is a Must as COVID Cases Spike

August 26, 2021/6813 views / 0 Comments/in BLOG, COVID-19, EHR, healthcare, HIM, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

While it seemed like the pandemic was waning in the U.S., it looks like it’s far from over. Unfortunately, the delta variant is here to wreak havoc once again – just look at the current scenario of the COVID-19 spikes across the states. The delta variant has even forced the Centers for Disease Control and Prevention (CDC) to update its guidance on wearing masks. CDC has once again asked even fully vaccinated individuals to wear masks, a decision that has sparked backlash and confusion among the general public. That being said, let’s take a closer look at the current situation, what hospitals are doing now, and how improving patient safety during patient visits (both in-person and virtual) is crucial – something that RightPatient can help with.

COVID cases are increasing once again

Florida has seen a huge spike – over 21,000 cases in a single day, and this is the highest since the pandemic! Earlier, the highest number of COVID-19 cases in a single day was slightly over 19,000 for the state.

Florida has also set a new record for COVID-19 hospitalizations – around 10,207 patients who were infected with the notorious virus. The previous record of the state was 10,170 patients per day.

Moreover, in San Fransico, around 233 healthcare workers tested positive for COVID-19, most of who were fully vaccinated.

In Massachusetts, there was a new surge of COVID-19 patients, and almost three-fourths of them were fully vaccinated!

Vaccinations are increasing too, fortunately!

Amongst all of the havoc caused by this new COVID-19 surge, vaccinations are fortunately increasing too. Around 800,000 people were vaccinated on July 25th – the highest doses in a single day in weeks.

How are hospitals responding?

Hospitals, especially in the U.S., never seem to catch a break, do they?

Well, many hospitals, if not all, are facing an increased number of patients – both COVID-19 and otherwise. Unfortunately, the non-COVID-19 cases are due to COVID-19 itself, ironically. These are the patients who couldn’t, or wouldn’t, get healthcare services since the pandemic began.

For instance, according to an official at Stanford Healthcare, they are completely full and are “outstripping” beds every day. These include both COVID and non-COVID cases. However, the non-COVID-19 ones need urgent care as they are quite ill. They delayed elective procedures themselves, or their dates were pushed back, due to, you guessed it, the pandemic.

Many hospitals, as a result, are once again, working hard towards improving patient safety. Healthcare providers are either postponing or reducing non-emergency and elective surgeries at their facilities. Others are changing their visitation policies, such as restricting in-person patient visitors (barring exceptional cases), allowing virtual visits, minimizing patient visitors, and so on.

As for providing healthcare services, the pandemic already showed how telehealth can be used to care for non-COVID-19 patients – the latter can just be in their homes and avail healthcare services. In fact, many healthcare providers are incentivizing patients for using telehealth during the surge. Lee Health, for instance, is waiving its charges for certain virtual visits.

However, the doors are still open for critical non-COVID-19 patients, and for improving patient safety, hospitals need to implement strategies that eliminate physical contact, prevent infection control issues, and improve patient outcomes.

RightPatient can help with all of that, fortunately.

Improving patient safety with RightPatient

RightPatient is the leading touchless biometric patient ID platform used by several healthcare providers. However, other than ensuring positive patient identification, using RightPatient benefits hospitals and patients in several ways.

RightPatient is perfect for the post-pandemic world as it identifies patients accurately safely and hygienically.

For appointment scheduling and virtual visits, patients only need to provide a selfie and a photo of their driver’s license during the registration process – RightPatient does the rest. For in-person visits, patients only need to look at the camera during the registration or verification process.

All of this ensures that the accurate medical record is selected every time, all without requiring the patient to touch any screens or devices – reducing infection control issues.

RightPatient also ensures that accurate information is fed into the appropriate EHRs each time – boosting patient data integrity, improving patient outcomes, and more.

RightPatient ensures accurate patient identification, is touchless, improves patient outcomes, prevents patient safety incidents, and reduces infection control issues for everyone in the facilities.

How are YOU improving patient safety at your healthcare facility?

How to Protect Patient Information as Data Breaches Become a Topmost Concern

August 25, 2021/6737 views / 0 Comments/in BLOG, Cybersecurity, Data Breach, Data Integrity, healthcare, Medical Identity Theft, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

We’ve talked about data breaches in hospitals and health systems more times than we can count. Unfortunately, these unwanted incidents just keep on happening, and even when the pandemic was at its peak, hackers didn’t stop. Thus, it isn’t a surprise that many healthcare executives are wary about cyberthreats that loom in the dark, just biding their time and waiting to attack more hospitals and steal patient information. That being said, let’s take a look at some recent cyberthreats faced by hospitals, what healthcare execs are saying, and how to protect patient information even if there is a data breach.

Most healthcare experts are worried about cyber threats

Let’s take a look at some of the recent worrying trends in health IT, according to some respected healthcare executives.

Half of them stated that the frequency of cyber-attacks on healthcare facilities is one of their primary concerns now – let’s explore the issue in detail.

Out of these execs, one of them expects that this will continue to be a huge problem for the foreseeable future – a worrying but accurate prediction, unfortunately.

Another exec stated that such cyber-attacks put patient data, arguably one of the most sensitive pieces of information available within hospitals, at huge risk. We’re inclined to agree, as most data breaches end up with hackers stealing patient information and selling it to fraudsters who commit medical identity theft down the line. Many caregivers, as a result, are searching for answers to the billion-dollar question – how to protect patient information.

Another exec stated that cyberattacks are rapidly evolving as hackers come up with innovative ways to attack and lock or steal patient information – something quite challenging to keep up with.

One of the execs that is worried about cyber-attacks stated that hackers and these issues hinder them from doing their jobs properly, which is to care for their patients. He also stated that effective cybersecurity practices and far more assistance are required to tackle cybersecurity and keep costs in check.

Another of these execs predicts that more hospitals and health systems will be focused on improving some aspects such as better integration between platforms, patient consumerization, and strategies that help with cybersecurity efforts.

However, not all healthcare executives chose cyber-attacks as their primary worries.

Others chose:

The boom of startups that give unrealistic expectations, taking up a lot of money from investors.
Mergers and acquisitions.
Mandates about sharing health information that are quite unclear and might be detrimental.
Clinician burnout due to EHR coding, among other issues.
Ensuring equity during telehealth visits.

While all of them are quite valid concerns, the biggest concern is how to protect patient information effectively – healthcare data breaches are occurring as we speak.

Hospitals must protect patient information effectively as data breaches are rampant

On the 15th of April, a phishing attempt was successful – unauthorized individual(s) got access to login credentials of an employee of Orlando Family Physicians. After a thorough investigation, it was found that three other employee accounts were accessed. While the access has been revoked, over 447,000 patients were exposed, such as names, health insurance data, Social Security numbers, and more. This is just a classic case of data breaches – something that has been repeating itself for several years in many hospitals and health systems.

Fortunately, as we mentioned at the beginning of the article, doing something about protecting patient data and preventing medical identity theft IS possible – let’s see how to protect patient information even if there is a data breach.

How to protect patient information with RightPatient

RightPatient is the leading touchless patient identification platform trusted by responsible hospitals and health systems for several reasons. Firstly, it ensures accurate patient identification starting from appointment scheduling and at any touchpoint across the care continuum. Secondly, it is easy-to-use, safe, and hygienic, as the interactions are contactless – something that is extremely valuable in a post-pandemic world. Thirdly, it protects patient data and blocks fraudsters during identity verification – preventing medical identity theft in real-time.

During the registration process, the patient just needs to look at the camera – the photo taken is attached to their medical record, essentially “locking” it from being meddled with by fraudsters. When the patient returns for future visits, all the patient needs to do is look at the camera – RightPatient automatically runs a search and presents the appropriate EHR when it finds a match between the saved photo and the patient’s live image. Any fraudster attempts will be red-flagged by RightPatient during this process – stopping medical identity theft in its tracks.

How are YOU protecting your patients’ information?

Denied Medical Claims Are Costly but Preventable with Patient Identification

August 23, 2021/6980 views / 0 Comments/in BLOG, Data Integrity, Denied Claims, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

The U.S. healthcare system is no stranger to problems, unfortunately. In fact, it has been plagued by a plethora of issues for several years. While some of the problems are definitely solvable, external issues alongside other factors cause the problems to continue. Some of the many problems are astronomical prices, the lack of price transparency, interoperability issues, the abundance of data breaches, medical identity theft, and patient safety issues. While we have covered some of these topics at one point or the other, let’s take a look at another crucial problem, denied medical claims, how they are problematic for everyone, and how positive patient identification can prevent them.

Denied medical claims are costly and cumbersome for everyone involved

Denied claims are not a recent problem within U.S. healthcare – most hospitals and health systems are quite familiar with them. One can safely say that denied medical claims are quite expensive – an average hospital can lose around $3.5 million due to them. However, denied claims not only affect hospitals but also insurers and patients, albeit in different ways – let’s see how.

Claim denials in a nutshell

In the U.S., healthcare is closely related to reimbursements from Medicare, Medicaid, and commercial insurers. Patients get health insurance, go to their healthcare provider, get treated, and that’s about it. However, a lot more goes on behind the scenes regarding healthcare reimbursements.

After providing healthcare services to the patients, the hospital processes the information and sends the claims to the insurance company. While healthcare providers usually get reimbursed by the payer, some of them face expensive hiccups. Due to billing or coding issues, patient identification errors, medical record mix-ups, or other problems, the payer identifies inconsistencies after receiving claims, and they might reject or deny said claims. While some claims can be resubmitted, checking for and fixing the errors is time-consuming, costly, and requires a considerable number of resources.

All of the above leads to back-and-forth exchanges between care providers and payers. Insurers have to reject claims, caregivers lose out on a significant amount of revenue, and many patients even receive shocking, incorrect bills. However, some even lose healthcare services, especially those associated with Medicaid.

Let’s take a look at a few statistics to see how Medicaid patients suffer due to denied medical claims. However, do keep in mind that denied claims can be detrimental for any patient.

A worrying study regarding denied claims

A very recent study has shed light on denied claims and how physicians or hospitals are reluctant to see Medicaid patients due to reimbursement issues.

According to the study, at least 25% of Medicaid claims have been denied upon initial submission. On the other hand, 7.3% of Medicare claims were denied whereas commercial insurers denied 4.8%.

Moreover, the study also states that around 17% of revenue is lost due to billing problems associated with Medicaid patients, whereas the numbers are quite lower for patients covered by Medicare (5%) and other payers (3%).

While any type of denied claim is extremely costly, the statistics show that the Medicaid ones are quite problematic. Moreover, since Medicaid is associated with low-income families, reimbursements are lower as well.

All of this just leads to caregivers being reluctant to look after Medicaid patients.

Denied medical claims are preventable

One of the topmost priorities of physicians and healthcare providers is to look after the patients, Medicare or otherwise. Instead of worrying about denied claims, hospitals and health systems can work on reducing or eliminating them with the right tools and strategies.

Fortunately, RightPatient, the industry’s leading touchless biometric patient identification platform, can help reduce denied claims substantially.

Denied and rejected claims typically occur because of billing and coding errors – most of which can be traced back to medical record errors, patient mix-ups, and identification issues. RightPatient eliminates all of that, and more, as it ensures that the accurate information is fed to the correct EHR at all times. As a result, billing and coding errors are drastically reduced and so are denied claims – boosting the bottom line.

How are YOU reducing denied claims in your healthcare facility?

Misidentification of Patients Can Cause Deaths – How Are Hospitals Preventing Them?

August 20, 2021/6641 views / 0 Comments/in BLOG, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

Unfortunately, misidentification of patients is something that’s still a prominent issue in hospitals and health systems. In fact, just a few weeks ago, there was a patient who received the wrong kidney, which was just one example of the many wrong patient surgery cases. Fortunately, the patient survived but just imagine the implications if the patient didn’t live! Not everyone recovers from patient misidentification mishaps unscratched – some even lose their lives.

Although these cases are occurring more frequently, most healthcare providers are responding reactively rather than being proactive and preventing such cases entirely. That being said, let’s take a look at a couple of other patient mix-up cases and how RightPatient is ensuring identity management in healthcare facilities to avoid such cases.

Misidentification of patients – a few more cases

A patient got the wrong medications

This one is an old story but is worth mentioning since it shows the actual dangers of patient misidentification. A patient, Z, had gone in for cancer treatment and the patient mix-up occurred in a busy registration area, something that is quite typical in hospitals. The EHR user was quite new but followed the facility’s rules – she entered the patient’s name according to the driver’s license. Unfortunately, she clicked on the first EHR that appeared without checking the others or inspecting them to see if this was the patient’s medical record or not. She was oblivious to the fact that there can be other patients with the same exact name – something that is quite a common issue.

The patient was given a wristband with the wrong information. Later down the line, the EHR user asked the patient whether it was accurate or not – the patient responded positively. However, during a testimony down the line, the patient said that he wasn’t wearing any glasses to be able to verify it accurately and was actually depending on the hospital to ensure his safety.

The patient was later sent to a busy area and the nurse asked whether his name was Z or not and also his birthdate – the most common (but unreliable) patient identifiers used. While the patient agreed, a mistake had already been made – as a result, the patient received chemotherapy for an entirely different patient whose name was also Z but had a different D.O.B.

During the same testimony, it was found out that this all happened because of miscommunication – the room was too loud so that the patient couldn’t hear properly, and he also said that the nurse had an accent that was difficult to understand. The nurse, on the other hand, said that the instructions were written as “day 1, day 8”, and she assumed that the patient came in on the scheduled day. All of these problems could’ve been avoided with positive patient identification using RightPatient – more on that later.

Fortunately, while the patient received the wrong treatment, the side effects were few, although, it was classified as wrong medication administration, something that’s quite common when misidentification of patients occurs.

While patient Z was extremely lucky to have survived, not everyone does – just like the patient in the next case.

The wrong patient was taken off of life support

This was quite a devastating case – the wrong patient was taken off life support.

The patient, Samuel (pseudonym), was apparently admitted to St. Barnabas Hospital and was unconscious. Later down the line, it was detected that due to OD, he was left in a vegetative state and required life support. His sister was contacted, and after a few days, she made the very difficult decision to take her brother off of life support.

Afterwards, it was identified that it wasn’t actually her brother but a different person entirely! Once again, this is a case of misidentification of patients. When the actual patient was admitted to the ER, the social security card identified him with his actual name (Samuel Richard Jackson). However, the hospital staff chose the medical record of Samuel Jackson, an entirely different patient. While the patient’s fate might have been uncertain, at least the proper family would’ve been notified if the accurate medical record was chosen.

As can clearly be seen, patient identification errors have severe consequences for everyone involved. The patients receive the wrong medication and treatments, resulting in detrimental healthcare outcomes, hospital readmissions, or even deaths, whereas the healthcare providers face lawsuits, suffer from losses, and lose goodwill. All of this is entirely preventable by ensuring accurate patient identification.

RightPatient eliminates misidentification of patients

RightPatient has been protecting millions of patients in several healthcare facilities with its touchless biometric patient identification platform. During the registration process, it attaches a photo of the patient to their EHR, “locking” them essentially. Even if a patient with the same name or characteristics comes up, the registered patients’ records will be safe, since their faces don’t match.

By identifying patients accurately right from appointment scheduling, check-in, and beyond, RightPatient eliminates chances of duplicate medical records, overlays, and patient mix-ups.

How are YOU preventing such mix-ups within your healthcare facility?

Another One Added to Wrong Patient Surgery Cases – Is Patient Misidentification To Blame?

August 1, 2021/7908 views / 0 Comments/in BLOG, EHR, healthcare, Medical Record Mix-ups, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

We’ve been talking about patient misidentification for quite a long time now, and for very good reasons. While many think that patient identification errors in hospitals are not that common or serious, but every now and then, a piece of news comes up that shows just how serious it can be. This time, a patient received a kidney that was actually meant for someone else – can you imagine? Without further ado, let’s dive deep into the unfortunate tale and see how wrong patient surgery cases can be prevented with positive patient identification.

A classic case of transplant mix-up

This unfortunate case of transplant mix-up is exactly what we warn healthcare professionals against – we’ve seen our fair share of wrong patient surgery cases.

It occurred in University Hospitals (UH) on the 2nd of July, and fortunately, the recipient survived, as the kidney was compatible with the patient. The patient is slowly recovering, according to a spokesperson, and the surgery of the actual patient who was supposed to get the kidney has been delayed. UH also notified UNOS (United Network for organ Sharing) about the transplant mix-up.

Moreover, UH isn’t divulging any more details about the situation as of now – they are analyzing the situation, investigating what caused the issue, and are working so that it never occurs again. However, the employees that were involved with the medical error are on administrative leave until the issue is figured out.

However, while this might seem quite unusual, wrong patient surgery cases do occur every now and then – something which we can confidently say occurs because of patient mix-ups due to poor patient identification systems.

Wrong patient surgery cases are uncommon, but not unheard of

Back in 2019, before the pandemic changed everything, wrong patient identification led to another transplant mix-up in Lourdes Hospital Transplant Center (which we’ve covered already). Coincidentally, it also was a case of a kidney transplant.

However, this was a much more transparent case as the patients had a similar name and age – something that we very well know leads to patient mix-ups, among other things. Fortunately, in that case, the patient who got the kidney survived as it was a perfect match.

This case was also reported to UNOS and the patient who was supposed to get the kidney had the transplant down the line.

However, in UH’s case, the patient who’s supposed to get the transplant is still on the waiting list. As already mentioned, UH isn’t releasing any details about the mix-up – but we are too familiar with such cases.

Wrong patient surgery cases occur due to poor patient identification

In Lourdes Hospital Transplant Center’s case, the patients had common names and were of similar age. This is a classic case of patient identification errors. Patient’s medical records are usually mixed up during registration, and if they have common characteristics, such devastating cases are generated.

We believe that whatever occurred in UH was due to patient misidentification, or the lack of proper patient identification.

Medical record mix-ups, poor quality patient data, medication administration errors, wrong transplants, detrimental healthcare outcomes, mistreatments, and adverse incidents are just some of the consequences of poor patient identification, and can even claim patients’ lives. The patients involved in the two wrong patient surgery cases above are extremely lucky to be alive – not everyone makes it out alive.

Such transplant mix-ups or patient mix-ups are deadly, but they ARE preventable – as long as the healthcare provider is ensuring accurate patient identification. We’re so concerned about such cases is because we help responsible hospitals and health systems prevent patient mix-ups with our industry-leading touchless biometric patient identification platform, RightPatient.

RightPatient prevents patient mix-ups and patient safety incidents

RightPatient prevents patient identification errors right from the start. It takes patients’ photos during registration and locks the medical records with them. Whenever a patient comes up later on, the platform provides the accurate medical record after comparing the saved photo with the live one. This makes sure that patient mix-ups are eliminated, as it uses the one characteristic that cannot be mixed up – patients’ faces.

RightPatient has a vast amount of experience with ensuring accurate patient identification in several hospitals and health systems, and we’re confident that it could’ve prevented such cases.

Are you preventing such mix-ups at your healthcare facility effectively?

The Importance of EHRs Shows Why Medical Record Errors Must be Prevented

July 30, 2021/7795 views / 0 Comments/in BLOG, Data Integrity, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

When caregivers are asked about the most important tool they have at their disposal to treat their patients, what answers are expected? Some would say their healthcare team, the cutting edge technology/procedures they have access to, the different solutions they have that improve healthcare outcomes, and so on. However, the most underrated and crucial tool is definitely the electronic health records or EHRs. Think of it – where would healthcare be without EHRs? EHRs ensure that the right information regarding the right patient is provided to the right medical team. However, this is applicable only as long as certain issues are prevented, especially medical record errors.

That being said, let’s take a deeper dive into how EHRs are the most important tool for healthcare providers and why ensuring patient data integrity is a must.

Healthcare is evolving but the starting point remains the same

Let’s go back to a time before the deadly pandemic. If someone went to a healthcare provider and told them that telehealth would become mainstream in the future, the provider would most likely say that they’re crazy! Look at the reality now – telehealth is still preferred by many, even while users are decreasing due to hospitals opening up.

Healthcare has been evolving – rapidly in some areas and steadily in others. One certain thing is that healthcare isn’t limited to the four walls of hospitals and health systems anymore – one of the consequences of the pandemic. However, whether it’s in-person visits or virtual ones (telehealth/telemedicine), the foundation for providing care to patients remains the same – EHRs.

EHRs are more important than most realize

Patients, caregivers, and others are quite satisfied with telehealth now.

Patients on the younger side have stated that they would like to continue using telehealth even if the national health emergency is over. That’s probably because it’s more convenient, easier, and safer – all the patients need is an internet connection with a communication device.

Caregivers have a bit more complex process to go through.

Caregivers who are providing telehealth services have to consider a lot of factors – the telehealth platform, the portal, the EHR system, identifying the right patient, rules and regulations, ensuring patient safety online, and more. Also, while providing virtual services to the patients, the physicians need to ensure that the necessary information is being fed to the EHRs of the patients accurately – just as they do during an in-person visit.

The bottom line is that whether the healthcare provider is seeing the patient within their facility or online, the one thing that basically remains constant is the patient’s EHR. However, issues such as medical record errors can mess EHRs up, derailing healthcare outcomes among other things – let’s see how.

Why it’s crucial to prevent medical record errors

One of the starting points of providing healthcare is the EHR. When the patient interacts with their healthcare provider, usually to schedule an appointment, one of the first things done by the caregiver is pulling up the patient’s EHR. It basically provides the entire medical history, recent lab test results, and other information required to treat the patient. Moreover, any new information captured by the caregiver will be added to the EHR. EHRs, by providing timely, relevant, comprehensive, and accurate information to the physicians, improve healthcare outcomes, optimize healthcare delivery, boost coordinated care, and reduce adverse events.

Now, imagine if an inaccurate EHR is selected – the consequences can be devastating!

Medical record errors such as duplicates and overlays lead to patient mix-ups. Patient A’s treatment will be based on patient B’s medical record, leading to detrimental healthcare outcomes, adverse effects, and worse. Patient data within the EHRs becomes unreliable as it is fragmented, erroneous, and inconsistent.

However, all of this can be prevented with positive patient identification with RightPatient.

RightPatient prevents medical record errors – and more!

By identifying patients correctly right off the bat, RightPatient ensures that accurate, high-quality data is fed to the EHRs every time the patient checks in for a healthcare visit. Patients only need to look at the camera – the touchless biometric patient identification platform does the rest.

With RightPatient, responsible healthcare providers are not only ensuring patient data integrity, but they are also improving patient outcomes, preventing patient safety incidents, and providing optimal healthcare services to patients.