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Dealing with Claim Denials in Healthcare Facilities

April 22, 2022/4600 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, 2022/4716 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, 2022/4473 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, 2022/4895 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, 2021/5016 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?

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

September 27, 2021/6783 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?

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

August 20, 2021/6646 views / 0 Comments/in BLOG, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

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

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

Misidentification of patients – a few more cases

A patient got the wrong medications

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

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

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

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

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

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

The wrong patient was taken off of life support

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

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

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

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

RightPatient eliminates misidentification of patients

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

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

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

4 Promising Health IT Practices That Improve Patient Outcomes

July 1, 2021/7456 views / 0 Comments/in BLOG, Cybersecurity, Data Breach, EHR, Patient Data, Patient Errors, Patient Identification, Patient Safety, Telehealth /by Matt Gibson

The pandemic, when it hit the U.S., spurred its healthcare providers to adapt to the rapidly changing landscape it forced on everyone. Hospitals and health systems had to search, come up with, and implement drastically different practices that many experts thought weren’t possible. Just look at telehealth – its future was quite uncertain. However, during the pandemic, both its popularity and usage skyrocketed as hospitals and health systems relied on it to provide care to non-critical patients without risking the latter’s safety. That’s just one example – there are similar promising health IT practices that are trending and set to grow in the future and improve patient outcomes in the process. Let’s take a detailed look at some of the more popular health IT practices that can improve quality and safety in healthcare facilities.

4 trending health IT practices that help improve patient outcomes

The increased role of IT teams

As the pandemic forced healthcare providers to switch from in-person visits to virtual ones, implement practices to aid remote work, and ensure that data management is accurate, it was the IT teams’ responsibility to ensure that everything went smoothly. Moreover, cybersecurity attacks were higher than ever since providers already had their hands full.

CIOs and their IT teams not only had their hands full during the pandemic but they also had added responsibilities and expanded roles to play. As COVID-19 cases are decreasing, healthcare providers are aiming for a different approach to providing better and safer healthcare services to improve patient outcomes in the process. As a result, CIOs and relevant IT personnel are in huge demand.

Talking about cybersecurity, let’s move on to the next point.

A much-needed focus on ramping up cybersecurity

As previously mentioned, hackers had upped their game last year. While many hackers had promised not to attack healthcare due to the unprecedented crisis, not all hackers shared the same sentiments. Unfortunately, many of them did attack while healthcare providers had their hands full with COVID-19 cases. This not only led to them stealing patient information and selling it to fraudsters on the dark web, but many incidents also disrupted healthcare operations. In fact, the IT systems of many hospitals were rendered unresponsive or slow as the information within the systems was locked and not available for use.

So, what did healthcare providers do to mitigate the issues?

Well, many of the hospitals saw what their contemporaries were going through and opted for better cybersecurity practices. While getting a new cybersecurity solution includes several impediments, hospitals opted for simpler solutions. For instance, many had cut off access to external emails whereas others focused on stricter screening of external emails.

However, while data breaches seem inevitable and as most caregivers cannot upgrade their cybersecurity solutions due to various reasons, they CAN prevent the endgame of most data breaches – medical identity theft. For instance, RightPatient prevents medical identity theft in real-time by identifying fraudsters during the registration process. The patient identification platform can prevent fraudsters from accessing services even if the data is breached, reducing litigation costs.

With cybersecurity attacks at an all-time high, it looks like healthcare providers are thankfully changing their approach and are working to rectify security gaps by providing better training to employees regarding cybersecurity practices, going for a proactive approach rather than a reactive one, and by hiring competent security professionals – helping enhance patient outcomes in the process.

Expanded telehealth usage

Is the rapid growth of telehealth even surprising at this point?

Before the pandemic, telehealth didn’t have a bright future. Apparently, it has been around for a long time, but experts were busy talking about its demerits, patients were wary of it, and there was a lack of consistent interest. As a result, telehealth was collecting dust, figuratively speaking. However, the pandemic changed everything – it showed how useful telehealth was. As regulations were relaxed around telehealth, it helped reach more patients and provide care to the non-critical ones, rapidly expanding its userbase.

Telehealth was one of the most trending health IT topics last year, and it still is reigning, as many actually prefer telehealth over in-person visits now and have said they will continue to use it even after the public health emergency is over.

Many healthcare providers, as a result, are going for a hybrid approach. They are planning to offer both in-person and virtual care, providing the best of both worlds to their patients. Not only will this help increase patient satisfaction, but it will also speed up processes and keep the patient volume down during in-person visits, something that’s quite necessary as the pandemic is not over yet, helping improve patient outcomes.

Utilizing contactless solutions can improve patient outcomes

There’s always been growing interest in contactless solutions for any given industry, but the pandemic has pushed it to the forefront – virtually everyone knows the risks of physical contact now. Therefore, many are developing contactless solutions for healthcare facilities that can reduce hospital-acquired infections and improve patient safety. However, did you know that such a solution has been in use for several years in many hospitals and health systems?

RightPatient, our touchless biometric patient identification platform, has been serving several healthcare providers for years, and it only requires patients to look at the camera. The platform does the rest and provides the accurate EHR to the registrar – improving patient safety, preventing duplicates and overlays, and reducing medical errors in the process. As previously mentioned, it also helps prevent medical ID theft in real-time by red-flagging fraudsters during the registration process.

That was just an example of how a touchless solution has been transforming patient safety in several ways – there are more solutions on the way that can improve patient outcomes and boost the bottom lines in the process.

Hospitals that Identify Patients Correctly Enjoy Several Benefits

June 30, 2021/7262 views / 0 Comments/in BLOG, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

We typically talk about grave situations – stories of patient mix-ups, healthcare data breaches, medical identity theft cases, denied claims, and more. However, this time, we will look at the more positive aspects – the additional benefits that healthcare providers who identify patients correctly enjoy. These range from preventing unwanted patient safety incidents within the premises to enhancing patient outcomes.

However, did you know that our touchless biometric patient identification platform can provide far more benefits? More on that later – let’s dive deep into the topmost benefits of ensuring proper patient identification in hospitals.

Why hospitals must identify patients correctly

Well, in order to understand that, first, one must understand why patient identification is such a big deal. For starters, patient identification is quite problematic in the U.S. healthcare system for several reasons. Since no effective standardized patient identifier has ever been implemented in the U.S., healthcare providers use different methods, solutions, or strategies to verify their patients, and most of them suffer from patient identification errors and the consequences that follow.

Fortunately, responsible healthcare providers don’t have to suffer from these issues because they have made patient safety their number one priority. These providers are utilizing effective solutions like RightPatient to eliminate errors by helping them identify patients correctly.

So, what are the benefits of accurately identifying patients?

Top benefits enjoyed by hospitals that identify patients correctly

Prevents fraudulent cases right from the start

Although wrong patient identification and medical identity theft are both crucial issues of the U.S. healthcare system, many don’t know that preventing the former can also prevent the latter.

It’s quite simple – since there’s no standardized and rigid way to identify patients accurately in most hospitals, fraudsters aren’t identified right off the bat. In fact, many medical identity theft cases remain undetected until the patient receives a shocking bill or notices anomalies with their EHRs.

Hospitals that identify patients correctly can prevent medical identity theft in real-time. When the fraudster comes in, proper patient identification will help officials flag them and catch them red-handed.

This is also applicable even in the case of data breaches. Even if healthcare data is breached, accurate identification will lead to fraudsters being caught in the act, preventing medical identity theft and reducing substantial expenses of rectifying medical record errors and litigation costs down the line.

Prevents expensive and dangerous medical record errors

One of the reasons why patient identification is such a mess has already been mentioned – the lack of an effective patient identifier. However, another reason is the overwhelming medical record errors that already exist in the systems. Duplicate medical records and overlays, namely, have been causing patient mix-ups, leading to the wrong patients getting transplants, incorrect treatments, and more. These duplicate medical record errors typically are created during the registration process, and both their creation and use can be eliminated if patients are identified accurately.

See, if the patient is accurately identified right from the start and the appropriate medical record is used throughout the patient’s medical care history, then duplicates and overlays can be avoided – eliminating the issues caused by them for both caregivers and patients, preserving authentic patient data. This leads to another benefit of proper patient identification.

Ensures patient data integrity

As mentioned, medical record errors, and patient misidentification in general, lead to patient data corruption. Unless patient data integrity is maintained, the information is useless for healthcare providers and quite dangerous for patients. Imagine if a patient has cancer but gets treated for heart disease – it would be catastrophic!

Patient data integrity failures lead to the wrong treatment plans, detrimental healthcare outcomes, readmissions, and even deaths. However, accurate patient identification ensures that the correct information is being recorded in the appropriate medical records – ensuring patient data integrity.

Enhances patient safety

By now, it should be clear that positive patient identification prevents a plethora of issues such as duplicates, patient data corruption, medical identity theft, among other things. However, identifying patients accurately also leads to better healthcare outcomes and prevents medical errors, improving patient safety in the process.

Medical errors caused by mix-ups are prevented which also reduces readmissions – improving patient outcomes. Accurate information arms healthcare providers with the relevant details about the right patient, helping them make informed decisions, something that’s not possible when patients are wrongly identified.

Reduces denied claims

Denied claims are a huge burden for any given healthcare provider, however, most of them can be prevented with accurate patient identification. Let’s look at an example of exactly how denied claims and patient misidentification are related.

Suppose a patient, A, comes in for a checkup and the physician recommends a follow-up, and a small surgical procedure is planned. During the first two visits, A has been identified properly and their medical record includes the proper information. However, prior to the surgery, A is misidentified and the wrong EHR is assigned. Moving forward, everything will be recorded in the wrong EHR.

Now, when it comes to receiving payment for the surgery, the hospital sends a claim to the patient’s insurance provider. However, when the insurance company detects inaccurate coding due to incorrect information, the insurance company “denies” the claim. These billing and coding errors need to be fixed which takes up a considerable amount of resources and time – creating inefficiencies.

Denied claims can cost north of $4 million for the average health system, making it extremely costly for even the largest provider.

Positive patient identification can prevent most denied claims as they are often caused by medical record mix-ups. Moreover, this also frees up FTEs (full-time equivalents) to do their jobs properly – improving efficiency and eliminating bottlenecks.

Improves the quality of healthcare services

Patient identification errors have been rampant for almost two decades, leading to data quality issues. As a result, this information cannot be trusted – if the data is inaccurate, then everything moving forward will also be full of issues.

Proper patient identification ensures that the right patient is connected to their accurate medical record at all times – this itself drastically improves the quality of services they receive. For instance, they won’t get redundant lab tests, incorrect medication, or the wrong treatment plans.

All in all, patient misidentification might seem trivial to many, but if accurate patient identification is ensured, then it brings several benefits for healthcare providers, patients, insurance companies, and everyone else involved.

However, did you know that our patient ID platform, RightPatient, can do even more than everything mentioned above?

RightPatient helps healthcare providers identify patients correctly

RightPatient is the leading biometric patient identification platform that has been helping several healthcare providers protect their patients. However, the factor that sets RightPatient apart from others is that it’s entirely touchless – patients only need to look at the camera during the verification process. The platform matches the saved photo with the live one and provides the accurate EHR once a match is identified.

The fact that RightPatient is contactless is why prominent healthcare providers have chosen it. The platform improves infection control and reduces HAIs (hospital-acquired infections) as there’s no physical contact required, making it ideal in a post-pandemic world.

Caregivers such as Community Medical Centers, Catholic Health Services of Long Island, and the University Health Care System have been using RightPatient and enjoying several benefits such as preventing medical identity theft, reducing duplicates and overlays, protecting patient records, and boosting their bottom lines. Be a responsible healthcare provider now and use RightPatient to see the difference it makes.

Preventing Medical Record Errors Improves Patient Safety

June 28, 2021/7485 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

Healthcare providers in the U.S. never seem to catch a break – they’ve always faced a plethora of issues even before the pandemic. For a brief refresher, the U.S. healthcare system suffers from outrageous costs, the lack of price transparency, ancient laws that hamper healthcare outcomes, the lack of proper interoperability, medical record errors, preventable medical errors, patient safety incidents, and more.

While all of that seems like a bit too much, there are actually far more issues that regularly challenge health systems and hospitals and hold them back from providing positive patient outcomes. One such crucial but overlooked issue that hampers healthcare outcomes is medical record errors. Let’s explore how they are created, what are the consequences, and how proper patient identification can enhance the quality and safety in healthcare facilities.

Medical record errors jeopardize healthcare outcomes in several ways

Patient safety incidents, detrimental healthcare outcomes, denied claims, patient mix-ups, and other adverse effects can be traced back to errors with medical records – the most common ones are duplicates and overlays. In fact, whenever an EHR error occurs, it typically goes undetected until an unfortunate event occurs such as the ones listed above. However, if one goes even further back, patient identification errors are likely to be the main culprit – let’s see how that happens.

Patient misidentification leads to most medical record errors

One of the most common causes that lead to medical record discrepancies is patient misidentification, and that’s because most healthcare providers are using obsolete means to identify their patients – more on that later. Let’s take a look at how duplicates and overlays are created within EHR systems.

Duplicate record creation

It’s quite straightforward – let’s start from the beginning. A patient comes into the hospital for a checkup, and since most hospitals suffer from patient identification problems, the EHR user is left with a difficult choice if they can’t find the accurate medical record. This happens because:

The patient has a common name
There are multiple patient records with the same characteristics
Searching for the right medical record is virtually impossible

Now, the choices the EHR user has are either diving deep and painstakingly finding the accurate medical record, assigning the medical record that seems to be the “closest match”, or, just to be safe, creating an entirely new medical record. However, the latter can be catastrophic for both the patient and the hospital. Saving a discussion about the consequences for a later part, let’s see how overlays are far more damaging.

Overlays are extremely dangerous

Duplicate records are created when a patient has multiple medical records. Overlays, however, are single medical records that contain information about multiple patients – clearly, these medical record errors can be very dangerous.

Let’s continue from the previous example – the EHR user selected a medical record that best matched the patient (X), but it actually belongs to a different patient (Y). When patient X has their medical checkup, their health information is recorded into patient Y’s medical record, rendering it corrupt, unusable, and dangerous. Next time, when either patient returns for medical treatment, they’ll be facing detrimental healthcare outcomes because the data in their medical record is unreliable.

Moreover, with the growing adoption of EHR systems, these issues are becoming far more common. In fact, according to AHIMA, smaller hospitals have around 5-10% of these duplicate medical records whereas larger health systems can have a whopping 20%. These errors can cause around $40 million in unnecessary costs in clean-ups, litigation costs, and others.

Unfortunately, the biggest issue with these duplicates and overlays is that, as previously mentioned, they remain undetected until an adverse event occurs. The best way to resolve medical record errors is by preventing them right from the start – accurate patient identification can help with that.

RightPatient prevents duplicates and overlays

RightPatient has been helping responsible healthcare providers accurately identify patients at any touchpoint with its robust biometric patient identification platform. It can be seamlessly integrated with any EHR system and it becomes a part of the EHR workflow.

Patients only need to look at the camera – the platform automatically locates the accurate medical record for the EHR user, making it a seamless, safe, and hygienic experience for everyone involved. It has been helping reputed caregivers like Grady health, TGMC, and Community Medical Centers prevent duplicate record creation, ensure patient safety, and boost the bottom line.