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How to Protect Patient Information as Data Breaches Become a Topmost Concern

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We’ve talked about data breaches in hospitals and health systems more times than we can count. Unfortunately, these unwanted incidents just keep on happening, and even when the pandemic was at its peak, hackers didn’t stop. Thus, it isn’t a surprise that many healthcare executives are wary about cyberthreats that loom in the dark, just biding their time and waiting to attack more hospitals and steal patient information. That being said, let’s take a look at some recent cyberthreats faced by hospitals, what healthcare execs are saying, and how to protect patient information even if there is a data breach.

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Most healthcare experts are worried about cyber threats

Let’s take a look at some of the recent worrying trends in health IT, according to some respected healthcare executives. 

Half of them stated that the frequency of cyber-attacks on healthcare facilities is one of their primary concerns now – let’s explore the issue in detail.

Out of these execs, one of them expects that this will continue to be a huge problem for the foreseeable future – a worrying but accurate prediction, unfortunately.

Another exec stated that such cyber-attacks put patient data, arguably one of the most sensitive pieces of information available within hospitals, at huge risk. We’re inclined to agree, as most data breaches end up with hackers stealing patient information and selling it to fraudsters who commit medical identity theft down the line. Many caregivers, as a result, are searching for answers to the billion-dollar question – how to protect patient information. 

Another exec stated that cyberattacks are rapidly evolving as hackers come up with innovative ways to attack and lock or steal patient information – something quite challenging to keep up with.

One of the execs that is worried about cyber-attacks stated that hackers and these issues hinder them from doing their jobs properly, which is to care for their patients. He also stated that effective cybersecurity practices and far more assistance are required to tackle cybersecurity and keep costs in check. 

Another of these execs predicts that more hospitals and health systems will be focused on improving some aspects such as better integration between platforms, patient consumerization, and strategies that help with cybersecurity efforts. 

However, not all healthcare executives chose cyber-attacks as their primary worries.

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Others chose:

  • The boom of startups that give unrealistic expectations, taking up a lot of money from investors.
  • Mergers and acquisitions.
  • Mandates about sharing health information that are quite unclear and might be detrimental.
  • Clinician burnout due to EHR coding, among other issues. 
  • Ensuring equity during telehealth visits.

While all of them are quite valid concerns, the biggest concern is how to protect patient information effectively – healthcare data breaches are occurring as we speak. 

Hospitals must protect patient information effectively as data breaches are rampant

On the 15th of April, a phishing attempt was successful – unauthorized individual(s) got access to login credentials of an employee of Orlando Family Physicians. After a thorough investigation, it was found that three other employee accounts were accessed. While the access has been revoked, over 447,000 patients were exposed, such as names, health insurance data, Social Security numbers, and more. This is just a classic case of data breaches – something that has been repeating itself for several years in many hospitals and health systems.

Fortunately, as we mentioned at the beginning of the article, doing something about protecting patient data and preventing medical identity theft IS possible – let’s see how to protect patient information even if there is a data breach. 

How to protect patient information with RightPatient

RightPatient is the leading touchless patient identification platform trusted by responsible hospitals and health systems for several reasons. Firstly, it ensures accurate patient identification starting from appointment scheduling and at any touchpoint across the care continuum. Secondly, it is easy-to-use, safe, and hygienic, as the interactions are contactless – something that is extremely valuable in a post-pandemic world. Thirdly, it protects patient data and blocks fraudsters during identity verification – preventing medical identity theft in real-time.

During the registration process, the patient just needs to look at the camera – the photo taken is attached to their medical record, essentially “locking” it from being meddled with by fraudsters. When the patient returns for future visits, all the patient needs to do is look at the camera – RightPatient automatically runs a search and presents the appropriate EHR when it finds a match between the saved photo and the patient’s live image. Any fraudster attempts will be red-flagged by RightPatient during this process – stopping medical identity theft in its tracks.

How are YOU protecting your patients’ information?

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Denied Medical Claims Are Costly but Preventable with Patient Identification

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The U.S. healthcare system is no stranger to problems, unfortunately. In fact, it has been plagued by a plethora of issues for several years. While some of the problems are definitely solvable, external issues alongside other factors cause the problems to continue. Some of the many problems are astronomical prices, the lack of price transparency, interoperability issues, the abundance of data breaches, medical identity theft, and patient safety issues. While we have covered some of these topics at one point or the other, let’s take a look at another crucial problem, denied medical claims, how they are problematic for everyone, and how positive patient identification can prevent them. 

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Denied medical claims are costly and cumbersome for everyone involved

Denied claims are not a recent problem within U.S. healthcare – most hospitals and health systems are quite familiar with them. One can safely say that denied medical claims are quite expensive – an average hospital can lose around $3.5 million due to them. However, denied claims not only affect hospitals but also insurers and patients, albeit in different ways – let’s see how.

Claim denials in a nutshell

In the U.S., healthcare is closely related to reimbursements from Medicare, Medicaid, and commercial insurers. Patients get health insurance, go to their healthcare provider, get treated, and that’s about it. However, a lot more goes on behind the scenes regarding healthcare reimbursements. 

After providing healthcare services to the patients, the hospital processes the information and sends the claims to the insurance company. While healthcare providers usually get reimbursed by the payer, some of them face expensive hiccups. Due to billing or coding issues, patient identification errors, medical record mix-ups, or other problems, the payer identifies inconsistencies after receiving claims, and they might reject or deny said claims. While some claims can be resubmitted, checking for and fixing the errors is time-consuming, costly, and requires a considerable number of resources. 

All of the above leads to back-and-forth exchanges between care providers and payers. Insurers have to reject claims, caregivers lose out on a significant amount of revenue, and many patients even receive shocking, incorrect bills. However, some even lose healthcare services, especially those associated with Medicaid.

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Let’s take a look at a few statistics to see how Medicaid patients suffer due to denied medical claims. However, do keep in mind that denied claims can be detrimental for any patient. 

A worrying study regarding denied claims

A very recent study has shed light on denied claims and how physicians or hospitals are reluctant to see Medicaid patients due to reimbursement issues. 

According to the study, at least 25% of Medicaid claims have been denied upon initial submission. On the other hand, 7.3% of Medicare claims were denied whereas commercial insurers denied 4.8%.

Moreover, the study also states that around 17% of revenue is lost due to billing problems associated with Medicaid patients, whereas the numbers are quite lower for patients covered by Medicare (5%) and other payers (3%). 

While any type of denied claim is extremely costly, the statistics show that the Medicaid ones are quite problematic. Moreover, since Medicaid is associated with low-income families, reimbursements are lower as well.

All of this just leads to caregivers being reluctant to look after Medicaid patients. 

Denied medical claims are preventable 

One of the topmost priorities of physicians and healthcare providers is to look after the patients, Medicare or otherwise. Instead of worrying about denied claims, hospitals and health systems can work on reducing or eliminating them with the right tools and strategies. 

Fortunately, RightPatient, the industry’s leading touchless biometric patient identification platform, can help reduce denied claims substantially.

Denied and rejected claims typically occur because of billing and coding errors – most of which can be traced back to medical record errors, patient mix-ups, and identification issues. RightPatient eliminates all of that, and more, as it ensures that the accurate information is fed to the correct EHR at all times. As a result, billing and coding errors are drastically reduced and so are denied claims – boosting the bottom line. 

How are YOU reducing denied claims in your healthcare facility?

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

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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. 

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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.

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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?

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The Importance of EHRs Shows Why Medical Record Errors Must be Prevented

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When caregivers are asked about the most important tool they have at their disposal to treat their patients, what answers are expected? Some would say their healthcare team, the cutting edge technology/procedures they have access to, the different solutions they have that improve healthcare outcomes, and so on. However, the most underrated and crucial tool is definitely the electronic health records or EHRs. Think of it – where would healthcare be without EHRs? EHRs ensure that the right information regarding the right patient is provided to the right medical team. However, this is applicable only as long as certain issues are prevented, especially medical record errors.

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That being said, let’s take a deeper dive into how EHRs are the most important tool for healthcare providers and why ensuring patient data integrity is a must. 

Healthcare is evolving but the starting point remains the same

Let’s go back to a time before the deadly pandemic. If someone went to a healthcare provider and told them that telehealth would become mainstream in the future, the provider would most likely say that they’re crazy! Look at the reality now – telehealth is still preferred by many, even while users are decreasing due to hospitals opening up. 

Healthcare has been evolving – rapidly in some areas and steadily in others. One certain thing is that healthcare isn’t limited to the four walls of hospitals and health systems anymore – one of the consequences of the pandemic. However, whether it’s in-person visits or virtual ones (telehealth/telemedicine), the foundation for providing care to patients remains the same – EHRs. 

EHRs are more important than most realize 

Patients, caregivers, and others are quite satisfied with telehealth now.

Patients on the younger side have stated that they would like to continue using telehealth even if the national health emergency is over. That’s probably because it’s more convenient, easier, and safer – all the patients need is an internet connection with a communication device. 

Caregivers have a bit more complex process to go through. 

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Caregivers who are providing telehealth services have to consider a lot of factors – the telehealth platform, the portal, the EHR system, identifying the right patient, rules and regulations, ensuring patient safety online, and more. Also, while providing virtual services to the patients, the physicians need to ensure that the necessary information is being fed to the EHRs of the patients accurately – just as they do during an in-person visit. 

The bottom line is that whether the healthcare provider is seeing the patient within their facility or online, the one thing that basically remains constant is the patient’s EHR. However, issues such as medical record errors can mess EHRs up, derailing healthcare outcomes among other things – let’s see how. 

Why it’s crucial to prevent medical record errors

One of the starting points of providing healthcare is the EHR. When the patient interacts with their healthcare provider, usually to schedule an appointment, one of the first things done by the caregiver is pulling up the patient’s EHR. It basically provides the entire medical history, recent lab test results, and other information required to treat the patient. Moreover, any new information captured by the caregiver will be added to the EHR. EHRs, by providing timely, relevant, comprehensive, and accurate information to the physicians, improve healthcare outcomes, optimize healthcare delivery, boost coordinated care, and reduce adverse events. 

Now, imagine if an inaccurate EHR is selected – the consequences can be devastating! 

Medical record errors such as duplicates and overlays lead to patient mix-ups. Patient A’s treatment will be based on patient B’s medical record, leading to detrimental healthcare outcomes, adverse effects, and worse. Patient data within the EHRs becomes unreliable as it is fragmented, erroneous, and inconsistent. 

However, all of this can be prevented with positive patient identification with RightPatient.

RightPatient prevents medical record errors – and more!

By identifying patients correctly right off the bat, RightPatient ensures that accurate, high-quality data is fed to the EHRs every time the patient checks in for a healthcare visit. Patients only need to look at the camera – the touchless biometric patient identification platform does the rest.

With RightPatient, responsible healthcare providers are not only ensuring patient data integrity, but they are also improving patient outcomes, preventing patient safety incidents, and providing optimal healthcare services to patients.

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Another Patient Misidentification Case Shows Why Hospitals Must Prevent It

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Patient misidentification strikes again. It’s not surprising at this point, as patient misidentification cases have been occurring frequently in hospitals and health systems. There are a plethora of consequences attached to it, which is why patient safety goals quite frequently have “improving patient identification” listed as one of the top goals to address. That being said, let’s take a look at the patient identification error in detail and how these cases are preventable with a robust patient ID solution. 

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A recent occurrence of patient misidentification, but certainly not the last one

Fortunately, the problem was detected before it caused any patient harm. While the patient, Ronnie (pseudonym), was waiting for a virtual visit, she was trying to convince the medical assistant that she didn’t have the rare condition called hereditary nonspherocytic hemolytic anemia. Ronnie doesn’t know how it got added to her EHR, however, that was not her only concern regarding the matter. As she was trying to get this inaccurate information removed, she experienced a lengthy and tedious process. 

The assistant informed Ronnie that only the person who added the condition can remove it – EHRs are quite sensitive documents, and access to modify them is restricted to only a handful of people. However, the assistant provided the name of the doctor, and the surprise here is that Ronnie had never had any physician by that name. 

The assistant was adamant that Ronnie might have had some encounter she forgot about – for instance, it might have occurred in an ER visit. However, Ronnie never went to the ER and got diagnosed with such a rare condition. She backed up her statement by adding that if she actually had hereditary nonspherocytic hemolytic anemia, she would’ve been informed about it. The assistant just reiterated that the physician has added it. Most probably, this occurred because Ronnie’s EHR was mixed up with some other patient and it was a condition that belongs to another “Ronnie” – a classic case of medical record mix-up caused by wrong patient identification

Unfortunately, the tale doesn’t end here – there’s far more to it. 

Ronnie had to go to extreme lengths to address the problem. As the discussion with the medical assistant got her nowhere, the condition was still present in her EHR. When Ronnie explained it to her physician, the latter tried to remove it but couldn’t, and neither could Ronnie’s other physicians. After trying everything, Ronnie submitted a formal request to modify her EHR – something many patients need to do to resolve patient identification errors.

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We believe that Ronnie’s among the lucky ones – many such cases remain undetected until it’s too late, causing detrimental healthcare outcomes. 

EHRs are beneficial but are bogged down due to patient misidentification

EHRs have a host of benefits and have been helping physicians see everything in one place, improve patient outcomes, and more. However, since EHRs contain sensitive information, editing them to rectify the errors is quite cumbersome – just look at the case above! Moreover, since caregivers have to share with other physicians due to coordinated care, these errors are seen by everyone involved in the patient’s treatment. 

This is just one case, and fortunately, Ronnie was able to identify the issue. As previously mentioned, this might have occurred because of a medical record mix-up – we know, because we’ve heard about numerous cases from hospitals and health systems. Unfortunately, there are thousands of patient identification errors in hospitals that are undetected and cause a plethora of issues – both financial and physical. How do we know so much about patient misidentification? 

Because our touchless biometric patient identification platform, RightPatient, prevents it and helps healthcare providers identify their patients correctly at all times. 

RightPatient ensures accurate patient identification at all touchpoints

RightPatient could have very well prevented the error in this case study – we have prevented such cases in numerous hospitals and have even drastically reduced duplicate record creation. The patients only need to look at the camera – our platform does the rest. During registration, RightPatient takes a photo of the patient and attaches it to the EHR. Whenever the patient comes in, the platform takes another photo and matches it with the saved one – providing an accurate EHR every time. 

RightPatient has been protecting millions of patient records in several hospitals and health systems. It ensures accurate patient identification, prevents medical identity theft in real-time, prevents duplicates and overlays, and more – ensuring positive patient outcomes.

Don’t become a mistaken patient identification story and contact us now to see how we can help you boost your bottom line.

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

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

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Revenue cycle management in healthcare facilities

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

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

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

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

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

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

Why optimizing RCM has never been more crucial

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

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

Strategies that enhance healthcare revenue cycle management

Examine the entire RCM process to identify gaps

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

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

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

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

Using solutions that guarantee accurate patient information

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

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

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

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Ensuring Healthcare Data Quality Boosts Hospitals’ Digital Transformation Efforts

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The U.S. healthcare system has always had a complex relationship with technology, to say the least. While it has always been open to ideas that can transform healthcare, there have been certain impediments. For instance, the concept of a unique patient identifier is around two decades old, but due to many concerns, one doesn’t exist yet. As a result, healthcare providers are either struggling with patient identification errors or are using a robust patient identification platform to resolve the issues. Moreover, new research demonstrates the complex relationship between healthcare and technology – healthcare is lagging behind other industries in terms of digital transformation. Let’s take a closer look at the study, why some are reluctant to pursue digital transformation, and how ensuring healthcare data quality can boost digital transformation, among other things. 

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Some stats regarding digital transformation

The study was conducted with over 300 C-level executives, and while it includes a variety of industries, it also compares healthcare with the others, providing a different perspective.

Overall, a whopping 82% of the respondents from all industries stated that data quality is a barrier to data integration. This falls in line with the problems faced in U.S. hospitals and health systems – healthcare data quality can be inconsistent and problematic. 

Healthcare was found to be comparable to financial services and the telecommunications industry in digital transformation – most of the respondents from these organizations stated that they were witnessing success rates of around 60%. While this number might be encouraging to some, healthcare lags behind organizations such as software and tech companies, who naturally are advanced in digital transformation, as well as transportation and logistics firms.

While different industries were surveyed, some commonalities show digital transformation exists as a common problem between them. For instance, around 80% of respondents stated that they found “enriching” existing data quite difficult, impeding the quest to find new insights or meaningful patterns. This is also an issue seen in hospitals and health systems, as ensuring healthcare data quality can be a considerable challenge for many – something which is preventable with proper patient identity management – more on that later. 

Healthcare data quality issues also lead to losing time and resources as data needs to be rectified for usage. The survey also reflected this issue – around 40% of the respondents stated that their data teams have to spend time to clean the data, time which they could’ve spent doing something more productive, as data quality issues should not exist in the first place. 

Healthcare data quality issues have a long history

It’s no secret that patient misidentification is a crucial issue in health systems and hospitals, and it leads to patient data integrity failure. Just imagine that a patient named Sam Jackson comes to the hospital and is assigned the medical record with the name “Sam Jackson”. However, the EHR actually belongs to a different Sam Jackson! The modified EHR will be full of errors and will be unusable and dangerous for both the Sams.

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Such problems have been going on for a long, long time, leading to patient data quality issues, medication errors, wrong treatments, detrimental healthcare outcomes, readmissions, and more.

High-quality patient data is a must

Hospitals and health systems have been investing considerable money and resources in population health management, big data, analytics, and other projects that can transform healthcare for their patients in a variety of ways. However, the only way these efforts can work is if they have access to patient data that is complete, accurate, timely, and relevant. Unfortunately, when patient data is corrupted because of duplicate and overlay records from identification issues, these investments are diluted and affect ROI, patient safety, and healthcare outcomes.

Digital transformation in healthcare, as a result, requires high-quality patient data, and everything depends on identifying the accurate patient record right from the start – something which RightPatient is built for. 

RightPatient ensures patient data integrity 

RightPatient has been ensuring patient data integrity for several hospitals with its touchless patient identification platform. Registered patients are identified accurately right from the start – all they need to do is look at the camera and the platform provides the right medical record. By ensuring that accurate patient information is fed into EHRs every time, RightPatient ensures that high-quality data is present within the facilities to boost digital transformation efforts and investments – improving patient outcomes and reducing unwanted incidents in the process.

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Claim Denials are Damaging More Than 30 Percent of Hospitals – Are You Stopping Them?

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Claim denials have always been a problem – it is a fact that they have occurred in all kinds of health issues for many years. Nevertheless, it got pushed to the back of the line due to the COVID-19 as well as problems with IT in the healthcare field, efforts to get people vaccinated, etc.

Sadly, claim denials have gone up – they are happening much more often now. In fact, it’s reported they have gone up 20 percent in the last 5 years! That, along with other gloomy statistics, was announced in a recent study from Harmony Healthcare. With that out of the way, it’s time to look more closely at this situation and how revenue cycle management in healthcare operations can be improved by identifying patients correctly.

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A short update on claim denials

Claim denials, additionally called denied claims, are simply claims normally sent in by a healthcare supplier to the authorized payer, except for particular reasons, they were deemed “unpayable.” That occurs because of issues with coding and billing, mixing up medical records, missing filing deadlines, inadequate medical needs, or additional pertinent explanations.

So, here is what’s going on currently regarding denied claims.

Several disturbing statistics concerning denied claims

The COVID-19 pandemic triggered nearly everything to become worse, including denied claims. In fact, the earlier stated study showed a massive one-third of hospitals stated their denial rates were 10% or over. The study included more than 130 healthcare providers all over the United States and this rate of denial ranged between 6 and 13%. The accepted “danger zone” for denied claims is touted as 10%. 

This study likewise explained why hospital administrators think denied claims happen. Thirty-two percent said it was caused due to coding errors while twenty percent said the reason was front-end concerns. Nonetheless, both these issues may be based on mix-ups with medical records, which comes from patients being misidentified – we will speak more on that topic later. 

Whilst these revealed denied claim frequency, what’re the real issues denied claims cause?

The massive effect of denied claims

Denied claims are exceedingly expensive if faced – and may amount to around $4.9 million for the healthcare supplier. No matter how big or small a provider is, that is a huge portion of cash, and could even cause some hospitals to close.

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Understand, denied claims are not merely expensive on their own, FTEs or full-time equivalents must do their best to fix any coding errors so the successive claims won’t be refused or refuted. This means the FTEs aren’t doing their normal job, which slows down other work and causes the whole process to be ineffective. Altogether, these facts cause a major blow to the bottom line of these hospitals. 

As earlier stated, numerous denied claims are generated because of issues at the front end as well as coding mistakes, which happen a lot due to misidentifying patients.

The way denied claims and misidentifying patients are linked

This is very easy to figure out – it begins at the registration desk. The incorrect EHR gets noted with the patient, so, incorrect info is placed in the medical record. That may occur because of an error like an overlay or duplicate. If no one discovers the error before the treatment is concluded, the patient’s provider ends up sending the wrong claim info to the authorized payer. 

As the claim is being processed, the authorized payer closely inspects it and sees there are errors, thus the claim gets denied. Misidentifying patients causes coding errors and front-end problems. These issues can be averted if the patient is identified properly. 

RightPatient decreases claim denials, and goes beyond! 

RightPatient helps many healthcare facilities protect millions of their patients’ records. It’s the industry’s top touchless biometric patient identification platform. It works by identifying patients via facial recognition, thus averting overlays, duplicates, and mix-ups with medical records from the beginning. Therefore, this averts the claim from being denied, thus saving hospitals lots of money. It just may be the answer you need to reducing denied claims.

The benefits of RightPatient do not end there. Besides reducing denied claims, RightPatient improves patient safety, enhances healthcare outcomes, and ensures positive patient outcomes. 

Does your healthcare facility prevent denied claims efficiently?

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The Importance of EHR Optimization and 3 Strategies for Improvement

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EHRs and EMRs are used interchangeably and they more or less serve the same function. In a nutshell, EHRs are a crucial part of the U.S. healthcare system and contain virtually all the information physicians and caregivers need to know about the patients. EHRs are required to ensure that the patients are receiving proper treatment plans, healthcare services, and so on. However, using EHRs is not enough – understanding them properly and ensuring EHR optimization is crucial as well, and the latter is something that many care providers miss out on.

That being said, let’s take a look at the importance of optimizing EHRs, how it benefits caregivers, and some strategies that help with optimization. 

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Importance of EHR optimization

Before diving deep into its optimization, let’s do a quick overview of EHRs. 

EHRs are the commonly used abbreviation for electronic health records and may contain a vast amount of health information such as patient names, billing information, progress notes, vitals, medical histories, medications, and treatment plans, lab test results, and much, much more. It is obvious that EHRs are extremely important and have a huge part to play in healthcare outcomes, billing, treatment workflow, etc. As a result, EHR optimization becomes even more important if caregivers want improvements in healthcare outcomes, fewer errors in medical billing, and so on. 

Unfortunately, many caregivers don’t keep up with EHR optimization, which leads to piling up issues and errors, unintuitive interface(s), duplicate medical records, and overlays, which cause patient mix-ups. All of this leads to patient safety incidents, preventable medical errors, billing and coding errors, or denied claims – impacting the ROI.

Just implementing an EHR system is not enough – providing ample training, customizing it to the hospital’s needs, ensuring proper governance, and using innovative solutions to bolster EHRs are crucial components to make it work. 

That being said, let’s take a look at some strategies that help with EHR optimization and ensure higher ROI, better bottom lines, reduced clinician burnout, fewer medical errors, and improved patient outcomes.

Strategies that bolster EHR optimization

Keeping EHRs accurately updated 

Ensuring that EHRs are updated at all times and are free of errors is a must. There are many cases where EHRs aren’t maintained accurately, leading to duplicate medical records or overlays. Not only do these issues with EHRs lead to wrong patient identification, but they also lead to patient safety incidents, denied claims, and might even cause deaths. One way to prevent these issues is by identifying patients accurately at all touchpoints, maintaining patient data integrity in the process. 

Receiving and incorporating feedback

One crucial fact that is overlooked by most caregivers is that feedback can lead to a host of improvements and optimization. Being open to feedback, receiving it, and incorporating it from the actual EHR users can drastically improve EHR usability. Physicians, clinicians, and registrars, among others, are the ones who use EHRs, and caregivers who are open to feedback from them can significantly improve their EHR systems by implementing required changes that optimize the workflow. Unfortunately, only around 34% of physicians are asked for feedback regarding the matter.

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Using solutions that bolster EHR systems and seamlessly integrate with them

EHRs bring a host of benefits to their users, provided that they are used appropriately and with the right solutions. Even EHR systems require support but that’s due to external factors. For instance, the lack of positive patient identification is still felt across the U.S. healthcare system because there’s still no standardized effective national patient identifier present. If truth be told, there might not be one in the near future – the project has been pending for around twenty years! 

However, there are solutions that seamlessly integrate with EHR systems and become part of the EHR workflow, one of the leading ones is RightPatient. 

As a touchless patient identification platform, RightPatient has been helping leading healthcare providers by identifying patients accurately in a safe and hygienic manner. Within hospitals, registered patients only need to look at the camera, and once RightPatient finds a match, it provides the EHR user with the accurate medical record.

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Improving Healthcare Outcomes with 4 Strategies

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COVID-19 has the U.S. healthcare system sweating through probably the most volatile phase in its history. Hospitals are opening up their doors and gradually receiving patients as things are getting much better with the distribution of vaccines. However, the danger of underlying issues that have plagued the healthcare system for decades still remains. Despite these problems, the burden of hospitals providing immaculate healthcare services is still there. That being said, here are some of the practices that can help hospitals with improving healthcare outcomes and reducing their issues.

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Improving healthcare outcomes is a major priority currently

Administering proper care at the proper time and the avoidance of patient safety incidents is a major objective of hospitals. Thus, hospitals are under pressure to implement relevant strategies and solutions that will enhance their effectiveness. This includes partnering with other care providers to protect patient data integrity. While implementing some of these strategies can be pretty expensive, they do help with improving healthcare outcomes – here are some of the most important ones:

Ensuring efficient collaboration with the patients’ care providers

The right kind of collaboration is important in healthcare nowadays and CMS has established new conditions that require caregivers to work together. It has upped the ante on the degree of seriousness of it all.

So, what is the correlation between collaboration and patient outcomes? How does it work to improve healthcare outcomes?

Before terms such as interoperability and collaboration existed, people often were loyal to a single healthcare facility. This has changed, especially with data sharing, EHRs, and interoperability – patients are now free to visit multiple caregivers for treatments to their various conditions and ailments. There might be an interrelation between patients’ conditions and this provides ground for caregivers to associate to ensure that they obtain all the necessary data and up-to-date information that will enable them to make the best decisions with regards to handling the patient and thus improving healthcare outcomes.

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A hospital that is open to collaboration and the implementation of required strategies and relevant solutions will go a long way in helping to improve patient outcomes. The CMS requirements mandate that caregivers support sending and receiving electronic notifications during ADT events that provide updated information about a patient’s condition. RightPatient is a useful tool that caregivers can use to ensure the proper identification of patients and prevent false alerts – more on that later.

Ensuring patient data integrity

The integrity of patient data is often overlooked when it comes to its effects on healthcare outcomes but it is crucial nonetheless. Inadequate positive patient identification can ultimately affect the integrity of patient data. This occurs when a patient is treated with the medical record of another patient or the data gets corrupted in the EHR as the wrong information gets saved in it. When the actual patient comes in for treatment, he gets the wrong administration due to inaccurate information. Thus, medical errors arise, leading to incorrect treatment plans, wrong medication, and more, which lead to negative healthcare outcomes.

Impersonation by a fraudster can also lead to the compromise of patient data integrity – it occurs during medical identity theft. This case is similar to patient misidentification, the only difference might just be that the impersonator does it deliberately. The fraudster receiving the treatment then gets his/her information added into the victim’s EHR thus corrupting patient data. If this passes on undetected, the victim could end up undergoing the wrong treatment procedure.

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Therefore, a patient’s data has to be protected against tampering to further improve the healthcare outcome of the patients due to the reception of the proper treatment on schedule. 

Avoiding preventable medical errors

The focus has also shifted to limiting the occurrence of otherwise avoidable medical errors. The statistics behind such errors are quite alarming. These are common as a result of technical errors, medication errors, medical record mix-ups, wrong information, and so on. Poor patient identification is also responsible for most of the preventable medical errors. Thus, if patients can be accurately identified, then it will significantly improve patient outcomes. 

Preventing patient misidentification

The common problem in all the scenarios above is patient identification errors. It causes a huge problem for hospitals and health systems in general as discussed earlier. With patient misidentification, patient safety can be jeopardized with false alerts rampant during collaboration with other caregivers, sharing corrupted patient information, and the consequence is medical error. The bottom line is that misidentification can affect healthcare outcomes and it can even lead to the death of patients. 

Fortunately, accurate patient identification with RightPatient can help improve healthcare outcomes. 

RightPatient has been helping improve patient safety

RightPatient, with its touchless biometric patient identification platform, has become the top choice for several healthcare providers. It has helped them to enhance patient safety, improve patient healthcare outcomes, and reduce the occurrence of medical errors. The benefits are numerous for both patients and caregivers and this includes safety – it is contactless and perfect for use in a post-pandemic world.