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Hospitals Are Facing Lower Reimbursements – Reduce Losses by Preventing Wrong Patient Identification

November 2, 2020/8104 views / 0 Comments/in BLOG, EHR, healthcare, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

The COVID-19 pandemic has – and still is – left an unprecedented impact on our lives, and it’s safe to assume that it will leave a mark for years, if not decades. While the novel virus has claimed over 1 million lives around the world, over 219,000 of them were Americans. The US healthcare system is also on the receiving end – it is expected to face unprecedented losses of around $323 billion this year. Many healthcare providers have been forced to shut their doors permanently, furlough or lay off employees, or introduce pay cuts to deal with the financial blows. To make matters worse, healthcare providers are receiving small amounts of reimbursements for treating uninsured COVID-19 patients. Let’s take a look at the scenario, the numbers associated with the issue, and how providers can mitigate these losses by preventing wrong patient identification.

COVID-19 has created an unprecedented financial strain for hospitals

COVID-19 has been spreading like wildfire, impacting everything and everyone it comes in contact with. After it hit the US, the healthcare system braced for impact the best way it could; hospitals canceled elective procedures and reassigned all resources to handle the surge of incoming COVID-19 patients. Naturally, hospitals and health systems are still suffering from the financial strain caused by COVID-19 as well as the cancellation of elective procedures.

Providers would get reimbursed for treating uninsured COVID-19 patients

Back in April, the Trump administration’s coronavirus treatment reimbursement program was announced. Healthcare providers who treated uninsured COVID-19 patients would be reimbursed using the money from the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This has been done so that caregivers don’t incur any more losses as well as to avoid uninsured patients facing shocking bills related to COVID-19. As a result, the Department of Health and Human Services (HHS) has reimbursed $881 million to around 8,000 providers to date.

However, it was estimated previously that the reimbursement for treating uninsured COVID-19 patients would range from $13.9 billion to $41.8 billion. As hospitals are facing losses of around $323 billion this year, they need higher reimbursements if they are to survive in the post-pandemic world.

Why is this happening?

One of the reasons pointed out by the Kaiser Family Foundation is the eligibility for receiving reimbursements – hospitals treating uninsured patients who have a primary diagnosis of COVID-19 will be receiving reimbursements. This means that even though healthcare providers might treat uninsured patients, if their primary diagnosis isn’t COVID-19, the caregivers won’t be eligible for reimbursements.

Another issue with the program is that it doesn’t guarantee that all caregivers treating uninsured COVID-19 patients will receive the reimbursements – it depends on the availability of funding.

Hospitals must cut costs by mitigating wrong patient identification

The biggest challenge hospitals are facing now is to survive the financial strain. As previously mentioned, many have already closed their doors. Others are utilizing alternative cost-cutting methods such as furloughing or laying off employees, introducing reduced salaries, or restructuring their operations.

However, healthcare providers have a long list of problems that stem from wrong patient identification, and if they can eliminate it, they can significantly reduce costs and mitigate losses – enough to survive the financial crisis. Moreover, patient identification errors have been impacting healthcare outcomes even during the pandemic – for instance, test results went to the wrong patients, treatment was delayed due to incorrect patient data, and so on. All of these issues can be eliminated with RightPatient.

RightPatient effectively prevents wrong patient identification

Wrong patient identification has been a significant problem for years. While many healthcare providers wisely chose RightPatient before the pandemic (thanks to its touchless nature) others are facing issues with their touch-based solutions. Many have even reported a significant drop in utilization of the touch-based patient identification solutions as patients are extremely reluctant to use them due to concerns regarding infections. While infection control used to be a concern for hospitals only, since the pandemic, patients are well aware of the consequences.

Thankfully, patients and caregivers don’t have to worry about this with RightPatient, the industry’s leading patient identification platform. It uses a characteristic that others cannot replicate or steal: patients’ faces. Using patients’ photos and a photo of their driver’s license or other identification cards after scheduling an appointment, RightPatient automatically matches the photos to ensure accurate patient identification right from the start and across the care continuum.

Leading providers have deployed RightPatient across their facilities and are reducing denied claims, preventing duplicate medical records, and enhancing patient safety – ultimately eliminating redundant costs and boosting their bottom line in the process. After the pandemic, every hospital needs to reduce such costs to survive – use RightPatient to help you do so.

Wrong Patient Identification Errors Lead to Several Issues – Are You Preventing Them?

October 30, 2020/13428 views / 0 Comments/in BLOG, Data Integrity, EHR, healthcare, Medical Record Mix-ups, Patient Errors, Patient Experience, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Matt Gibson

Patient identification has always been hit or miss within the US healthcare system. Wrong patient identification errors cause a plethora of serious issues for not only healthcare providers but also patients. Patient mix-ups, patient safety issues, medical identity theft, duplicate medical records, and overlays are just some of the many issues that can be traced back to patient identification errors. These issues have been popping up even more during the pandemic, leading many experts to demand a patient identifier. While we’ve talked about all of that in previous articles, let’s take a look at a very recent patient mix-up, its consequences, and how positive patient identification can prevent such cases.

Another one added to the list of wrong patient identification

The mix-up took place back in August at Washington-based Sacred Heart hospital. Interestingly, the person with whom the hospital mixed up the information was a former patient of the healthcare provider.

For simplicity’s sake let’s call the actual patient Samantha and the former patient (who got the call) Rebecca.

Back in August, Rebecca’s daughter was called and she was informed that her mother was hospitalized due to a critical injury. However, the daughter responded that Rebecca was right in front of her and fine, but the staff at the hospital was adamant and said that her mother was injured and admitted. Understandably, Rebecca was quite worried about the real patient, Samantha.

Rebecca and her daughter reportedly informed the healthcare provider that they had a case of mix-up on their hands – she said that she didn’t know who was being treated under her name or why. In response, she was told that the hospital would rectify the issue. However, that was only the start.

What happened down the road?

Since Rebecca was a former patient of Sacred Heart, she checked her records to see if it was fixed or not. Unfortunately, the wrong information was still present, and to make things worse, other irrelevant materials were added, such as $3,000 worth of bills. Moreover, the provider also tried to bill her old insurer, which naturally didn’t work. Subsequently, the provider attempted to help her get insurance.

The actual patient was safe

Rebecca heaved a sigh of relief when she found out that Samantha was out of danger – she kept in contact with the hospital over the phone. When this was over, Rebecca was also relieved that she didn’t receive the wrong bills as a result of the mix-up.

Wrong patient identification errors are quite common

While this case didn’t have any adverse consequences, not everyone is as lucky. Wrong patient identification errors occur every day and most are not identified until it’s too late. Not only are they problematic for patients, but they create issues for caregivers as well.

Patients face delays in treatment, incorrect procedures, and repeated lab tests – ultimately hampering patient outcomes as well as jeopardizing patient safety in the process. Moreover, they receive shocking bills for medical procedures or treatments they never received. The lucky ones can have them written off as denied claims, but this is still a huge cost for the providers.

On the other hand, healthcare providers face unwanted attention, loss of goodwill, denied claims, lower scores, and might even risk losing CMS reimbursements (as they are tied to patient safety).

All of this is leading to healthcare experts and leaders rallying for a state-funded patient identifier. While this appeal has been denied for over two decades, forward-thinking hospitals and health systems are not waiting for it, and have taken the initiative themselves to eliminate issues related to wrong patient identification errors.

Leading providers are using RightPatient

RightPatient is the industry’s leading touchless patient identification platform trusted by providers such as Grady Health, Catholic Health of Long Island, Terrebonne General Medical Center, and University Health Care System. Using the photos of patients, it prevents patient identification issues like mix-ups, duplicates, medical identity theft, denied claims, and more.

After successfully scheduling an appointment, patients receive an SMS or email, after which patients are required to provide a personal photo and a photo of their driver’s license. RightPatient matches the photos automatically and verifies the identity of the patients remotely.

Be a responsible healthcare provider and prevent mix-ups and the issues associated with patient misidentification by deploying RightPatient.

Patient Safety and Quality Improvement Can be Achieved with Positive Patient Identification

October 21, 2020/10160 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Infection Control, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Among the several issues faced by the US healthcare system, one of the more prominent is patient misidentification. We know this to be true because even during the coronavirus pandemic, experts have stated that patient matching issues were continuing. Moreover, coalitions were formed to demand the fabled “unique patient identifier” once again. But why do healthcare providers demand patient identifiers time and again? Let’s take a look at some statistics that show how serious the issue is, some consequences caused by the absence of effective patient identification, and how patient safety and quality improvement are related to it.

Patient identification issues are nothing new

The last decade has been a transition towards technology for the US healthcare system. Caregivers such as physician practices, hospitals, and health systems have made the jump from traditional paper medical records towards the more standard electronic health records (EHRs). However, as they did so, they saw the issues that occurred due to the absence of an effective patient identifier nationwide. One of the biggest challenges is matching patients to their accurate medical record whenever they arrive for healthcare services. Let’s review some recent statistics about how common misidentifications are.

Some stats to back it up

According to a study conducted by eHealth Initiative, approximately 38% of the respondents have suffered from an unwanted event caused by patient misidentification within the last 2 years. Many of these events are caused by duplicate medical records, and an overwhelming 66% of the respondents blame data entry errors that lead to duplicates. Moreover, 80% of the providers have dedicated FTEs (full-time employees) or third-party contractors to solve these issues. The biggest barriers to reducing poor patient matching were the lack of prioritization and the lack of technology. 32% of the caregivers stated that they had around 3-10% duplicates within their EHR systems. All of these statistics show that patient misidentification is growing and needs to be addressed by caregivers. Fortunately, many hospitals and health systems are already using touchless patient identification platforms like RightPatient to solve these issues, but more on that later. Let’s see how patient misidentification is a barrier to patient safety and quality improvement.

Patient misidentification hampers patient safety and quality improvement

While patient misidentification causes a lot of problems for any given caregiver and patient, let’s take a look at how it impacts patient safety, and in turn, healthcare quality.

Patient misidentification is closely related to duplicate medical records

Duplicates can lead to patient misidentification and vice versa. For instance, if a patient comes in and provides their nickname instead of the name on the medical record, the registrar won’t be able to accurately identify the medical record. Thus, after failing to find the record, a new one gets created, leading to another duplicate record within the EHR system.

Likewise, if there are many duplicates within the system against the same patient, there are high chances that all of them have incomplete and inconsistent information. This will lead to matching the patient to the improper medical record. Both of these scenarios will lead to incorrect procedures, adversely impacting patient safety.

Patient misidentification hampers patient data integrity

As previously stated, data entry errors are quite common during registration. Thus, if patients are associated with the wrong medical record, they will be treated based on someone else’s medical history, illnesses, allergies, and so on. One single pill can severely impact the patient’s health – one can imagine what would happen if the whole procedure was wrong! Such cases have led to delayed care, repeated lab tests, and compromised patient safety.

Patient misidentification leads to medical errors

Quite closely tied with the previous point, patient safety and quality improvement cannot be achieved if medical errors keep occurring. While medical errors happen for a variety of reasons, many are preventable, and as stated previously, 38% of the healthcare providers surveyed reported that they suffered from medical errors tied to patient misidentification. These errors could have easily been prevented had the caregivers used robust patient identity matching solutions.

Patient safety and quality improvement is achievable with RightPatient

Leading healthcare providers such as Catholic Health Services of Long Island, Terrebonne General Medical Center, Community Medical Centers, among others, have been using RightPatient and improving patient safety and quality of care. As the healthcare industry’s leading touchless patient identification platform, RightPatient has years of experience helping hospitals and health systems identify patients’ accurate medical records across the continuum of care. The platform uses patients’ photos to identify their accurate medical records, prevent medical identity theft, avoid duplicate records, and prevent medical errors – enhancing patient safety and ensuring a hygienic environment that will be crucial in a post-pandemic world.

3 Patient Safety Measures Hospitals Must Take in a Post-Pandemic World

October 14, 2020/10566 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Medical Identity Theft, Patient Data, Patient Errors, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Matt Gibson

COVID-19 has changed reality for us – it has changed the way we lead our lives. Sanitizers, masks, and social distancing have become quite integral parts of our daily lives now. Wherever we go, social distancing practices are encouraged for a safer environment. However, it has shaken the healthcare systems of the world to their core, especially that of the U.S. With the highest number of cases in the world (as of now), hospitals are slowly opening their doors for regular patients. Keeping that in mind, hospitals must take patient safety measures while they are opening to ensure that patients receive care in a safe and hygienic environment. Let’s take a look at some common steps hospitals can take to prevent patient safety issues.

Some insightful statistics

According to a survey by Sage Growth Partners, 24% of the respondents (healthcare professionals) believe that issues such as disparate EHRs and lack of actionable data at the point of care lead to patient safety issues.

Improving patient safety is also among the top three priorities of the respondents, besides delivering high-quality care and increasing efficiency and reducing costs – all of which can be done by ensuring accurate patient identification (more on that later).

Let’s explore what kind of patient safety measures will help hospitals enhance patient care.

Patient safety measures that can help enhance patient care

Planning everything well in advance

While many might think that everything is slowly returning to normal, it’s quite the opposite. Working from home is still being utilized by most organizations, social distancing is still being practiced, and wearing masks and sanitizing regularly are still highly encouraged.

Since hospitals are opening slowly, they should plan every step carefully along with contingencies while keeping worst-case scenarios in mind. Hospitals need to plan the opening days and rather than opening the whole facility at once, they should open in phases. This will help reduce the risk of any mass outbreaks of COVID-19 – managing a mass outbreak at a single location will be much easier than managing outbreaks at all the facilities.

Also, hospitals should decide at what capacity will they operate and the duration for that testing phase. If all goes well, they can slowly increase the capacity of patients they will be serving.

Finally, the inventory required for all of the above needs to be planned to ensure that the necessary materials are available at all times. For instance, PPE has become quite critical, and these should be ordered well in advance before the stock runs out within the facilities. Thus, instead of reordering the materials when they’re at 30%, they should be reordered at, say, 45% – these are essential materials, after all.

Enforce safety measures for everyone

It goes without saying that every individual must practice a minimum level of social distancing to help themselves and others stay safe from the novel coronavirus. Sadly, not everyone follows that. Thus, the hospitals must enforce that everyone within the facility must follow the social distancing rules to a T. Not only is this one of the most common patient safety measures, but it also enhances safety for the physicians, nurses, and every other healthcare staff.

Keep brightly colored posters in places where they will catch everyone’s attention. Place stickers on the floor with six feet between them to show where patients or caregivers must stand, especially in busy places like registration desks. Make sure that everyone is wearing masks and that sanitizers are available everywhere. Keeping the facilities hygienic is crucial to enhance patient safety.

Ensure accurate patient data

One of the most crucial factors that make or break patient safety is patient data, as the former is heavily reliant on the accuracy of patient data. Imagine this, if the patient is treated based on inaccurate patient data, they will face delayed or incorrect medications, leading to poor healthcare outcomes. One of the most common ways patient data gets corrupted is via duplicate records.

If a patient has multiple records, there are high chances that the registrar will select the one with inconsistent or fragmented data, leading to adverse outcomes. Thus, ensuring that patient data integrity is maintained at all times is crucial for improving patient safety. Fortunately, RightPatient does all that – and more.

RightPatient is the leading patient identification platform used by healthcare providers like Terrebonne General Medical Center, Grady Health, and Catholic Health of Long Island. With a robust photo-based engine, it ensures that the patients are identified accurately at all times across the care continuum, helping patient data integrity by avoiding duplicate medical records. Moreover, it ensures that the patients are who they say they are and not impostors, preventing medical identity theft in real-time.

Finally, a platform like RightPatient is critical in a post-pandemic world because it is entirely touchless. Thus, it helps caregivers and patients operate in a hygienic environment by preventing infection control issues.

Use RightPatient now and enhance patient safety at your facilities, prevent medical identity theft, and prevent duplicate medical records – enhancing patient data integrity along the way.

Patient Safety and Quality Can Be Improved by Preventing Duplicate Medical Records

October 12, 2020/9702 views / 0 Comments/in BLOG, Connected Health, Data Integrity, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Matching /by Matt Gibson

Patient safety is one of the more integral aspects of any given healthcare system. It ensures that patients are getting the required treatment without any medical errors or harm, healthcare outcomes are optimal, and healthcare services are delivered to the highest possible standard. While those are the common aims, the reality is quite different in the U.S. healthcare system. It has always been inundated with a number of serious issues – healthcare data breaches, medical identity theft, patient identification issues, lack of price transparency, and duplicate medical records are just some of them. The root cause of many of the issues are duplicate medical records. While we already had a closer look at duplicate medical records and how it impacts revenue cycle optimization, let’s have a look at how preventing duplicates can lead to enhanced patient safety and quality, among other things.

How duplicates impact patient safety and quality of healthcare

In a previous article, we’ve already seen how medical record errors like duplicates and overlays are created and how they cause claim denials. Let’s see how they impact patient safety and quality of healthcare as well.

AHIMA’s Shannon Harris and Shannon H. Houser stated in an issue of the Journal of AHIMA that duplicates and overlays don’t only cause financial woes, but lead the physicians and healthcare staff to inadvertently causing medical errors. For instance, imagine that a single patient has duplicate medical records in a hospital’s EHR system. While treating the patient, the physician will see the duplicates but chooses the one that has obsolete information. Since the information is not updated, the treatment or medication might very well cause adverse effects. Such cases might even lead to transferring the patients for emergency treatments, leading to jeopardized patient outcomes.

That’s not the only way duplicate medical records impact patient safety and quality of healthcare – let’s look at the latter. When you have fragmented information within duplicate records, issues such as repeated lab tests and delays in treatment are quite common. Since the majority of the healthcare providers’ registration systems have ineffective patient identity matching techniques, the number of duplicates keeps on increasing, leading to patient safety issues, patient data corruption, and financial troubles in the form of denied claims.

How are hospitals addressing duplicates?

Sadly, rectifying duplicates and overlays are quite complex and a nightmare for any given healthcare provider. While most of the hospitals are trying to fix duplicates by reallocating their HIM resources and even dedicating some of their FTEs (full-time employees) to identify and rectify the erroneous records, unless they address the frontend issues (read: identify patients accurately), it will be a never-ending cycle. Patients will be misidentified, duplicates will be created, and FTEs will be assigned to fix them on the backend, taking up valuable time and resources.

So, can hospitals address these issues and prevent duplicate medical records on the frontend?

RightPatient enhances patient safety and quality of healthcare

As previously mentioned, if the patients are accurately identified during the registration process, duplicates can be prevented right from the beginning. That’s what we do best with our industry-leading patient identification platform. RightPatient, with its touchless design, ensures that patients are identified across the care continuum, starting from appointment scheduling. Patients only need to provide their selfies and a photo of their driver’s license when they schedule appointments. RightPatient matches the photos and makes sure that the accurate patient record is identified every time the patient accesses healthcare services, remotely or otherwise.

When the patients arrive at the hospital, all they need to do is look at the camera – RightPatient matches the saved photo and the real-time photo during the check-in process, preventing duplicates, eliminating denied claims, and enhancing patient safety. The best part of RightPatient is that the entire identification process is touchless, creating a safe environment for all involved in a post-COVID-19 world.

Revenue Cycle Optimization Efforts Are Hampered by Duplicate Medical Records

October 9, 2020/10456 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, HIM, Medical Record Mix-ups, Patient Experience, Patient Identification, Patient Matching, Patient Safety /by Matt Gibson

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

How duplicates get created

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

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

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

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

How revenue cycle optimization is hampered by duplicates

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

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

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

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

Providers dedicate FTEs for fixing medical record errors

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

RightPatient enhances revenue cycle optimization

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

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

A Closer Look at Duplicate Medical Records and How They Can Be Prevented

October 8, 2020/11024 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Matching, Patient Safety /by Matt Gibson

There are a lot of issues with the U.S. healthcare system, but a few of them can be traced back to medical record errors – duplicate medical records and overlays, to be precise. For instance, duplicate records and overlays lead to patient safety issues, reduced healthcare outcomes, patient misidentification, billing and coding errors, denied claims, and revenue cycle management issues. Even during the coronavirus pandemic, duplicates have been leading to poor patient identification – hampering the response rate and patient outcomes. Let’s take a closer look at how and why duplicates are created, their effects on patients and caregivers, and how they can be prevented with RightPatient.

Duplicate medical records and overlays

With the technological advancements available today and being arguably the world’s most advanced country, one might ask why are duplicate records a thing in the U.S. healthcare system? Well, there can be many explanations for this – errors made during registration, already existing duplicate records, the lack of a proper patient identification system, pressure at the frontend, and so on.

Duplicate medical records and overlays occur especially within the premises of busy healthcare providers – when under a tremendous amount of pressure, registration employees are more likely to make mistakes. While hiring more staff to reduce the pressure might work, without an effective patient identification platform, these errors will inevitably continue to be created. Before diving into how they are created, let’s distinguish between duplicate records and overlays.

Duplicate records

It’s self-explanatory from the name itself. Duplicate records refer to more than one medical record assigned to a single patient – this itself implies the complications such records bring. For instance, it means that there will be redundant records within the EHR system, leading to patient data integrity issues. Moreover, each duplicate record will have different, incomplete, obsolete, or inconsistent information – leading to data corruption. Caregivers have to make important decisions based on the information within medical records (lab test results, vitals, medications, allergies), and when they are using wrong or fragmented information, quality of care takes a hit. Overall, patient safety is compromised – more on that later.

Overlays

Overlays are in a league of their own. The main difference between overlays and duplicates is that overlays are created when one patient’s medical record or its information is entered into an entirely different patient’s record – merging the information together. While they only occur rarely, they can be expensive and extremely dangerous for both patients and caregivers according to HIM Briefings as well as our own experience. Not only do overlays corrupt patient data, but they also lead to patient safety issues, repeated lab test results, wrong treatment, and so on.

Now that we’ve seen what duplicate records and overlays are, let’s see how they get created.

How are duplicate medical records and overlays created?

These medical record errors are usually made during the patients’ and caregivers’ first point of contact – registration. These are typically busy areas for any given hospital – naturally, the employees have a short amount of time and a huge amount of work. Add to that the lack of an effective patient identifier, patients sharing the same information (names, DOBs, etc.), and a sea of medical records, and you have an environment that is likely to result in duplicate records and overlays.

Most of these issues occur because the registrars have no concrete way to identify patients accurately. Moreover, common names, nicknames, name changes, entering incorrect data, and misspelling patient names are some factors that will hinder the attempts to find accurate records. For instance, there might be quite a few “Will Smiths” in the EHR system. Also, “William Smith” might have his record saved under “Will Smith”, but he mentions himself as the former in front of the registrar. Moreover, many patients have their names changed after marriages or separations. All in all, there are a lot of factors in play here.

The impact of medical record errors

There are many consequences of having duplicate records and overlays in EHR systems for both patients and caregivers.

AHIMA has stated that 20% of the medical records in healthcare systems with multiple facilities are duplicates, and they can cost up to $40 million for any healthcare provider. Moreover, these lead to wrong treatment, undesirable patient outcomes, and thus, lower ratings and loss of goodwill for hospitals. Other consequences faced by hospitals are denied claims and poor revenue cycle optimization, hitting their bottom lines, and reducing their already razor-thin margins.

Patient safety takes a huge hit – when a patient gets treated with a fragmented or an entirely different medical record, there are so many things that could go wrong! Wrong medications, delays in treatment, repeated lab tests, and even death are the consequences for patients. All of these issues are avoidable if the caregivers use an effective patient identifier to prevent duplicate medical records and overlays. This is where RightPatient comes in.

RightPatient prevents duplicate medical records and more

For years, RightPatient, with its touchless biometric patient identification platform, has been preventing medical record errors such as duplicates and overlays. Not only that, but it also ensures accurate patient identification using the one factor that doesn’t change and cannot be stolen or transferred – the patients’ faces.

After scheduling an appointment successfully, patients are sent an SMS or email and are asked to provide their selfies and a photo of their driver’s license. The platform matches the photos and ensures that the patients are accurately identified right from the start. Whenever patients visit the hospital, those enrolled under RightPatient only need to look at the camera – the platform identifies them with the saved photo, retrieving the appropriate medical records, preventing duplicates in the process.

Prevent duplicates and enhance patient safety now with RightPatient.

CMS Interoperability and Patient Access Final Rule Requires a Robust Patient Identification Software

October 6, 2020/10315 views / 0 Comments/in BLOG, Connected Health, Data Integrity, EHR, healthcare, Medical Record Mix-ups, Patient Errors, Patient Experience, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Matt Gibson

This has been quite a year for the U.S. healthcare system – nobody could’ve predicted all the series of events. While the novel coronavirus is still raging on, telehealth is experiencing unprecedented growth. On the other hand, hospitals are facing immense financial strain due to the pandemic’s consequences such as the cancellation of elective procedures and lower inpatient visits. However, despite all the recent developments healthcare providers need to work on something else as well – supporting e-notifications. CMS has made some additional changes to the Medicare Conditions of Participation (CoPs), and while providers will be busy brainstorming about how to best approach the requirements, many will overlook one critical factor that will either make or break their e-notifications – patient identification. Let’s take a look at what the rule specifically says about e-notifications, who is eligible, how it helps caregivers, and how a robust patient identification software like RightPatient is a must for ensuring proper e-notifications.

The Interoperability and Patient Access Final Rule – in a Nutshell

While the rule itself is quite vast and detailed, we’ll cover the e-notifications part briefly. The basic meaning of the rule is clear from its name. For years, the U.S. healthcare system has been suffering from the lack of proper interoperability for a number of issues – patient misidentification being a major reason. However, with the “companion final rule”, as per CMS, things are about to change for the better, as it will introduce a certain level of interoperability that will ultimately boost coordinated healthcare efforts.

The “companion final rule” states that healthcare providers such as critical access providers, acute care, or psychiatric hospitals must send out real-time e-notifications during ADT (admission, discharge, or transfer) events to a patient’s caregivers such as established primary care practitioners, post-acute providers & suppliers, primary care practice groups & entities, as well as any other practitioners, groups, or entities primarily responsible for the patient’s care. The information sent must contain the patient’s name, the treating practitioner’s name, and the sending institution’s name, at the very least. Finally, these are applicable during inpatient ADT events and ED admissions or discharges.

Any caregiver that uses digital medical records such as EHRs or EMRs must support e-notifications by May 1, 2021, to ensure CMS compliance.

With that out of the way, let’s look at how the rule requires accurate patient identification and how a robust patient identification software is critical for its success.

Why patient identification will make or break your CMS compliance

Healthcare providers are already busy working on e-notifications support, and while there are a lot of great solutions out there, providers shouldn’t forget the foundation upon which e-notifications depend on – proper patient identification.

The Interoperability and Patient Access Final Rule requires hospitals to identify their patients accurately across the care continuum, especially if they want to send out e-notifications to the proper caregivers. Sadly, patient identification has always been problematic – it is an overlooked but significant concern for the U.S. healthcare system. One might ask how are patient identification and e-notifications related – let’s learn more.

Imagine this – a hospital already has patient misidentification cases because they don’t use an effective patient identification software. If a patient comes in and is misidentified, not only will the treatment be affected, but the hospital will be sending out false alerts to the wrong caregivers. This will wreak havoc for all the caregivers involved with the patient.

If such cases become common, then the patients, as well as the care coordination teams, will start questioning the credibility of the caregiver sending out false alerts. As a result, the hospital will lose goodwill and risk its CMS reimbursements. After COVID-19, not a single hospital can afford to make such mistakes – the pandemic has already caused the worst financial strain on hospitals and health systems in recent times. Thus, patient identification is a crucial component for the e-notifications to work. If caregivers don’t have a robust patient identity matching system in place, they need to upgrade it before the e-notifications support deadline.

RightPatient is the most robust patient identification software

RightPatient has been accurately identifying patients for years. With its touchless patient identification platform, RightPatient ensures that patients are identified accurately and safely right from the start.

After a patient schedules an appointment, they are sent an SMS or email and are required to provide a selfie and a photo of their driver’s license. The platform automatically matches the photos and remotely ensures patient identification. If it’s a new patient, the platform will automatically assign new biometric credentials for them.

During hospital visits, patients only need to look at the camera – RightPatient matches the saved photo with the photo taken by the camera – ensuring accurate patient identification. Best of all, it’s an entirely touchless process, something that is mandatory in a post-pandemic world.

RightPatient is the leading patient identification software in the healthcare industry and is used by prominent caregivers such as Terrebonne General Medical Center, Community Medical Centers, and Catholic Health Services of Long Island. Be a responsible healthcare provider and upgrade your patient identification system now to prevent misidentification cases, medical identity theft, and ensure compliance with the Interoperability and Patient Access Final Rule.

Telehealth Is Here to Stay – Ensure Patient Data Integrity While Using It

September 30, 2020/11175 views / 0 Comments/in BLOG, Connected Health, Data Integrity, Duplicate Medical Records, EHR, healthcare, Medical Identity Theft, Patient Data, Patient Identification, Patient Safety, Photo Biometrics, Telehealth /by Matt Gibson

To put it bluntly, the coronavirus pandemic has been catastrophic for the entire world. The U.S. has been leading with the highest number of cases – 6,550,637 at this point. However, there has been a silver lining in the whole coronavirus pandemic – telehealth. Not only did it experience a meteoric rise in the U.S., but it also helped to flatten the curve – patients don’t have any risk of contracting the virus when they use telehealth. While the increased usage of telehealth demonstrates that it’s here to stay for the foreseeable future, healthcare providers must ensure that they are protecting patient data integrity during these visits. Let’s see how accurate patient identification can help.

Telehealth’s rise

Telehealth isn’t anything new – it’s been in the healthcare space for quite some time now. Sadly, people were busy debating its pros and cons for years. However, 2020 will be remembered as the year of telehealth – its potential was showcased during the pandemic.

People praised its elimination of the physical barriers required for healthcare – people would be able to consult with their caregivers without having to worry about the novel coronavirus – a stable internet connection and a communication device are all they need. It enabled healthcare services to be continued at a time when social distancing was required – creating a win-win situation for all. Laws were relaxed regarding telehealth while providers and officials urged patients to use telehealth instead of coming for hospital visits. Quite naturally, the usage increased exponentially. Let’s take a look at an example – MUSC Health and its experience with telehealth.

They used “virtual urgent care technology” – something that was initially created to provide patients with a way to be observed for non-critical cases, and converted that to screen potential COVID-19 patients. Moreover, they had the capabilities and resources to dramatically adapt tools to better fight the pandemic. They also enabled remote patient monitoring and a telesitter program as part of their approach, and they believe that telehealth is here to stay. Overall, healthcare providers in the past few months have observed that telehealth can be used to provide patient care while mitigating the risk of contracting COVID-19.

Some stats regarding telehealth usage

The current stats are in line with the providers’ experiences with telehealth. McKinsey & Company stated that in 2019, a meager 11% of the U.S. patients were using telehealth. As of April 2020, 46% of the patients are using telehealth. Even healthcare providers witnessed around 50-175 times more patients using telehealth visits compared to the pre-pandemic period. However, one has to consider the risks associated with it just like with inpatient visits, for instance, patient data integrity, patient identification, and medical identity theft.

Patient data integrity must be ensured

It’s quite natural that some of the issues plaguing conventional healthcare might be seen during telehealth visits as well. One of the biggest challenges is preventing medical identity theft.

Healthcare data breaches have been occurring more than ever, where most of the stolen patient data is sold off to fraudsters. They then assume the identities of the victims and use their healthcare services. This leads not only to billing the victims for services they never used but also corrupts the patient data – because the fraudsters’ data is saved in the victims’ medical records. Thus, patient data integrity is compromised in the process.

Experts believe that the pandemic will lead to increased numbers of medical identity theft cases. This is because patient data is not adequately protected by the majority of caregivers due to budgetary issues. Moreover, with the pandemic causing arguably the worst financial crisis healthcare has ever faced, providers need to consider every option in order to survive.

RightPatient ensures patient data integrity – even during telehealth visits

While healthcare data breaches are inevitable, medical identity theft can be prevented. One of the reasons why medical identity theft has become a major threat is because there is no proper patient identity verification system in place to prevent these crimes. Most of the patient identification systems use credentials – something that can be stolen or transferred.

Fortunately, RightPatient can help prevent medical identity theft. It uses the thing that fraudsters or hackers cannot steal – patients’ visual likeness. Using a photo-based search engine, RightPatient matches the photos of the selfie provided during appointment scheduling with the patient’s driver’s license. Fraudsters are red-flagged immediately, preventing medical identity theft in real-time.

During inpatient visits, all the patients need to do is look at the camera – the platform matches the photo it takes with the one it saved during registration. This creates a safe, hygienic, and touchless environment for everyone involved – something which became more crucial than ever due to the pandemic.

RightPatient helps maintain patient data integrity by ensuring that the accurate medical record is associated with the correct patient every time, preventing medical identity theft, and avoiding duplicate medical records. Try RightPatient now to see how it can help you enhance patient safety during these trying times.

Patient Safety and Quality Healthcare Require Patient Identification During the Pandemic

September 23, 2020/10364 views / 0 Comments/in BLOG, COVID-19, Data Integrity, Duplicate Medical Records, EHR, healthcare, Patient Errors, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Matt Gibson

Another day, another new initiative by healthcare leaders regarding patient identification. One might wonder that given the pandemic and its ongoing effects on healthcare, why is that a top priority right now? Well, that’s what the healthcare experts have been demanding as inaccurate patient data negatively impacts patient outcomes during this crisis. The U.S. healthcare system has been suffering due to the absence of a patient identifier for decades now – the ban is still in effect on a UPI. Let’s look at what industry experts are saying and how positive patient identification can ensure patient safety and quality healthcare.

The importance of patient identification according to experts

This isn’t the first time leaders have talked about the need for accurate patient identification and it won’t be the last time. Healthcare providers have been struggling with patient identification for decades now, leading to compromised patient safety, inaccurate patient data, and unwanted healthcare outcomes. Add the pandemic to the equation, and identifying patients accurately becomes more important than ever as accurate data sharing is a topmost priority.

Recently, a session organized by the ONC (Office of the National Coordinator) for Health IT brought up the topic. According to Tom Leary, HIMSS VP of Government Relations, incorrect patient data leads to adverse impacts on public health response initiatives. He further elaborated on that – patient identification errors during the ongoing crisis led to several issues like improper data sharing, delays in sharing test results, and inaccuracies within longitudinal patient records. According to Mr. Leary, some nurses even tried to Google patients to identify them and contact them regarding their test results!

Preparing for COVID-19 vaccines, whenever they’re created, will require accurate patient identification during large-scale immunizations to identify the infected ones, the ones who got the shots, and to identify the outcomes of the cases, stated Mr. Leary. Not having any proper patient identity verification system in place is just worsening the health outcomes and adding fuel to the ongoing fires during the pandemic. Thus, to ensure patient safety and quality healthcare, proper patient identification is an absolute must.

Patient safety and quality healthcare depend on identifying patients

As previously mentioned, many might think that with the pandemic still impacting healthcare significantly, patient misidentification is the last thing we need to worry about. However, Mr. Leary, as well as other healthcare industry experts, thinks otherwise. During the ONC session, they have already demonstrated how patient misidentification is affecting healthcare outcomes. But even before the pandemic, patient identification errors were notorious for adversely impacting patient safety and quality healthcare.

Let’s go back to the time before the pandemic struck the U.S. Even then, the healthcare system had a plethora of issues, one of which was duplicate medical records and overlays. Imagine – a patient came to the hospital and they were assigned a duplicate record, based on which the whole treatment will be provided – so many things could go wrong!

An incomplete or inaccurate EHR leads to repeated lab tests, improper treatment, and even deaths due to a single misidentification. As a result, patient safety is severely impacted as well as healthcare outcomes. Patient misidentification cases are associated with unwanted incidents that can haunt caregivers – loss of goodwill and litigation costs are just some of the consequences.

Even before the pandemic, patient misidentification was a significant issue within the healthcare system. However, the COVID-19 crisis demonstrates how patient identification errors impact patient outcomes during a time when accurate patient information is of the essence.

Experts are urging for the UPI once again

It’s been around two decades since the ban was imposed on a state-funded UPI (unique patient identifier), but industry experts are once again rallying to remove the ban this year. Even if the UPI is finally mandated, responsible healthcare providers will combine it with an effective patient identifier. Such a patient identification policy will encompass several benefits such as enhanced interoperability, reliable patient matching, and improved healthcare outcomes. So, out of all the different patient identification solutions out there, which one is the best match?

Patient safety and quality healthcare require RightPatient

RightPatient has been ensuring accurate patient identification for years now, but why is it the best solution? Well, it can be seamlessly integrated with EHRs to become part of the workflow, making it perfect to be used alongside the UPI, should the latter get approval. Moreover, RightPatient eliminates the biggest headache of providers currently – infection control issues, as it is a touchless solution. With its photo-based search engine for identifying patients during appointment scheduling and beyond, RightPatient is the most feasible choice for positive patient identification post-COVID-19.