Dealing with Claim Denials in Healthcare Facilities

April 22, 2022/4599 views / 1 Comment/in BLOG, Data Integrity, Denied Claims, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

Healthcare providers have always been under a lot of pressure. Patient mix-ups, identity theft cases, denied claims, medical record errors, data breaches, and patient safety incidents are just a few examples of the challenges. However, all of these issues were more visible than ever with COVID-19. Claim denials were one of the most difficult challenges, as there were more patients in need of healthcare services during the pandemic’s peak. Both healthcare providers and payers were (and still be) at odds over denied claims, and the situation will only worsen as rules and regulations change. While hospitals are already suffering from massive losses, refused claims exacerbate the situation. That being said, let’s take a look at a few strategies for dealing with claim denials in healthcare facilities.

Strategies that can help reduce claim denials in healthcare

Provide training to the coding team

Coding errors are one of the most regular reasons for claim denials in healthcare facilities. For example, suppose a patient came in and requested healthcare services; the latter has a unique code. However, the coding team utilized the incorrect code, and when the payer inspects the claim, it is classified as denial because the incorrect code was used.

To avoid such errors, healthcare providers must train the coding team on topics such as common coding errors, coding do’s and don’ts, recent updates, and so on.

Ensure that physicians record information correctly

A lack of proper clinical documentation is another factor that contributes to claim denials in healthcare. The coding team is not responsible for every denied claim. When clinical documentation problems occur, wrong codes are almost always selected, resulting in denied claims.

As a result, healthcare providers must guarantee that physicians properly and timely record all paperwork in suitable medical records. RightPatient can aid in the proper identification of medical records and the reduction of denied claims.

Ensure that claims are submitted timely

Another reason contributing to denied claims is the failure to submit them on time, which can be easily rectified. Healthcare providers should set goals for their coding teams in order for them to process claims in a fast and accurate manner. They should, for example, categorize which batch of claims will be delivered and when they should be sent and check for errors.

While this does not always succeed, detecting the issues that cause late submissions can assist providers in addressing the issue and reducing future claim denials.

Ensure accurate patient identification to reduce denials in healthcare

One common cause of denials in healthcare facilities is medical record errors such as duplication and overlays, the majority of which result in mix-ups, improper treatment, and, predictably, billing and coding issues. The majority of medical record errors arise because there is no standardized patient identification in the US healthcare system.

While many healthcare providers waited for a standardized and effective patient identifier while dealing with duplication and denied claims, forward-thinking health systems already prevent them with RightPatient.

RightPatient is a touchless biometric patient identification platform used by top healthcare organizations such as Terrebonne General Medical Center, Duke Health, Community Medical Centers, and University Hospital. RightPatient uses one of the most secure, sanitary, and non-transferable properties of patients: their faces.

During registration, patients must look at the camera; RightPatient takes a snapshot and compares it to existing medical information to identify duplication. If no matches are identified, a new EHR is created with the patient’s photo attached. Whenever the patient comes to the hospital for additional healthcare services, they only need to look at the camera, And RightPatient generates the necessary medical record in seconds.

RightPatient isn’t just for registration; healthcare providers can use the platform throughout the care continuum. After scheduling sessions, remote patients can send selfie photographs as well as a photo of their ID card. RightPatient examines the photographs for a match, then searches to see if there are any existing records, and either produces new credentials for new patients or sends the proper EHR to the hospital for existing patients.

RightPatient not only makes accurate patient identification simple, but it’s also safe, secure, clean, and seamless. Healthcare providers may smoothly link RightPatient with their EHR systems, making the latter part of the EHR workflow.

Using RightPatient, some prominent healthcare providers reduce patient misidentification, eliminate duplicate medical records, minimize denied claims, and enhance patient safety and quality.

Common Reasons for Patient Identification Errors in Hospitals and How to Solve Them

April 20, 2022/4713 views / 1 Comment/in BLOG, Data Integrity, Denied Claims, EHR, healthcare, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

Positive patient identification is an important but underappreciated component of the US healthcare system. Healthcare providers maintain patient safety, appropriate medical treatment, and good healthcare results by precisely identifying patients and using their relevant electronic health information. For instance, the physicians know of the patient’s comprehensive medical history, the revenue cycle team knows which claims to submit to the insurer, and the hospital records the patient’s information in the appropriate EHR. Unfortunately, this isn’t always the case; patient identification errors in hospitals are all too common and can generate a slew of issues for healthcare providers, patients, and insurance companies.

Patient identification errors in hospitals generate a variety of issues, including:

Patient safety issues
Patient data integrity failure
Patient mix-ups
Medical record errors like duplicates and overlays
Denied claims
Detrimental patient experience
Medication administration errors
Financial and legal issues

While those are some of the issues created by patient misidentification, let’s look at some of the common reasons why they happen in the first place, as well as how a touchless biometric patient identification platform like RightPatient ensures positive patient identification.

Common reasons for patient identification errors in hospitals

Patient misidentification during registration

In hospitals, patient misidentification is most common during registration. Patients are wrongly identified and linked to the incorrect EHRs from the start during the registration procedure. As a result, the patient will receive ineffective care because the physicians will be relying on someone else’s medical history.

The patient’s EHR is difficult to find

The registration areas are arguably high-pressure situations, as patients are constantly arriving, and a limited number of workers are required to process them for treatment. However, when the registrar examines the EHR system, they may discover that no medical records match the patient. At times, registrars may detect that too many EHRs correspond to the patient. In these instances, registrars must select an EHR, and the chances are that they will select the erroneous one, resulting in improper patient identification.

Reducing patient waiting times

As previously said, any given healthcare provider’s registration area is quite hectic. Patients are begging for treatment, and registrars are under intense pressure to shorten patient wait times. Because there is no standardized precise patient identifier in place, searching for the relevant medical records can take a long time. Because the EHR system contains tens of thousands of medical records, the registrar may wind up picking the incorrect medical record.

Existing duplicate medical records

This may appear perplexing, but patient identification errors in hospitals and medical record errors are inextricably linked; the other will follow naturally if one occurs.

Patient identification, for example, occurs when an incorrect medical record is picked. When the registrar searches the EHR system and finds no EHRs with the patient’s name, they create a new medical record. However, due to a lack of definite patient identification, the patient’s genuine medical record could not be identified, resulting in a new duplicate medical record.

Similarly, duplicate medical records within the EHR system are bound to induce patient misidentification because all of the records are inconsistent and fragmented, resulting in patient safety issues, incorrect treatment, and worse.

Human errors

Human error is another prominent cause of patient misidentification in hospitals. While registrars, nurses, and other healthcare workers already work in a high-stress environment, a single typing error can force them to select the wrong EHR.

Patients themselves submit false, wrong, or incomplete

Patient misidentification in hospitals happens when patients offer insufficient or incorrect information to medical employees. For example, a patient’s medical record is maintained with the name “William Smith,” yet he gives the registrar the name “Bill Smith.” The registrar will search for his medical record using the keyword “Bill Smith,” which will not yield the genuine EHR.

On the other hand, patients falsify information to obtain treatment in the name of someone else. It’s nearly impossible to identify the falsehood because healthcare providers don’t employ a reliable patient identification system throughout the states.

RightPatient can prevent all of the above and more.

RightPatient prevents patient identification errors in hospitals

RightPatient is a touchless biometric patient identification platform that accurately identifies patients across the treatment continuum. During the registration process, the platform captures patients’ photographs and ties them to the proper EHRs, effectively locking the medical records. When the patients return, the platform must authenticate their identities – the patients only need to glance at the camera – it’s that simple!

RightPatient enhances patient safety, minimizes denied claims, strengthens patient data integrity, and ensures that the proper patient is receiving the right treatment at all times.

How Patient Safety and Quality in Healthcare Can be Improved With Positive Patient ID

February 14, 2022/4469 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, Infection Control, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

While COVID-19 has been arguably the most talked-about issue over the past few years, it’s not the only problem that healthcare providers face. Even now, a plethora of problems continues to plague the US healthcare system. Duplicate medical records, overlays, medical identity theft, lack of proper patient identification, labor shortages, massive financial losses, and infection control issues are just some of them. While not all of these factors are solvable by the hospitals themselves, ensuring positive patient identification can help reduce many significant problems. With that being said, today, we’ll be considering how effective patient identification can improve patient safety and quality.

Five ways that patient identification improves patient safety and quality

It ensures patient data integrity

One significant issue that healthcare providers face in the US is the lack of data integrity in medical records or EHRs, which can often be traced back to patient misidentification. It’s pretty simple: if a patient has more than one EHR, their medical history, allergies, medications, vitals, etc., will be spread across several different medical records.

There are thousands of fragmented EHRs like these. As such, the patient will receive treatments based on a highly fragmented EHR; it doesn’t provide the complete collection of patient information. As a result, treatments may be inaccurate or less effective. However, there’s an even more severe scenario. In cases where there’s a lack of accurate patient identification, hospitals could use one of these EHRs to treat the wrong patient!

The presence of positive patient identification, on the other hand, ensures patient data integrity at all times since patients are treated using accurate EHRs whenever they come in. This remains true both for virtual and inpatient visits.

It ensures positive patient outcomes

Positive patient identification ensures that accurate EHRs are associated with the correct patients across the care continuum. Doing so helps the patients receive the best possible treatment plans and care without inaccuracies, helping them recover without any unwanted incidents, thereby enhancing patient safety and quality in the process.

Patients can receive the wrong treatment without accurate patient identification since they’re associated with incorrect medical records, which can lead to dangerous and adverse incidents.

It reduces medical record errors

One of the biggest problems caused by patient misidentification is that it leads to medical record errors, such as duplicates and overlays. Naturally, these can be detrimental to patient outcomes. Imagine a scenario whereby a patient has multiple EHR documents; if just one of those records is used to treat them, the treatment plan would be based on incomplete information, hence leading to ineffective treatment. On the other hand, overlays are even more dangerous; these are merged EHRs, but they often belong to different patients! Whichever patient gets treated using such an inaccurate EHR record could naturally face detrimental and wrong treatments down the line unless it’s detected and resolved quickly.

Fortunately, accurate patient identification prevents medical record errors right off the bat. Ensuring that accurate EHRs are used every time that patients come in for an appointment helps avoid the creation of duplicates and overlays, thereby saving considerable costs for the hospital and improving patient safety and quality of care overall.

It avoids mixups

Patient mix-ups can be hazardous and can even lead to the wrong patient getting the treatment or surgery intended for another. It might sound like a basic mistake that would never happen, but in reality, such an event has happened numerous times where the wrong patient received kidney transplant surgery.

One of the most common reasons for this is because patients had similar names and characteristics on their EHRs, which can easily lead to mixups, especially in high-pressure environments. In other cases, the wrong patient may have received chemotherapy that was assigned to a different patient for lifesaving treatment. Meanwhile, patients receiving the wrong medication and so on are potentially common risks due to mixups and mistakes.

Most of these mixups can be traced back to – you guessed it – patient misidentification. As such, ensuring positive patient identification is one of the most effective ways for hospitals to prevent these mixups and avoid jeopardizing patient safety overall.

It boosts infection control efforts

It might seem a little unclear as to how accurate patient identification can help boost infection control issues? Well, integrating a touchless patient identification platform such RightPatient helps with that. RightPatient doesn’t just ensure that the patients are identified correctly across the care continuum, but it also ensures that this care is provided hygienically.

Patients only need to look at the camera for registration; the platform captures a photo and attaches it to their EHRs, essentially locking them. Whenever patients come in for subsequent visits, all they need to do is look at the camera, and the platform automatically matches the current photo with the saved one.

RightPatient is already helping several healthcare providers ensure accurate patient identification, improve patient safety, and bolster infection control efforts effectively. As such, it could be a valuable tool to implement for your own healthcare facility’s management systems, too; why not give it a try?

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?

Patient Safety Improvement in Hospitals with 5 Strategies

November 11, 2021/5430 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Patient safety is one of the key components that is crucial for preventing patient harm, ensuring proper healthcare outcomes, and reducing redundant costs for healthcare providers. Without it, adverse events lead to patients receiving the wrong care, and according to WHO, one in ten patients is harmed while receiving healthcare services. Fortunately, half of these adverse events are preventable – let’s take a look at some patient safety improvement strategies that can help with that.

5 strategies for patient safety improvement

Nurture a patient safety-focused culture

One of the best patient safety improvement strategies is to foster a culture that focuses heavily on improving patient care. All employees, from the janitors to the decision-makers, must be a part of the culture and focus on patient safety and quality healthcare more than anything else. In fact, healthcare providers that aren’t fostering such patient-centered cultures are struggling with adverse events, medication errors, and worse. For instance, physicians must focus on patients themselves rather than their medical records and involve them in the decision-making process. This way, they can get better insights into the patient’s ailments to help them identify the problems in a more reliable manner.

Identify and work on mistakes

Rather than only acknowledging the mistakes that lead to patient safety incidents, working towards preventing future incidents is a much more sensible strategy. What’s even better is identifying the issues before they happen and preventing them. For instance, there are different solutions available that can help identify potential issues and address them effectively. In the case of mistakes that already took place, identifying why they occurred and coming up with strategies that can prevent future occurrences is the tried and tested solution.

Reduce chances for human error

While technology is evolving rapidly, most healthcare providers, unfortunately, are still stuck with ancient processes and manual methods. This leaves room for human error, something that can jeopardize patient safety in hospitals significantly. For instance, if paper is used for recording medicine administration, handwriting or common names can lead to mix-ups, leading to an adverse impact on healthcare outcomes. On the other hand, if digital solutions are used, then not only will it speed up the process, but it will also make it more reliable and safe (especially if patient photos are used for identification). This is just a simple example, but reducing chances for human error ensures patient safety improvement across the care continuum.

Ensure a clean environment and enforce hygiene rules

While many might have forgotten that we’re still going through a pandemic, hospitals and health systems must ensure that they are providing a safe environment for everyone involved. Not only must hospitals ensure that they keep their facilities clean, but they also need to ensure that everyone in the facilities is complying with safety rules such as wearing masks and maintaining distance. All of this leads towards reducing HAIs (hospital-acquired infections), improving patient safety in the process.

Ensure accurate patient identification

One of the topmost patient safety goals for many years has been improving the accuracy of patient identification, and according to the Joint Commission, it will once again be the number 1 goal for 2022. This just shows how important accurate patent identification is for patient safety improvement.

The problem is that patient misidentification leads to a number of issues – duplicate medical records, patient record mix-ups, wrong treatment, and even medical identity theft. All of these lead to adverse healthcare outcomes, hospital readmissions, and even deaths.

Fortunately, accurate patient identification IS possible – hospitals that have been using RightPatient are protecting millions of patient records and improving patient safety.

RightPatient is a touchless biometric patient identification platform that essentially locks medical records during the registration process with patient photos. Registered patients only need to look at the camera when they revisit hospitals – RightPatient compares the photos and provides the accurate medical records for use, preventing duplicates, overlays, and medical errors. Moreover, it also helps prevent HAIs as it’s entirely touchless – improving patient safety on two fronts.

How are YOU improving patient safety at your hospital(s)?

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”

Another Patient Mix-Up Leads to the Wrong Surgery – Are These Preventable?

October 13, 2021/5515 views / 1 Comment/in BLOG, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

We’ve seen and already covered many patient misidentification stories. These range from a mistaken patient identity that almost led to huge financial losses, wrong patient surgery cases that caused kidney transplant mix-ups, to a patient identification error that caused the wrong patient to be taken off of life support. Clearly, patient misidentification can cause serious to life-changing consequences for anyone involved. Unfortunately, today’s article is no different – the patient involved underwent a life-altering surgery only to find out that it was a case of a patient mix-up.

That being said, let’s take a closer look at what exactly occurred, how patient mix-up cases can lead to drastic consequences, and how they demonstrate the importance of accurate patient identification.

A patient mix-up led to misdiagnosis and laparoscopic prostatectomy

There’s probably nothing worse than being told by your physician that you have a deadly disease, right? What about being told you actually don’t have the disease AFTER the life-changing surgery?

Unfortunately, that’s exactly what happened with Eric Spang, 48, a man who lived happily with his family in Pennsylvania before he was misdiagnosed with prostate cancer. After learning the truth, Mr. Spang, quite naturally, became depressed and devastated both physically and emotionally.

Everything was going quite normally in Mr. Spang’s life until he received the results from a routine prostate screening. His physician informed him that he, unfortunately, had a common indicator of prostate cancer – elevated PSA (prostate-specific antigen) levels. The later course of action was to get a biopsy to see if it indeed was cancerous or not – this is where the patient mix-up occurred and changed everything for both the patients and their families.

Mr. Spang got the biopsy result back – it was positive. The physicians recommended a laparoscopic prostatectomy – his entire prostate gland would be removed. After discussing it with his wife, Mr. Spang chose to go for the surgery, hoping that it would save his life and put an end to this nightmare.

The bad news didn’t end here for the family, unfortunately. After the surgery, Mr. Spang and his wife found out that he didn’t have prostate cancer – the biopsy result belonged to an entirely different patient! While under different circumstances this might have been good news, it wasn’t for Mr. Spang – the irreparable damage had been done. Quite understandably, Mr. Spang was devastated.

Mr. Spang’s attorney, Aaron Friedwald, has filed a malpractice suit against Tower Health as well as the urology group. One of the reasons for this is because Mr. Spang wanted a second biopsy done to see if the results were consistent or not. However, his urologist did not recommend it, whereas his physician said that his prostate looked good as other tests showed no worrying issues. Getting a second biopsy might have cost a bit more, but it would’ve saved Mr. Spang from the entirely unnecessary surgery and devastation.

Patient mix-ups are a huge cause for concern

Well, this misdiagnosis can be traced back to patient mix-ups – something caused by patient misidentification. Moreover, this is just one case, and as we mentioned in the beginning, we’ve covered cases like this in the past. However, these are the ones that are reported – what about those that go unnoticed and undetected? Imagine getting a kidney removed and finding out that it was entirely unnecessary or getting the kidney that was meant for another patient!

All of these mix-ups have drastic consequences for patients, their families, as well as healthcare providers. Patients’ and their family’s lives are irreversibly changed and they can file a malpractice suit against the healthcare providers and other parties involved. Not only do such cases attract unwanted attention to the hospitals but it also increases litigation costs, loss of goodwill, and might even cause patients to switch to other healthcare providers.

However, these consequences are entirely avoidable with positive patient identification across the care continuum, and that’s what RightPatient does.

RightPatient prevents mix-ups across the care continuum

Leading healthcare providers such as Terrebonne General Medical Center, University Health Care System, and Hugh Chatham Memorial Hospital are using RightPatient to identify patients accurately, prevent mix-ups, and protect patient records.

Patients are quite receptive to the touchless biometric patient identification platform. During hospital visits, RightPatient takes a photo of the patient and attaches it to the patient’s EHR after running a search to see if it already exists in any other EHR, preventing duplicates. Afterward, these patients only need to look at the camera – RightPatient runs a search and upon finding a match, provides the accurate medical record.

For remote patients, the patients are sent an SMS with a link to provide a selfie and a photo of their driver’s license or similar information – RightPatient compares the photos for a match and remotely authenticates patient identities.

Doing so every time the patient visits, in-person or otherwise, ensures that the accurate information is being fed to the appropriate EHR – preventing transplant mix-ups, patient safety incidents, and even medical identity theft.

How are YOU preventing such disastrous cases at your healthcare facility?

Securing Healthcare Data Must Be a Priority as COVID Cases Postpone In-Person Visits

September 27, 2021/6780 views / 0 Comments/in BLOG, COVID-19, Data Integrity, EHR, healthcare, Medical Identity Theft, Patient Data, Patient Identification, Patient Outcomes, Patient Safety, Telehealth /by Matt Gibson

Unfortunately, the pandemic rages on. COVID-19 cases in the U.S. are increasing and the number this year has already surpassed last year’s figures, according to John Hopkins University. It’s sad to say that the numbers this year will increase further, with new variants, debates regarding masks and social distancing, and individuals who have not been unvaccinated. Healthcare providers are having to return to stricter protocols to try to reduce the number of cases, and many are canceling visits, postponing nonemergency procedures, running out of capacity, and are, once again, opting for virtual healthcare. That being said, let’s take a closer look at the situation, what some hospitals are going through, and why securing healthcare data is crucial during both virtual and in-person visits.

Idaho is facing a huge challenge due to COVID cases

This isn’t a surprise – many hospitals in different states are facing the same scenario due to COVID-19 spikes. For instance, health systems like Saint Alphonsus and St. Luke’s in Idaho have already paused non-emergency procedures.

The reason is quite simple – they are running at full capacity, seeing far more COVID-19 hospitalizations, and are being forced to reallocate resources to serve COVID-19 patients. In fact, COVID-19 daily hospitalization rates have gone up 35%, and it looks like more hospitals and health systems will have to follow the same rules.

The state has already entered a “Crisis Standards of Care” which was enacted as there’s a shortage of healthcare staff as well as beds, the latter because of a surge in COVID-19 patients.

Experts are even predicting up to 30,000 COVID-19 cases per week within the state, starting mid-September!

Within all the chaos, securing healthcare data to ensure accurate patient identification and sending reports to accurate personnel is a must.

Other states are also witnessing similar COVID-19 surges, such as Georgia and parts of California, leading to capacity constraints, postponed non-emergency procedures, and stricter visitation guidelines.

Telehealth might be the answer, as long as it protects healthcare data

Most hospitals will opt for offering virtual care again – it has already shown its capabilities in treating non-critical patients without risking anyone getting infected with COVID-19.

While telehealth has a huge number of supporters now, experts worry about a number of issues. One of the biggest concerns is that, just like in-person visits, telehealth might result in medical identity theft cases.

Securing healthcare data during both in-person visits as well as virtual ones, thus, becomes a huge concern. Fortunately, RightPatient is more than up for the challenge.

Securing healthcare data is possible with RightPatient

RightPatient is the leading touchless patient ID platform and several healthcare providers trust it to protect millions of patient records.

By ensuring proper patient identification, RightPatient ensures that the EHR is used for the appropriate patient – preventing mix-ups, duplicates, and medical identity theft.

For in-person visits, the patient just needs to look at the camera for registration. RightPatient takes a photo and attaches it to the patient’s EHR – these can’t be accessed by fraudsters. For instance, if a fraudster tries to access services, RightPatient will identify that the person’s face doesn’t match with the saved photo – red-flagging the individual and preventing medical identity theft in real-time.

For telehealth sessions, after patients schedule appointments, they will receive an SMS. They will need to provide a selfie along with the photo of their driver’s license – RightPatient will automatically compare the photos, and upon matching, create biometric credentials for the new patients and validate registered ones. In this case as well, if the platform identifies discrepancies, it will red flag the individual, preventing them from tampering with the EHRs, securing healthcare data, and preventing medical identity theft in the process.

RightPatient is the future of patient identification

Whether it’s online visits or in-person visits, hospitals and health systems must protect patient data, improve patient safety, and prevent identity theft. While several caregivers such as Terrebonne General Medical Center, Hugh Chatham Memorial Hospital, and University Health Care System are already using RightPatient to protect their patients, many caregivers are still using ancient methods to identify patients – putting them at risk.

How are YOU protecting patient records and ensuring positive patient identification at your healthcare facility?

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

September 14, 2021/6865 views / 0 Comments/in BLOG, Data Breach, Data Integrity, EHR, healthcare, Medical Identity Theft, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

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

Healthcare data breaches update

Over 3 million patients’ information was exposed this August

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

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

Over 600,000 patients’ information exposed

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

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

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

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

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

Medical ID theft is the common consequence of data breaches

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

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

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

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

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

RightPatient prevents medical ID theft in real-time

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

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

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