Hospitals Might Lose $323 Billion – Reduce Yours by Ensuring Patient Data Security

July 24, 2020/9316 views / 0 Comments/in BLOG, COVID-19, Cybersecurity, Data Breach, Health Care, Medical Identity Theft, Patient Identification, Patient Matching, Patient Safety /by Matt Gibson

Healthcare around the world has been arguably facing one of its biggest challenges yet, and the US healthcare system is no exception to the effects of the coronavirus pandemic. While there are spikes in COVID-19 cases, things are looking quite bleak for the financial performance of hospitals this year. To be exact, over a staggering $323 billion could be lost only in 2020! Is there any solution to mitigate the losses? RightPatient might be the answer – as it ensures patient data security and prevents medical identity theft in real-time. Let’s explore.

Unimaginable hospital losses

It is quite simple – due to the pandemic, hospitals had to focus more on the overwhelming number of COVID-19 patients, and thus, stopped treating regular patients. While this was expected, the financial losses are still huge.

According to the American Hospital Association, healthcare providers have reported declines of 34.5% in outpatient volume and 1.5% in inpatient volume, on average. Projected losses for the duration of March–June 2020 have been around $202 billion. Moving forward, the AHA estimates that the second half of 2020 will incur a loss of around $120.5 billion for providers – leading to an unprecedented sum of $323 billion in losses for the year 2020. However, the AHA does warn that this might be an understatement – the numbers might go even higher.

Providers do not expect losses to reduce for the rest of the year either. The AHA’s president has even stated that the US healthcare system is facing the biggest financial crisis in its history due to the pandemic as well as reduced patient numbers.

While the US federal government has provided over $170 billion as emergency funding for the providers, many fear that it might not be enough to overcome the heavy losses.

Medical identity theft is on the rise

While COVID-19 and its long-lasting effects are raging on, that has not stopped hackers from attempting to steal sensitive patient data through healthcare data breaches. Security experts have stated that there is a huge opportunity for hackers to steal patient data since it is rich with valuables like Social Security numbers, insurance information, and so on. Moreover, they can sell patient records for up to $1000.

Healthcare in the US is expensive, and that is the reason why medical identity theft is so common. Fraudsters simply buy the patient data from the black market, and do not need to worry about any more healthcare expenses – the fraudulent bills are passed on to the shoulders of the victims. As can be seen, ensuring patient data security is quite important.

Medical identity theft not only hampers the patients financially – it affects patient safety as well. When a fraudster uses the patient data to gain access to healthcare services such as expensive procedures, medications, and equipment, their data is recorded into the victims’ patient records. Thus, the patients might further suffer from incorrect medications and procedures based on an altered medical history, making patient data security a topmost priority, even during the pandemic.

Ensure patient data security with RightPatient

RightPatient has been protecting millions of patient records for leading healthcare providers for years. It is a touchless biometric patient identification platform that locks the medical records of the patients with their photos upon registration. After enrollment, all the patients need to do is look at the camera and the platform matches the photos and provides the correct patient record within seconds. Thus, if a fraudster comes by, he/she will be red-flagged, preventing medical identity theft.

Moreover, due to the pandemic, patient identification in hospitals needs to be upgraded to a touchless platform like RightPatient to prevent infection control issues and enhance patient safety. RightPatient meets all the requirements for any given health system or hospital by preventing medical identity theft, ensuring patient data security, enhancing patient safety, and preventing duplicate record creation, boosting the bottom lines. Reduce your losses by using RightPatient and protecting patient records now.

5 Tips for Preventing Medical Identity Theft in Healthcare

July 22, 2020/15768 views / 0 Comments/in BLOG, Clinical Efficiency, Connected Health, COVID-19, Cybersecurity, Data Breach, Data Integrity, Facial Reciognition, Health Care, healthcare, Infection Control, Iris Recognition, Medical Identity Theft, Patient Errors, Patient Experience, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Ryan Stephens

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.

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.

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.

Verifying Patient Identity – Top 3 Benefits

July 17, 2020/11973 views / 0 Comments/in BLOG, Clinical Efficiency, COVID-19, Duplicate Medical Records, Health Care, healthcare, Medical Identity Theft, Patient Experience, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Ryan Stephens

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.

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:

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.

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.

Can Revenue Cycle Improvement Prevent Hospital Closures?

January 2, 2020/6576 views / 0 Comments/in BLOG, Health Care, Revenue Cycle Management /by Matt Gibson

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

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

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

But why are these hospitals being closed?

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

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

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

What to take away from this example?

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

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

How can hospitals achieve revenue cycle improvement?

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

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

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

How patient engagement solutions benefit physicians

July 2, 2019/6332 views / 0 Comments/in BLOG, Health Care, Patient Engagement /by Matt Gibson

The number of patients who seek treatments for their ailments at retail clinics is continuously increasing. Also, mid-level staff and nurse practitioners are getting the chance to handle everyday clinical care. These may indicate that primary care physicians have lessened pressure, but the reality is entirely the opposite – they have to handle an unprecedented level of stress. So, where do patient engagement solutions fit in? Let’s analyze.

These summaries were found after conducting a study. It included information from medical bills as well as relevant EHR data, where 4900 primary care practices were visited by 5 million patients 40 million times. This study found primarily two things in its duration:

6% increase in average work performed was witnessed during each visit
10% increase in the average number of recorded diagnoses each visit

However, some may be skeptical and think that these numbers are inflated, saying the sample healthcare providers may have meddled with the recorded data due to requirements of Medicare rules and contracts which are risk-based. On the other hand, the more optimistic people feel that primary physicians are working harder per patient, and their reasoning is simple – these physicians are handling the more complex cases because the easier ones are being pushed out to others.

A healthcare official from a renowned hospital has stated the same – the patients with less severe cases, like a running nose, go to the nearest clinics, whereas the complicated cases have insurance and thus line up for primary physicians. The official explained that the patients they treat are the ones with complex health issues like diabetes, hypertension, and heart failure, as well as depression, and even if they come with a small problem, they need to keep these other complex diseases in mind while treating them. Thus, the more complex the situation and the condition, the more tests and consultations are required.

Usually, such pressure can cause burnout within the physicians, that too without the help of patient engagement solutions which may have eased their situations. Conversely, many feel that they actually enjoy those patients who need their care and this makes such stress worth it. Nevertheless, they do not enjoy switching from complex to uncomplicated patients repeatedly, as it disrupts their workflow.

Also, even if these primary physicians are not handling the more uncomplicated cases, they still need to review some of them and participate in the decision-making process. Thus, the primary care physicians have a lot on their plates, and all of this creates dissatisfaction, burnout, turnover, early retirement – all of which is undesirable by the healthcare industry.

What can be done to reduce this stress? To keep the physicians more involved and engaged with their patients, the healthcare systems can use patient engagement solutions like CircleCare. This app helps the physicians to be in contact with the more complex patients once they are discharged, and both parties can provide essential updates to each other. The physician can also offer advice for small ailments the patients face. On the other hand, the patients will be able to record their blood glucose level, blood pressure, track their steps, schedule medicine, and so on. These features will not only help the patients to maintain their health but also provide this data to the physicians whenever required without hassle, thus providing motivation to these hardworking physicians for achieving better patient outcomes. Once the hospital is registered with the service, the patient only needs to download the app, and he/she’s connected with the healthcare provider and the physician for engagement, which will help to keep them healthy, and thus increase the patient retention rate.

HIMSS 2019 – Interoperability Showcase; What Is the Foundation of Interoperability?

February 17, 2019/6023 views / 0 Comments/in Health Care, News, Patient Identification /by Mizan Rahman

HIMSS 2019 – Interoperability Showcase; What Is the Foundation of Interoperability?

HIMSS19 Global Conference & Exhibition, Orlando, FL

On the last day before leaving, I decided to stop by the interoperability pavilion at HIMSS – this was one of the busiest and well-presented parts of the show. The section, showcased by the VA (US Veteran Administration), was very extravagant – you usually see such displays from any of the federal government agencies only in Washington D.C. The VA is definitely a front-runner in interoperability – they are the first one to initiate the blue button program to share medical records. The jam-packed area with vendors and exuberant people from all corners of the HealthCare industry clearly shows the importance of the mission. As I was snapping a selfie, Andy Pincsak from Phillips Health jumped in & joined my memory lane – I thought it was a very nice and friendly gesture! Why can’t we all be like that with each other?

Snapping a selfie with Andy Pincsak from Phillips Health

The HIMSS Interoperability Showcase™ was the highest trafficked area of the exhibit floor

Innovative Solutions on the Exhibit Floor

Why Is Interoperability Such a Big Deal?

The fundamental premise of interoperability is to share data between organizations – so a patient can move from provider to provider and his/her data can be seamlessly shared between the providers. This is very serious because an average American with chronic conditions, such as diabetes, sees multiple physicians from various organizations. To orchestrate a meaningful treatment regimen to such patients, it’s imperative that each of these providers has real-time visibility of each patient’s care-cycle. Hence, interoperability is extremely crucial.

Innovation Live brought together startups, accelerators, and other innovative companies to showcase the future of healthcare IT

What’s the Fundamental Flaw in the Healthcare Interoperability Movement?

For interoperability to be successful, the providers must match and identify the patient as they move between the organizations – to be clear, your social security number is the unique identifier. But in healthcare, every organization assigns its own unique numbers to each patient. Therefore, how will organization A notify organization B that John Joe with ID “DX213” is the same “John Doe” with ID “74537”? Currently, this is done using fuzzy match. However, on an average 8% of the time, a patient is registered under a different name – I am serious – this is called a duplicate patient record. Since many people have common names and there is no social security number in their health record, a simple mistyping – usually called fat finger – causes the creation a different record for a patient that already has a record. Therefore, how in the world can all these providers really work in harmony and share data with such a mess? It does not take a rocket scientist to understand these issues. To achieve real interoperability, we need clean and uncorrupted data.

HIMSS Interoperability Showcase

Is There Any Solution Without Using a Social Security Number?

Of course there is. Since we can’t rely on names and names also change, we can easily add patient biometric data with each medical record. Once a patient is tagged with his/her biometrics, they will always be identified with just biometrics. Basically, a patient will just walk into a provider’s office, have their biometrics taken and the system will find the record with biometrics. Now, if all providers are using a photo based system like RightPatient, then the patient can move between whole ecosystems without ever worrying about ending up with corrupted data. Why we are not using our natural identifier to protect our health and implement seamless interoperability?

EHRs: Why are physicians and patients dissatisfied with them?

September 5, 2018/11683 views / 0 Comments/in AI, Analytics, Artificial Intelligence, BLOG, Clinical Efficiency, EHR, Health Care, healthcare, Patient Experience, Patient Identification, Patient Outcomes, Patient Safety /by Michael Trader

Electronic health records (EHRs) are supposed to make things easier for doctors, improve health outcomes for patients, and create a better experience for everyone. However, most research indicates the opposite. There is a high level of EHR dissatisfaction among practitioners and the impact on patient experience has been underwhelming. So, what has gone wrong?

When EHR system use became mandated, clinicians were expected to experience initial growing pains as they were forced to learn new skills. However, as comfort levels grew, their perceptions were expected to change over time, resulting in better communication and care. Unfortunately, doctors are still complaining about EHRs even after several years of widespread implementation and use. In fact, research shows that EHRs have become a major contributing factor to physician burnout.

The aforementioned Mayo Clinic Proceedings study also found that as many as 84.5% of physicians are using EHRs and the majority of them are not satisfied. Most physicians feel that EHRs are inefficient and require too much manual data entry where time is spent on clerical tasks rather than patient interactions.

Likewise, patients are also not satisfied with EHRs as they notice doctors spending more time looking at the computer screen during their visits. Research shows that gaze time (amount of time the doctor looks at the patient) is directly related to patient satisfaction.

Apart from data entry issues, a RAND study identified many other reasons for EHR dissatisfaction among physicians. For example, most physicians agreed that EHR interfaces were not intuitive, thus hampering their workflow instead of augmenting it. They also complain that EHRs are not implemented well enough to facilitate the proper exchange of information. Many physicians feel overloaded with irrelevant information.

Doctors also noticed that templates provided with EHR systems degraded the quality of their reports. Even more worrisome is that most physicians found that EHRs are not improving over time.

Undoubtedly, these studies indicate the need for a system update and technology that frees doctors from having to spend time on routine clerical or data entry tasks. This technology would ideally enable clinicians to focus on their primary responsibility – carefully listening to, observing, and getting to know their patients so they can provide the highest level of care.

This is where RightPatient can help by providing an AI system that automatically identifies patients when they arrive and then engages with them to collect useful information that is pushed into the EHR system. This enables clinicians to understand much more about a patient’s condition while reducing their data entry burden. With RightPatient, doctors receive concise, relevant, and real-time information regarding their patients to save time, increase efficiency, and improve the patient experience.

Making the most of patient wait times

August 14, 2018/10763 views / 0 Comments/in AI, Analytics, Artificial Intelligence, BLOG, Clinical Efficiency, Health Care, healthcare, Patient Experience, Patient Identification, Patient Outcomes, Patient Safety /by Mizan Rahman

The U.S. healthcare system has long suffered from the problem of excessive patient waiting times. In 2015, 32% of visits to the ED resulted in patient wait times of up to an hour. Obtaining an initial outpatient appointment with a physician can take a month or more. The fact is that waiting times can be unbearably long for patients and doctors are often helpless in solving the issue.

Long waiting times can have a negative impact on a patient’s health by causing delays in consultations. Furthermore, wait times reduce patient satisfaction scores with healthcare service providers. Research has shown that patient satisfaction scores were affected across almost every aspect of care delivery when waiting times were long, with patients reporting lower levels of confidence in the care provider. Longer waiting times not only impact overall patient satisfaction, they also negatively affect the way that patients perceive the information, instruction, and care provided by their caregivers and physicians.

Clinics have adopted various methods to improve satisfaction while a patient is waiting for an appointment. These typically involve providing information regarding different disease conditions, tips on practicing a healthy lifestyle, etc.; essentially, they try their best to make waiting areas comfortable and informative. Additionally, some clinics use office staff to gather information from the patient. However, in many cases, the information provided by the clinic may not be relevant to the patient. Similarly, gathering information about the patient through staff is an expensive activity with limited benefits.

As we have seen, patient wait times can have a negative impact on both patients and their clinicians. However, what if there was a way to utilize these waiting times more productively? Can patients be engaged in a more meaningful way while they are waiting? This is precisely where RightPatient can help.

RightPatient can help to improve the patient experience and optimize wait times through its autonomous check-in process. When patients arrive for scheduled outpatient visits, RightPatient automatically recognizes them and engages through an AI-driven chat session. This enables patients to learn about their conditions as important clinical information is collected, which is automatically fed into the EHR. The clinical team can review this information prior to the consultation, saving time and increasing efficiency by eliminating the need for manual data entry into the EHR system. Physicians can then spend this time interacting directly with the patient to bolster satisfaction and clinical outcomes.

RightPatient enables doctors to spend more time focused on what they want to be doing – listening to patients, addressing their emotional and physical well-being, and spending less time worrying about data entry into health records. Satisfied and engaged patients also respond more favorably to more personal interactions with their caregivers, creating a win-win environment.

Reducing opioid abuse by knowing the right patient

July 16, 2018/13726 views / 0 Comments/in AI, Analytics, Artificial Intelligence, Big Data, BLOG, Data Integrity, data mining, Health Care, healthcare, Medical Record Mix-ups, Patient Errors, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety, population health, precision medicine, Predictive Analytics, value-based care /by Michael Trader

The US is enduring a massive opioid abuse epidemic. Not only are they widely prescribed, but prescription opioids are now more widely abused than street drugs. If we look at the anatomy of the opioid crisis, it is genuinely frightening. In 2016, 116 people died each day due to opioid overdose, resulting in more than 42,000 fatalities in a single year.

The question is, why is this happening? How are 11.5 million individuals misusing prescription opioids? How is it that each year, 2.1 million people misuse opioids for the first time? It seems that, at present, there is no clear path to stunting this epidemic. Opioid abuse is already costing the US economy more than half a billion dollars annually.

How did we get to this point?

Since the 1990s, the pharmaceutical industry started pushing opioids and assured doctors that these drugs were safe. Consequently, doctors began widespread prescription of these drugs. However, blaming the pharmaceuticals industry and doctors alone ignores many other pertinent factors.

There have been many changes regarding the prevalence of various diseases over the last three decades. Slowly and steadily, medicine has become dominated by chronic and painful health conditions. It is estimated that one-third of the U.S. population or 100 million Americans are living with a chronic and acute pain condition. Among them, one-fifth are living with moderate to severe pain. Considering these statistics, it follows that opioids would be widely prescribed. However, 8-12 percent of those prescribed opioids result in patients developing an addiction.

Opioid misuse is not just limited to those living with painful conditions. Many of the prescribed opioids end up in the wrong hands. Many addicted to opiates hide their identity or medical conditions and visit various clinics under different aliases. For doctors, it is challenging to identify the right patient.

How can we reverse the epidemic?

To bend the trend downwards, efforts must be implemented at every level. At the community level, we must educate the public and raise awareness about the health risks of opioid abuse. Policymakers should advance legislation to address the problem. Above all, there is a need to change the way medicine is practiced; healthcare providers must take higher precautions at the clinical level.

Clinicians cannot and should not deprive people in pain from drugs that can bring them needed comfort. However, big data and technology can assist them in differentiating between the right patient and the wrong one. This is where RightPatient can play a vital role. Powered by artificial intelligence, the platform can help clinicians to thwart medical identity fraud and ensure that a patient’s complete and accurate medical history can be retrieved.

By recognizing the correct patient, clinicians can better understand the validity of patient complaints along with a patient’s disease history. When and where was the patient last prescribed an opioid? Did the patient rightly identify himself/herself?

RightPatient can be one way to prevent opioid abuse.

How Can You Protect Your Investment in a Population Health Solution?

February 9, 2018/14238 views / 0 Comments/in AI, Analytics, Artificial Intelligence, Big Data, BLOG, Data Integrity, data mining, Health Care, healthcare, Medical Record Mix-ups, Patient Errors, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety, population health, precision medicine, Predictive Analytics, value-based care /by Mizan Rahman

Healthcare in the U.S. is going to see a paradigm shift in the next five years that will move it from a fee-for-service (FFS) payment model towards a value-based model. Simply said, those who produce better results and improve patient quality of care at lower costs will reap higher dividends. This shift will require better use of technology and significant changes to many platforms and their capabilities, including more investment in big data, analytics, and patient matching systems. These investments in population health management technologies will provide the real-time information needed to make more informed decisions.

Population health solutions play a critical role in moving healthcare from a treatment-based to a prevention-based model. These platforms enable providers to better prepare for patient-reported outcomes, provide data regarding social determinants of health and activity-based costing, and match extracted data outcomes with the right patient.

Current state of U.S. healthcare

The U.S. spends more on healthcare per capita than any other nation in the world but fails to produce better results for life expectancy and other health outcomes. Moreover, U.S. taxpayers fund more per capita on healthcare (64%) than those in other countries, including those with universal health programs.

These facts suggest that encounter-based medicine might be contributing to sub-optimal results in the U.S. and there is a need for change. That change is prompting the rise of population health management and data analytics technologies.

The population-based model is based on aggregating patient data across various health information resources, forming a comprehensive, longitudinal health record for each patient, and leveraging analytics to produce insights that clinical teams can use to improve care and lower costs. In addition to health and financial data derived from electronic health records (EHRs) and medical claims, information such as a patient’s socio-economic status, personal support network, and habitat conditions can be useful in building preventative care strategies.

For example, a patient diagnosed as prediabetes would be classified as high-risk in an encounter-based model. However, this does not take into consideration the patient’s lifestyle and behavioral patterns. Many prediabetics can avoid developing diabetes by modifying habits such as diet and exercise. Patients who smoke, abuse drugs, or have a sedentary lifestyle are much more at risk of developing the disease. Identifying these genuinely high-risk patients requires access to accurate data that is linked to the correct record.

Challenges in moving to a population health solution

At present, a tremendous amount of patient data is available but it is not unified – it exists within different institutions and across various platforms. Thus, the available information is very difficult to match with the right patient (if not impossible in some cases) and such data has little practical value. Population health solutions need a system that can match patients with their available data and provide information on the best recommendations for preventative care, helping to improve outcomes and save resources.

Therefore, the most important variable in extracting value from a population health solution is ensuring that a patient’s captured data is matched to the correct record. Better data warehousing and mining capabilities will serve no purpose if healthcare providers lack the ability to match the output with the right patient. At present, not only do patient identification issues exist within a single healthcare institution, but these issues become even worse when patient data is exchanged across multiple systems, with error rates rising to 60%.

Failure to properly identify a patient means loss of historical medical history, social indicators, financial information, medications, allergies, pre-existing conditions, etc. – vital information that puts the patient and healthcare provider at greater risk. These data integrity failures can significantly dilute the efficacy of population health initiatives.

In fact, the transition from fee-for-service to value-based healthcare is only going to work if healthcare entities invest in patient matching technology alongside their investments in big data and analytics platforms. These investments should go hand-in-hand since patient matching errors can have such a substantial impact on data quality.

Population health management is among the top six categories in healthcare that are attracting investments from venture capital firms. Other segments include genomics and sequencing, analytics and big data, wearables and biosensing, telemedicine, and digital medical devices.

Thus, the industry is investing in technologies that will play a significant role in value-based care and population health management. However, the success of any population health initiative depends on the right patient being identified every time so that medical records and the corresponding patient data are not mixed-up. Considering the data fragmentation that exists in healthcare and lack of standards around patient identifiers, AI-based systems like RightPatient are the only way to ensure reliable identification of patients across various data platforms and maximized investment in population health management.