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Hospitals are Prioritizing Patient Matching Accuracy

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Patient identification has been haunting the healthcare industry since its inception. Using the existing practices in the industry, accuracy rates are significantly low and cannot be used to exchange health data effectively, as reported by officials from different healthcare systems such as hospitals and physicians. The industry is in dire need of patient matching improvement. 

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However, the above report is not the only one – other statements point towards the same conclusion of requiring patient matching improvement, as per the research brief from Pew Charitable Trusts. A study was conducted by Pew researchers along with Massachusetts eHealth Collaborative (MAeHC) that sought to identify the current situation of patient identification in the healthcare industry. They did so by collecting information from different healthcare executives with the use of interviews. Another aspect of the study was to identify how to achieve patient matching improvement. The sample of this study was healthcare experts and influential figures from various practices and sizes who served numerous patients in diverse regions all over the country.

A vast majority of the sample expressed the same view – patient identification and matching were quite inaccurate and desperately needs an overhaul, thanks to the increasing demand for interoperability.

Healthcare providers are now motivated to exchange more health data due to the recent CMS Promoting Interoperability program. That’s not all! CMS is also going to be granting incentives to accountable care organizations (ACOs) who will show savings through activities which support care coordination.

According to the Pew researchers, healthcare systems like hospitals and clinicians eligible for these programs need to exchange information with others so that all of the parties have the latest patient data from other various institutions.

The hospital officials stated that it is quite challenging to measure the match rates, resulting in their efforts being ineffective to examine and improve the patient identification rates. They also had difficulty providing a number when asked for the identification rates within their organizations. This was because many hospitals only keep a record of the duplicates identified through EHRs, whereas others do not know which files are relevant and which are unlinked.  Thus, without knowing the actual number of correct matches, these healthcare systems cannot determine their match rates. Therefore, only the amount of misidentifications was provided by them, thus summarizing the research.

It was also identified that healthcare systems could easily match patient identities when asked by organizations they are in constant contact with. Both automated and manual processes are utilized to link records to the correct individual.

However, whenever it is an organization with whom the healthcare system is not in contact with regularly, match rates are inclined to be lower. This is because these unsolicited requests introduce more blockades because the healthcare system may not have a record of that individual, and the healthcare system uses automated processes for such applications. On top of that, the research also showed that urban areas require better identification rates compared to rural areas as not much-sharing activities take place in the latter.

Some healthcare executives also think that improved patient identification matching requires significant costs. However, many believe that biometric patient identification is the solution to improve matching rates and is worth the cost. Some hospitals are even utilizing iris scanning solutions like RightPatient to identify all their patients and pull their relevant data from their EHRs and show a significant change. They report that it is fast, accurate and improves the overall patient experience as well as speeding up the whole process and saving valuable time of the physicians so that they can concentrate on more critical tasks such as the patients themselves. 

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How Can You Protect Your Investment in a Population Health Solution?

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Healthcare in the U.S. is going to see a paradigm shift in the next five years that will move it from a fee-for-service (FFS) payment model towards a value-based model. Simply said, those who produce better results and improve patient quality of care at lower costs will reap higher dividends. This shift will require better use of technology and significant changes to many platforms and their capabilities, including more investment in big data, analytics, and patient matching systems. These investments in population health management technologies will provide the real-time information needed to make more informed decisions.

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Population health solutions play a critical role in moving healthcare from a treatment-based to a prevention-based model. These platforms enable providers to better prepare for patient-reported outcomes, provide data regarding social determinants of health and activity-based costing, and match extracted data outcomes with the right patient.

Current state of U.S. healthcare

The U.S. spends more on healthcare per capita than any other nation in the world but fails to produce better results for life expectancy and other health outcomes. Moreover, U.S. taxpayers fund more per capita on healthcare (64%) than those in other countries, including those with universal health programs.

These facts suggest that encounter-based medicine might be contributing to sub-optimal results in the U.S. and there is a need for change. That change is prompting the rise of population health management and data analytics technologies.

The population-based model is based on aggregating patient data across various health information resources, forming a comprehensive, longitudinal health record for each patient, and leveraging analytics to produce insights that clinical teams can use to improve care and lower costs. In addition to health and financial data derived from electronic health records (EHRs) and medical claims, information such as a patient’s socio-economic status, personal support network, and habitat conditions can be useful in building preventative care strategies.

For example, a patient diagnosed as prediabetes would be classified as high-risk in an encounter-based model. However, this does not take into consideration the patient’s lifestyle and behavioral patterns. Many prediabetics can avoid developing diabetes by modifying habits such as diet and exercise. Patients who smoke, abuse drugs, or have a sedentary lifestyle are much more at risk of developing the disease. Identifying these genuinely high-risk patients requires access to accurate data that is linked to the correct record. 

Challenges in moving to a population health solution

At present, a tremendous amount of patient data is available but it is not unified – it exists within different institutions and across various platforms. Thus, the available information is very difficult to match with the right patient (if not impossible in some cases) and such data has little practical value. Population health solutions need a system that can match patients with their available data and provide information on the best recommendations for preventative care, helping to improve outcomes and save resources.

Therefore, the most important variable in extracting value from a population health solution is ensuring that a patient’s captured data is matched to the correct record. Better data warehousing and mining capabilities will serve no purpose if healthcare providers lack the ability to match the output with the right patient. At present, not only do patient identification issues exist within a single healthcare institution, but these issues become even worse when patient data is exchanged across multiple systems, with error rates rising to 60%.

Failure to properly identify a patient means loss of historical medical history, social indicators, financial information, medications, allergies, pre-existing conditions, etc. – vital information that puts the patient and healthcare provider at greater risk. These data integrity failures can significantly dilute the efficacy of population health initiatives.

In fact, the transition from fee-for-service to value-based healthcare is only going to work if healthcare entities invest in patient matching technology alongside their investments in big data and analytics platforms. These investments should go hand-in-hand since patient matching errors can have such a substantial impact on data quality.

Population health management is among the top six categories in healthcare that are attracting investments from venture capital firms. Other segments include genomics and sequencing, analytics and big data, wearables and biosensing, telemedicine, and digital medical devices.

Thus, the industry is investing in technologies that will play a significant role in value-based care and population health management. However, the success of any population health initiative depends on the right patient being identified every time so that medical records and the corresponding patient data are not mixed-up. Considering the data fragmentation that exists in healthcare and lack of standards around patient identifiers, AI-based systems like RightPatient are the only way to ensure reliable identification of patients across various data platforms and maximized investment in population health management.

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How RightPatient Prevents Chart Corrections in Epic and Other EHRs

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I’ve visited enough of our customers to know that hospital emergency rooms and free-standing EDs can sometimes be chaotic environments. Unlike most outpatient registration areas, patients who arrive to the ED do not have scheduled appointments and often go through a triage process with a nurse where they are “arrived” within the electronic health record (EHR) system. This is essentially a quick registration that begins the documentation of a patient’s visit information on his/her medical record. Unfortunately, this process often results in what are known as chart corrections.

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As one might imagine, a clinician’s primary focus is on the health and safety of the patient. Nurses that triage patients are trying to enter patients into the EHR system so they can receive the appropriate care as quickly as possible. Unfortunately, data entry errors during this process are commonplace. For example, EHR system users may create a “John Doe” or “Jane Doe” medical record if they cannot properly identify the patient. Or, users may mistakenly select the wrong record because it shares a similar name with the patient in need of care.

When EHR users select the wrong patient medical record, all subsequent information pertaining to that visit is entered into that record (sometimes referred to as a medical record “overlay”). This is a data integrity failure and results in data entry errors that need to be resolved with a chart correction. So, a chart correction in the Epic EHR or other EHR systems is the process of fixing a “wrong chart entry” or overlay record that was caused by a patient identification error.

Wrong patient, wrong record data integrity failures within the EHR system can have disastrous consequences. At best, the healthcare provider must spend internal Health Information Management (HIM) resources to perform chart corrections and resolve medical record overlays, costing $60-$100 per hour for an average of 200 hours per overlay record. At worst, wrong patient errors can affect clinical decision making, patient safety, quality of care, and patient lives. This is why organizations like AHIMA have strongly advocated safeguards that healthcare providers can use to prevent medical record mix-ups, improve data integrity, and reduce the risk of adverse events.

RightPatient is the ideal safeguard to prevent wrong patient medical record errors and chart corrections within Epic and other EHR systems. The AI platform uses cognitive vision to instantly recognize patients when their photo is captured and automatically retrieve the correct medical record. This becomes a seamless module within EHR system workflows so there is no disruption to users.

Customers like University Health Care System in Augusta, GA are effectively using RightPatient to reduce chart corrections in Epic. In fact, UH saw a 30% reduction in Epic chart corrections within months after implementing RightPatient. 

Healthcare providers using RightPatient to capture patient photos significantly reduce their risk of data integrity failures. This enhances patient safety and health outcomes while reducing costs – important goals in the age of population health and value-based care.

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Value-Based Care: A Patient-Centered Approach Requires Knowing Your Patient

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Aspirin, penicillin, monoclonal antibodies, interventional cardiology, and genome editing have undoubtedly revolutionized medicine. However, while all of these have been breakthroughs in the field of medicine, not much has changed in the way that doctors do their jobs. Patients visit their doctors, the doctors diagnose, they recommend tests, they prescribe drugs, and they are compensated according to the volume of work done or the number of procedures performed.

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If medicine is to progress in the 21st century, things have to change at every level, including the way that doctors work and receive compensation, the way they identify the right patient, and the way that patients are treated.

The long-awaited system that is going to change the way doctors work and are compensated will soon become a reality. This new system is called value-based care.

Value-based care is about compensating doctors according to outcomes. This encourages more personal attention to patients and transitions the healthcare system from cure-based to preventive medicine. It is a system in which doctors receive a higher level of compensation for either better outcomes from procedures or enabling patients to avoid health-related problems altogether.

There are several benefits of a healthcare system where the right patient gets the right kind of care.

Value-based care can save patients a lot of money. Putting aside the historical projections of healthcare inflation, the U.S. is also facing major epidemics of chronic, non-communicative diseases like diabetes, high-blood pressure, and cancer. It is no secret that many of these ailments are preventable with timely intervention and/or the correct behavior. Value-based care creates an environment where doctors can help patients to avoid these diseases by intervening at the right time. A doctor would identify the right patient to design a prevention plan before a disease can manifest where things become more complicated and expensive.

Once the right patient, a patient with a high risk of developing a chronic illness, has been identified, the doctor would be encouraged to spend more time with her, teaching her to take better care of herself so that complications can be avoided. There would be a reward system for identifying the right patient and taking timely preventative measures. It would also result in higher patient satisfaction.

A value-based care system would also lower drug costs. Historically, manufacturers decide the price of their medications without taking into consideration the value that a particular drug has in terms of its effectiveness and overall patient wellbeing. A value-based system would also encourage the development of personalized medicine where treatment plans and even pharmaceuticals can be tailored to specific patient needs.

The backbone of the value-based care system would be patient identification and data mining. Many are already demonstrating why medicine should incorporate more data-based modeling to augment physician decision-making.  Data mining helps doctors and the healthcare industry as a whole to better understand the outcomes of various therapeutic approaches. Ultimately, it can help to create the right kind of individualized solution for the right patient.

Unfortunately, realizing optimal results from data mining and value-based care has its challenges, especially as healthcare organizations start mining data that has been accumulated over long periods of time. On average, at least 8% of hospital patient records consist of duplicate data. Thus, an intelligent way to sort out these duplications and identify the right patient is desperately needed.

It is stated that value-based care is about the right patient getting the “right care, in the right place and at the right time.” Instead, the maxim should be, “RightPatient® enables the right care, in the right place, at the right time.”

RightPatient® guarantees that a patient medical record is never mixed up with another record and the hospital ecosystem will always recognize the patient with the help of cognitive vision. Mistakes from common patient names, fraud, human error and other issues are always prevented.

As we all know, chains are only as strong as their weakest link. In many hospitals or medical institutions, there is an urgent need to strengthen this weakest link throughout the entire system – overcoming the errors of false identity and data duplication with RightPatient. Only then can the benefits of value-based care and data mining be fully realized.

How Big is the Patient Mix-up Problem in the U.S.?

How Big is the Patient Mix-up Problem in the U.S.?

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How Big is the Patient Mix-up Problem in the U.S.?

Hollywood has created several films featuring a person that was wrongly informed about cancer or another fatal disease with the patient being told that they only have a few months/days left to live. Upon hearing this news, the patient goes on a spending spree and adventure only to discover in the end that things have been mixed up. This might make for a great movie but in the real world, if such a patient mix-up happens, the outcomes may be far worse. 

But just how frequently does this medical record mix-up problem happen in real life?

It seems that the problem of so-called mistaken patient identity is big enough to cause serious problems – something that is very evident from the article published in the Boston Globe, reporting 14 cases of mistaken identity. 

Reports indicate that medical errors due to patient mix-ups are a recurrent problem. Consequently, a wrong person may be operated on, the wrong leg may be amputated, the wrong organ may be removed, etc. In fact, CNN reported that in 6.5 years, in Colorado alone, more than 25 cases of surgery on the wrong patient have been reported, apart from more than 100 instances of the wrong body parts being operated on.

It would be challenging to estimate the true total number of patient mix-ups simply because the vast majority of them go unreported until something untoward happens. Even in cases where complications do occur, most medical organizations would not be eager to publicize them. 

Today, it is widely accepted that medical errors are the third largest killer in the U.S.; that is, far more people die of medical errors compared to diseases like pneumonia or emphysema. It is now estimated that more than 700 patients are dying each day due to medical mistakes in U.S. hospitals. This figure clearly indicates that medical errors often occur even though a fraction of them will have fatal outcomes. It also tells us that cases of patient mix-ups may be shockingly high and indeed underreported.

Though several thousand cases of mistaken patient identity have been recorded, it remains the most misunderstood health risk, something that hospitals barely report, and an outcome that patients do not expect to happen.

The U.S. healthcare system is extremely complex, making it challenging for a single solution to resolve this issue. There have been lots of efforts to implement a unique identity number for each patient (a national identifier) but political roadblocks have proven difficult to navigate. The chances are bleak that any such national system would be created, as patients remain profoundly worried about the privacy of their data.

At present, perhaps the best option is that each hospital finds its own way to solve this problem by developing some internal system to make sure that patient mix-ups don’t happen. Or, a better idea is to leave this task to the professional organizations that specialize in the business of improving patient identification. The RightPatient® Smart App is a perfect example of an innovative solution that is powered by deep learning and artificial intelligence to turn any device like a tablet or smartphone into a powerful tool to completely eliminate the problem of mistaken patient identity.

Technological solutions are often meant to augment human efforts, not to replace them. Here are some of the ways to avoid patient mix-ups:

  • Always confirm two unique patient identifiers within the EHR (Electronic Health Record), like patient name and identity number.  Though this is a standard practice, many mistakes still occur due to similar first or last names. Thus, an app like RightPatient can help to eliminate the chances of such an error.
  • Two identifications should be used for all critical processes.
  • There must be a system to alert staff if two patients have a similar first or last name.
  • Avoid placing patients with similar names in the same room.

Although patient misidentification and medical record mix-ups continue to plague the U.S. healthcare system, there is hope to address this serious issue with solutions like RightPatient. Now, we just need healthcare providers to make this a priority and take action.