Five Common Patient Safety Concerns Hospitals Must Address Effectively

January 20, 2022/4894 views / 2 Comments/in BLOG, COVID-19, healthcare, HIM, Infection Control, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

Arguably, hospitals and health systems have been facing a very rough patch due to COVID-19, and with its latest variant, Omicron, it looks like it will continue to haunt everyone for quite some time. While COVID-19 is the biggest problem right now, it’s not the only one – healthcare providers need to address several issues to treat patients effectively and safely. With that out of the way, let’s dive deep into some of the typical patient safety concerns hospitals need to address effectively.

Five patient safety concerns hospitals need to focus on

COVID-19

Quite unsurprisingly, this tops all lists regarding patient safety concerns in the world now. This has been the most significant and unprecedented challenge healthcare providers have faced in recent years. Even with the new vaccines, rules and regulations, cases are still increasing due to the Omicron variant.

The variant has caused several hospitals to permanently close their doors, rapid changes to the entire healthcare landscape, incorporation of telehealth into the mix and adoption of other practices – desperate times call for desperate measures.

While hospitals have already allocated or built separate facilities to accommodate COVID-19 patients, surges created by new variants have overwhelmed them. During such surges, hospitals postpone non-emergency elective procedures and surgeries, limit visitors, shorten visiting hours and encourage telehealth to protect regular patients from catching COVID-19 at their facilities. While these have become the typical responses, it disrupts the healthcare experience for many patients – what if the non-emergency procedure is crucial for the patient, or what if the hospital suspends ALL elective procedures? These are some questions that need answers from healthcare providers.

Healthcare staffing issues

The virus has led to another problem – a shortage of healthcare professionals. Many professionals contracted the virus. Unfortunately, some lost their lives, and others had to isolate themselves. On the other hand, hospitals incurred huge losses since elective procedures and regular healthcare visits were postponed or canceled. They had to furlough or lay off workers and introduce pay cuts. These actions led to massive shortages as nurses and other healthcare staff members had to look after far more patients than they could manage.

This is a huge patient safety concern because fewer healthcare staff members mean that the treatment will be rushed and compromised. Patients won’t receive the level of care they need, and increased pressure on healthcare staff members might lead to mistakes.

Issues with diagnoses

While diagnostic errors were common before COVID-19 wreaked havoc, the virus has caused many patients to miss out on scheduled diagnostic tests or even have them delayed. In the pre-pandemic era, errors such as delayed diagnosis, misdiagnosis and failure to diagnose related diseases were common. However, healthcare providers were forced to delay all procedures barring COVID-19 cases to allocate resources to deal with the pandemic.

Due to such delays, the patients’ health problems worsened, leading to more complex treatment plans, higher risks and chances of patient safety incidents. Once again, healthcare providers are using telehealth to address this issue. Although diagnostic tests are virtually impossible, patients need to physically come to healthcare facilities for the tests.

HAIs – one of the most significant patient safety concerns now

Hospital-Acquired Infections (HAIs) are quite problematic and have become one of the prominent patient safety concerns in the US, especially after COVID-19. Hospitals consist of patients suffering from different diseases, some of which are contagious. When other people, be it patients or healthcare staff members, have contact without ample protection, they’ll contract the virus as well. This is how COVID-19 has spread, and healthcare providers need to use innovative solutions and strategies to prevent HAIs. For instance, touchless patient identification platforms like RightPatient can help with infection control and reduce HAIs effectively – more on that later.

Errors during surgeries

Surgical mistakes are one of the biggest challenges for most healthcare providers. Surgical errors come in various forms, from retained surgical instruments and wrong-site surgery to operating on the wrong patient. A frequent surgical mistake is when patients get mixed up due to common names. While there are miraculous cases where the initial patient survived, these are dangerous nonetheless.

Surgical mistakes due to patient misidentification can be prevented with a tried and tested biometric patient identification like RightPatient. Using their photos, it ensures that patients are identified accurately and safely across the care continuum.

RightPatient prevents duplicate medical records and mix-ups – preventing patient safety incidents in the process.

How are you addressing patient safety concerns at your healthcare facility?

Accurate Patient Identification Tops 2022’s Patient Safety Goals

December 7, 2021/5015 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, HIM, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

There is a lot going on in the U.S. healthcare industry right now. While some might argue that the industry has always been a dynamic field, which is true, it’s safe to say that the pandemic has pushed healthcare into overdrive. While healthcare data breaches, increased hospitalizations, vaccine booster shots, and oral pills to tackle COVID-19 dominate the news, the Joint Commission has announced next year’s National Patient Safety Goals applicable beginning January 1, 2022.

Unsurprisingly, again in 2022, the number one priority for improving patient safety, as per the Joint Commission, is identifying patients accurately. This highlights the importance of positive patient identification, which we’ve been promoting for a long time. That being said, let’s take a look at the top patient safety goals for 2022, why patient identification has been a topmost priority for years, and how RightPatient can effectively help meet those goals.

What are patient safety goals?

Every year, the Joint Commission collects information on patient safety issues that plague hospitals, health systems, and other healthcare facilities. After collecting all the data via credible sources and experts, the Joint Commission releases a list of goals that healthcare facilities need to implement in order to improve patient safety.

As healthcare is quite broad, the Joint Commission has divided it into chapters such as Ambulatory Health Care Chapter, Assisted Living Community Chapter, Behavioral Health Care & Human Services Chapter, Hospital Chapter, Home Care Chapter, etc. However, in all nine chapters, the number one goal is to identify patients correctly (residents in the case of Nursing Care Centers). This shows how imperative proper patient identification is as it’s the top priority in all the chapters.

That being said, let’s look at next year’s goals for the Hospital Chapter, as that’s our primary focus.

2022’s patient safety goals for hospitals

Next year, according to the Joint Commission, healthcare providers need to focus on the following goals to improve patient safety at their facilities:

Accurate patient identification
Improving staff communication
Using medicine safely
Using alarms on medical equipment
Infection prevention
Identifying patient safety risks
Preventing errors in surgeries

Comparing them with the goals for 2021, there hasn’t been any significant change in the goals or their order. But why is patient identification always the topmost goal?

Accurate patient identification has been a priority for years

Patient misidentification isn’t anything new. Since there was a ban on creating a state-funded patient identifier around two decades ago, patient identification errors have been quite common. To this very day, a standardized and effective patient identifier doesn’t exist. Since misidentification has led to duplicate medical records, overlays, and medical record mix-ups, they have also created medication administration errors, repeated lab tests, patient data integrity failure, delays in care, transplant mix-ups, and even deaths! As a result, patient misidentification quickly became a patient safety concern.

Every year, healthcare experts come together and demand that the ban against a state-funded patient identifier is lifted. However, to this very day, the ban on the unique patient identifier is in effect.

While different healthcare providers use various methods, solutions, and strategies for accurate patient identification, a touchless biometric patient identification platform like RightPatient is the most ideal and future-proof platform for that. In fact, RightPatient also helps with a few of the other patient safety goals – let’s explore how.

RightPatient helps improve patient safety in several ways

RightPatient is helping several leading healthcare providers enhance patient safety by protecting patient medical records, ensuring accurate patient identification, and reducing infection control issues. It captures patient photos during the registration process and attaches them to EHRs.

For subsequent visits, returning patients only need to look at the camera for verification. RightPatient compares the live photo with the saved one and provides accurate EHRs, preventing mix-ups, duplicates, and other problems associated with misidentification.

RightPatient can be used for remote authentication as well – patients need to provide a selfie along with the photo of their driver’s license after scheduling appointments. RightPatient compares the images, and after a successful match, provides the patients with biometric credentials – check out the video to learn more about it.

RightPatient helps with several patient safety goals:

It ensures accurate patient identification
It prevents errors in surgeries by preventing patient mix-ups
It reduces infection control issues (it’s a touchless experience for both patients and caregivers)
It improves staff communication as redundant lab tests, mix-ups, and delays are reduced
It reduces medication administration errors

How are you planning to improve patient safety at your healthcare facilities, and does the strategy include a solution that solves several problems simultaneously as RightPatient does?

Why is Patient Safety Important and How Can RightPatient Help?

November 9, 2021/5392 views / 0 Comments/in BLOG, Data Integrity, healthcare, HIM, Medical Record Mix-ups, Patient Data, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Ensuring and improving patient safety has always been important in the U.S. healthcare system. However, as we’re living in a pandemic, it is more important than ever now. As many hospitals have reopened, and others are planning to do so, most of them are concerned about keeping incoming patients safe and preventing any new COVID-19 outbreaks. Patient safety can be ensured with a number of strategies, including improving accurate patient identification, ensuring patient data integrity, and ensuring infection control – more on this later. That being said, let’s take a look at why is patient safety important now more than ever, what are the benefits, and how hospitals and health systems can improve patient safety with RightPatient – creating a safe environment for patients and caregivers.

COVID-19 has changed the landscape

Most people would agree that COVID-19 has changed everything. Not only has it affected our daily lives, but it has changed the way we work, the way we socialize, and the way we receive healthcare. To examine how COVID-19 has changed everything for hospitals, let’s take a look at a simple example.

Patient safety in hospitals and healthcare systems can be ensured in several ways – one of which is ensuring proper infection control. In the pre-pandemic period, only healthcare providers were concerned about infection control issues – it wasn’t a concern for the majority of patients. However, the pandemic has taught everyone a lot – social distancing, wearing PPE, sanitizing frequently, and so on. Quite naturally, all patients are concerned about infection control in hospitals now.

Earlier, when coming to hospitals, patients weren’t much concerned about catching viruses. Now, patients need to think twice before coming to hospitals and most of them typically come with as much protection as possible. Their concerns are quite valid too – what if a COVID-19 positive patient was in the vicinity, or what if the patient touched a surface?

That was just a simple example, but it provides a version of an answer as to why is patient safety important, especially now. Hospitals and health systems have the challenging task of keeping patients safe while ensuring them that they’re taking the most stringent measures to provide a safe environment for everyone in the facility. Otherwise, patient safety incidents could lead to patient harm, disability, and even deaths!

That being said, let’s take a closer look at some of the benefits of ensuring patient safety within healthcare facilities.

The benefits that show why is patient safety important

It prevents patient harm

Quite naturally, ensuring patient safety helps improve patient outcomes – they are simply getting the appropriate treatment plan that fits their ailments. Many cases have occurred where the patient wrongly receives the treatment that’s meant for someone else – leading to hospital readmissions, adverse effects, and worse. Improving patient safety ensures that high-quality care is provided to all the patients every time they interact with the healthcare provider.

It prevents medication administration errors

A huge concern of patient safety advocates is patients getting the wrong medicine or the wrong dosage – the results can be catastrophic! Using medication management protocols and accurate patient identification whenever necessary, nurses and therapists can easily confirm what dosage and which medications are required by the patients and at what times – improving patient safety.

It prevents infection control issues

As mentioned above, one of the patient safety concerns is infection control. Having a strict hygiene policy isn’t enough anymore – hospitals need to screen their patients strictly whenever one comes in to see whether they’re showing symptoms of COVID-19. However, doing it properly not only prevents the spread of the notorious virus but also other lesser-known infections within the healthcare facility. Otherwise, the spread will lead to other patients becoming sicker in the process.

It reduces costs

Preventing patient safety incidents saves numerous costs – costs that arise from patient harm, litigation costs, denied claims, patient misidentification, medication administration errors, and more. All of this, when summed up, becomes a large amount of money for any given hospital or health system, and given the pandemic’s pressure on healthcare providers, they need to reduce costs as much as possible.

Fortunately, RightPatient knows why is patient safety important, and it helps to improve it in several ways.

RightPatient boosts patient safety efforts

RightPatient is a touchless biometric patient identification platform that’s already deployed at several hospitals and health systems and is protecting millions of patient records – improving patient safety in the process.

For registration, patients only need to look at the camera when they come in for in-person hospital visits, making it a touchless, hygienic, and safe experience – preventing infection control concerns and improving safety.

Remote patients receive a link via an SMS to provide their photos after they schedule appointments. New patients need to provide a photo of their driver’s license along with a selfie for registration. RightPatient runs a search to see if the photos match and provides credentials to the new remote patients.

RightPatient not only ensures a contactless and hygienic experience, but it also ensures that the correct information is fed to the appropriate EHR – preventing medication errors, mix-ups, or duplicates. It even prevents medical identity theft as fraudsters will be identified once they try to go through the verification process.

RightPatient knows why patient safety is important, which is why it helps to improve it on several fronts. How are YOU ensuring patient safety at your healthcare facility?

RightPatient Partners with Harris Healthcare to Secure and Maintain EMPI Data Integrity

November 8, 2021/5087 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, HIM, Partnerships, Patient Data, Patient Identification /by Michael Trader

Very recently, RightPatient and Harris Healthcare’s DIS (Data Integrity Solutions) Business Unit have announced a strategic partnership to tackle patient data integrity issues by ensuring accurate patient identification.

Harris DIS includes QuadraMed, which focuses on EMPI management and data cleanups, and Just Associates, focused on helping hospitals and health systems achieve and maintain a highly accurate and quality MPI. QuadraMed provides end-to-end patient identity management to prevent duplicate medical records and dirty patient data to improve patient data integrity. From data analysis to cleanups, Just Associates performs the critical tasks necessary for a pristine MPI. Its state-of-the-art suite of identity management solutions and services includes continuous duplicate detection (IDSentry™), ongoing MPI management (IDManage™), and customized MPI clean-up services (IDResolve™).

By using the RightPatient Integrity Platform with Harris DIS’ existing solutions, patient identity management will be much more secure, accurate, and efficient. The collaboration provides important protections against front-end contamination of the MPI and EMPI and helps eliminate patient misidentification and safety issues created by “dirty” patient identification data.

The problem of patient misidentification and dirty patient data

Several factors cause front-end contamination and dirty patient data within an MPI or EMPI, such as frequent flyers, medical identity theft, and duplicate medical records. There may even be duplicate records that have very limited or contrasting information.

RightPatient Integrity Platform incorporates patient photos into the Quadramed SmartID platform, helping identify and resolve these challenging duplicate records that were created from cases of alias or stolen identities. This helps reduce new duplicate and overlaid medical records right from the start, while Just Associates focuses on creating and maintaining a pristine MPI/EMPI environment and supporting rapid and accurate patient identification.

RightPatient advances Harris DIS’ ability to address key health information issues by reducing the volume of potential duplicate medical records, preventing patient misidentification, enhancing patient safety, and ensuring patient data integrity across the care continuum. Doing so is more important than ever as remote patient registrations have increased due to COVID-19.

RightPatient and Harris DIS’ partnership aims to improve the overall efficacy of medical data clean-ups and ongoing data integrity efforts with RightPatient’s robust de-duplication engine. It secures patient information and minimizes the ongoing cost of maintaining quality patient data.

How RightPatient and Harris DIS improve patient identity management

Typically, an EMPI contains patient information from a health system’s several facilities such as labs, hospitals, physician practices, and pharmacies. Front-end contamination is common if positive patient identification isn’t ensured during the registration process. This later leads to dirty patient data, duplicates, overlays, patient safety incidents, write-offs, and more.

RightPatient and Harris DIS can address and solve patient misidentification right off the bat using patient photos.

During the registration process, hospitals collect the patient information along with their photos. The MPI data is then sent to QuadraMed for analysis and cleaning, after which RightPatient Integrity Platform receives a copy of the patient photos along with the corresponding MRNs (medical record numbers). Using RightPatient’s powerful photo-matching engine, the patient photos are deduplicated to bolster overall system analytics.

RightPatient Integrity Platform with Harris DIS can be used for:

Existing EMPI data cleanup projects
Identifying duplicates during the registration process
Hospitals that are starting to capture patient photos

The impact of effective patient identity management

RightPatient’s leading touchless patient identification platform is being utilized by numerous healthcare providers to identify their patients safely, reliably, and effectively.

During the registration process at hospitals and healthcare facilities, patients just look at the camera and the platform takes a photo and attaches it to the medical record. During remote registrations, patients receive an SMS after which they provide a selfie and a photo of their driver’s license. The platform then searches for a match between the two photos and assigns biometric credentials to new patients.

The same expertise comes with the RightPatient Integrity Platform which can be seamlessly integrated with any EHR, including QuadraMed’s SmartID Platform. This enables healthcare providers to:

Prevent duplicate and overlaid medical records during registration
Ensure remote patient photo capture and authentication
Bolster de-duplication and EMPI data cleanup efforts
Ensure clean patient data across the care continuum
Improve patient safety and prevent medical errors
Reduce write-offs and denied claims
Prevent cases of identity theft and “frequent flyers”

Protection of Medical Records is Critical as Data Breaches Appear Unstoppable

September 2, 2021/6675 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?

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

August 26, 2021/6815 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?

Healthcare Revenue Cycle Management Optimization is Crucial as In-Person Visits Increase

July 25, 2021/7423 views / 0 Comments/in BLOG, Denied Claims, HIM, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Revenue Cycle Management /by Matt Gibson

Believe it or not, while COVID-19 was arguably one of the worst problems faced by the U.S. healthcare system, it was just ONE of many. That’s right, there are a plethora of issues that have been hampering healthcare for years, causing patient safety incidents, lost revenue, and more. Unfortunately, these losses went through the roof due to COVID-19 – they were estimated to be around $323 billion in 2020. While the pandemic is slowly waning, things are going in the right direction as providers are opening their doors for in-person visits. To recover from the pandemic’s financial losses, healthcare revenue cycle management optimization must be one of the topmost priorities for health systems – let’s take a closer look at why it’s important and some strategies that can help with revenue cycle optimization.

Revenue cycle management in healthcare facilities

Healthcare revenue cycle management might be quite complex, as it contains many intricate processes, but it is simple enough to understand.

Revenue cycle management, in a nutshell, is used by hospitals and health systems to keep track of the “revenue” they receive by treating patients. It has many steps, but RCM starts from the first interaction with the patient, for instance, appointment scheduling, and continues until caregivers receive the final payment.

If broken down, revenue cycle of healthcare facilities usually contains 7 components:

Preregistration
Registration
Charge capture
Claim submission
Remittance processing
Insurance followup
Patient collections

As this list shows, the revenue cycle starts from the first interaction with the patient and ends with receiving the full amount for providing healthcare services to the patient.

While it might seem simple, healthcare revenue cycle management is quite complicated and difficult, especially when it comes to collecting claims from the payers (insurance providers).

Why optimizing RCM has never been more crucial

While it was always important for healthcare providers to improve RCM within their facilities, doing so now might ensure their survival and get them through this trying time. COVID-19 has drastically affected healthcare providers, and while some received bailouts in billions, others had to close their doors permanently. The rest of them are simply struggling through the financial losses, but as in-person visits are increasing, things look brighter for the caregivers, as long as they are implementing strategies that optimize RCM right from the start.

That being said, let’s take a look at some of the strategies that can be employed to optimize healthcare revenue cycle management.

Strategies that enhance healthcare revenue cycle management

Examine the entire RCM process to identify gaps

While the age-old saying is “If it isn’t broke, don’t fix it”, rapidly evolving environments beg to differ. How do you know that it’s working out fine for you? Unless your denied claims are reduced to virtually zero, there’s always room for improvement.

Analyze the entire RCM process to see if there are addressable gaps that require improvement – even the smallest ones matter. Talk to patients, survey your RCM team, take a look at the current numbers, and determine where you want the numbers to be. If issues are not found, then great – the problem might not lie in RCM, but if issues exist, work on them. RCM is evolving rapidly, and with the changes brought about by COVID-19, introducing technology in almost every aspect of the service to improve efficiency and collaboration has become the new normal. And speaking of collaboration, let’s move to the next point.

Improve collaboration between your front-end and back-end RCM teams

The traditional practice is that the front-end and back-end teams work towards the same goals, but separately. However, if they work more collaboratively then the entire process will become seamless and it will help optimize RCM as information is never lost or misinterpreted – helping to receive payments much faster and in greater numbers, improving the bottom line.

Using solutions that guarantee accurate patient information

When it comes to RCM, one of the biggest impediments to its optimization is denied or rejected claims – most of which can be traced back to billing and coding errors. On the front-end, if the patients are misidentified or if inaccurate medical records are used, then there are bound to be inconsistencies that are picked up by the payers. These errors lead not only to billing errors and denied claims, but can also be detrimental to positive patient outcomes – affecting the bottom line and the goodwill towards the hospital. As a result, ensuring patient data integrity and accurate patient identification is a must – both of which can be done with RightPatient.

RightPatient is a tried and tested biometric patient ID platform that safely and accurately identifies patients using their faces. The patient only needs to look at the camera – the platform does the rest, making it an entirely contactless process, something that is crucial in the post-pandemic world.

Not only does RightPatient make identification faster and accurate, but it also ensures that accurate information is fed to the registered patients’ EHRs every time they opt for healthcare visits, reducing billing and coding inconsistencies and denied claims in the process.

How to Protect Patient Data at Your Hospital

July 2, 2021/7732 views / 0 Comments/in BLOG, Data Integrity, healthcare, HIM, Medical Identity Theft, Patient Data, Patient Errors, Patient Identification, Patient Safety /by Matt Gibson

The U.S. healthcare system has never had a shortage of problems – it has always dealt with several issues simultaneously. The exorbitant prices, the lack of price transparency, medical identity theft cases, lack of patient identification in hospitals, preventable medical errors, and archaic laws are just some issues that plague healthcare. Healthcare data breaches have unfortunately been growing at an exponential rate. With no signs of them stopping anytime soon, it becomes crucial that healthcare providers, professionals, and everyone involved with patient information be vigilant regarding protecting the data. With that out of the way, let’s take a look at how to protect patient data within hospitals and health systems with 5 practices.

Why protecting patient data is becoming so important

Those who are familiar with the U.S. healthcare system know that data breaches are occurring left, right, and center. These data breaches have several grave consequences such as patient information being stolen, being sold in the black market, being used for medical identity theft, patient data integrity failure, litigation costs, loss of goodwill – the list just goes on. And all of this might occur simply because a healthcare staff member opened an external email without being wary of the possible risks.

As a result, healthcare professionals and facilities need to be on guard at all times against such cyberattacks so that they don’t lead to data breaches, disruption of operations, or the most common endgame – medical identity theft.

With the “why” out of the way, let’s dive into the “how”, to be more precise, how to protect patient data.

How to protect patient data with 5 practices

Work on HIPAA compliance

HIPAA, or the Health Insurance Portability and Accountability Act, mandates that healthcare providers along with anyone else dealing with patient information protect patient information effectively at all times. It provides many rules and regulations that cover a lot of aspects, and if applicable organizations aren’t ensuring compliance, then they’ll be heavily penalized.

However, working on HIPAA compliance just for the sake of avoiding penalties won’t help. HIPAA provides several guidelines on how to protect patient data at rest and during transmission. If these guidelines are taken as starting points, not only will HIPAA compliance be ensured, but patient data will also be protected – reducing chances of data breaches. There are even solutions such as HIPAA compliance software that can also aid in compliance – helping identify security gaps and reducing the administrative burden in the process.

Improve user authentication practices

Patient data can be breached from anywhere, and with many healthcare staff working remotely, the risks are just increasing. Putting safeguards in place that enforce limited access to everyone that deals with patient information can slow down breaches. This way, even if the hacker has access to the employee’s account, they will only have restricted access to sensitive information.

Always encrypt sensitive information

Encrypting sensitive information makes it useless for hackers – it makes the information unreadable by outsiders or unauthorized users. Enforce employees’ use of encryption whenever transmitting sensitive patient information.

Provide training on patient data security whenever required

Too many training sessions on patient information security can be ineffective and counterproductive, and too few can reduce its importance. Instead, find the sweet spot for your organization to provide training sessions regarding patient information security.

For instance, whenever there’s news about another data breach that can provide meaningful information, conducting a training session and disseminating the information to the employees can help – learning from others’ mistakes might just be the thing that will prevent a data breach. Also, regularly provide updates on how to handle external emails and requests – the safest bet is treating each email as a suspicious one.

Implement solutions that protect patient data

Several constraints prohibit healthcare providers from fully being protected against data breaches – cybersecurity budgets and hackers coming up with innovative ways to attack being the most common ones. However, while data breaches might seem inevitable for many, patient data can be protected, but how?

RightPatient is the answer.

It is a touchless biometric patient identification platform that prevents medical identity theft in real-time. By ensuring accurate patient identification, RightPatient successfully red-flags fraudsters during the registration process. This prevents fraudsters from tampering with the EHRs, ensuring patient data integrity, and protecting patient data in the process.

How are you protecting patient data at your healthcare facility?

Revenue Cycle Optimization Efforts Are Hampered by Duplicate Medical Records

October 9, 2020/10586 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, HIM, Medical Record Mix-ups, Patient Experience, Patient Identification, Patient Matching, Patient Safety /by Matt Gibson

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

How duplicates get created

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

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

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

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

How revenue cycle optimization is hampered by duplicates

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

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

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

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

Providers dedicate FTEs for fixing medical record errors

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

RightPatient enhances revenue cycle optimization

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

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

Peace of Mind: A Short Guide To Who Handles Your Private Medical Information

August 15, 2017/7139 views / 0 Comments/in BLOG, Cybersecurity, Data Integrity, Guest Blog Posts, HIM /by John Trader

The following guest post on who handles Protected Health Information (PHI) was submitted by Brooke Chaplan.

From basic information such as your height and weight to the types of medications you are taking, your health history, diagnoses, billing information and more, your healthcare providers have access to an incredible amount of very personal information about you and others in your family. This is information that you do not want to fall into the wrong hands. This begs the question of who actually has access to all of the information in your medical file.

Many patients are unaware of how many people have access to their sensitive medical information.

Well-Trained and Screened Candidates

In most healthcare offices, hospitals and other settings, the administrative or medical team that has access to your records is usually well-trained and thoroughly screened. These individuals typically must pass a thorough background check before being permitted to work in the office, and the office often has safeguards and high-tech protocols to prevent employees from mishandling or abusing the information that they gain access to. Some of the professionals with the most access are healthcare administrators that hold a degree in their field.

Your Health Insurance Company

If you are one of the many millions of Americans who have access to health insurance, your health insurance company may keep track of your medications, treatments, diagnoses and more. Health insurance professionals are often required to uphold strict standards of confidentiality in the same way your healthcare providers are. In addition, as is the case with hospitals and medical offices, health insurance companies usually go to great lengths to prevent employees from misusing or abusing the data that they come across over the course of their regular work day.

Potential Hackers

In 2015, as many as a third of all Americans were impacted by a security breach that involved their healthcare data or records. Information such as their address and Social Security information may have been passed on to hackers. Some hackers sell the data they obtain through their attacks, and others use it personally with malicious intent. For example, with your name, address, Social Security number and birth date, they can commit identity theft. Many medical offices and hospitals are aware of this and other potential risks to their patients, and they regularly take steps to continuously update and improve technology in an effort to reduce this risk for their patients.

Your private data should remain private at all times, but the unfortunate reality is that the system in place in the healthcare industry right now is not perfect. Patients should make inquiries to their healthcare providers to learn more about the steps a particular office or hospital is taking to keep their data from falling into the wrong hands.

Author bio:

Brooke Chaplan is a freelance writer and blogger. She lives and works out of her home in Los Lunas, New Mexico. She loves the outdoors and spends most her time hiking, biking, and gardening. For more information contact Brooke via Twitter @BrookeChaplan.