How palm scanning technology helped Carolinas HealthCare System improve patient identification

Misidentifying a patient can lead to significant consequences, including reduced clinical productivity, revenue loss and even patient harm.

In a webinar sponsored by Imprivata and presented by Becker's Hospital Review, Tom McDermott, vice president of sales at Imprivata PatientSecure, and Mike Hill, assistant vice president of information and analytics services at Charlotte, N.C.-based Carolinas HealthCare System, discussed how the health system implemented a biometric identification platform across its 40 hospitals and 900 clinics.

If a patient is misidentified during a medical visit, a clinician or registrar might pull up incomplete or incorrect medical records, or even begin a duplicate one. On average, clinicians waste 28.2 minutes per shift searching for correct medical records for patients, according to an Imprivata-sponsored Ponemon Institute survey of 503 healthcare executives and providers.

Incorrect identification can also affect a health system's bottom line: The average hospital loses $17.4 million each year in denied claims because of misidentified patients. Not to mention, the majority of providers (86 percent) know of or have witnessed a medical error due to patient misidentification.

"There's all kinds of scenarios in which you could put the patient in danger because you don't have the correct information in front of you," Mr. McDermott said. "If they have some allergies, if they have high blood pressure, if they have a pacemaker."

The top three factors that lead to patient misidentification are difficulty finding a patient medical record (68 percent), searching for a patient and finding duplicate medical records (67 percent) and pulling up an incorrect record with the same name or date of birth (61 percent), according to the survey.

Carolinas HealthCare System, which was one of Imprivata's first customers, experienced some of these challenges first-hand. However, after deploying a biometric identification platform, the health system saw its duplicate medical record rate fall 98 percent.

Challenges with manual patient identification
About a decade ago, Carolinas HealthCare System reported a duplicate medical record rate of 5 percent. The health system, which was managing more than 5.8 million patients across its facilities, partially attributed this misidentification to registrars feeling rushed or facing communication barriers with patients.

"Registrars and front desk staff have a very difficult job," Mr. Hill said. "They're trying to choose a single patient out of millions of records, they're given limited information, sometimes they're asking these questions in public spaces and, of course, there is that time crunch. It isn't surprising that some of these variables come into play where there can be some communication gaps."

Although Mr. Hill said Carolinas HealthCare System's duplicate record rate was lower than the national average, the organization recognized the potential for the issue to negatively affect patient care. And, as the health system moved forward with acquisitions and mergers, it worried the rate would continue to grow.

"For us, creating a duplicate in any one of our registration systems created a duplicate in our [enterprise master patient index], which then results in a duplicate in our EMR," Mr. Hill said. "It was all cascading, and that would present a clinician with an incomplete or inaccurate record."

How biometric technology improves patient identification
Carolinas HealthCare System officials decided to explore a new identification method to improve patient identification and lower the rate of duplicate records that occurred as a result: biometric technology, which recognizes patients based on physical characteristics, like fingerprints or iris scans.

"A patient's biometric data is something that they always have with them," Mr. Hill said. "It's something that's a part of them." On the other hand, manual identification processes are less reliable, as they are prone to human error.

After doing a sweep of the vendor landscape, Carolinas HealthCare System ultimately chose to implement Imprivata's PatientSecure platform, which identifies patients using palm-vein recognition. To enroll in the voluntary program, a patient undergoes a biometric palm scan, which is permanently linked to their medical record.

At all future appointments at the health system's hospitals or clinics, patients simply scan their hand at the registration desk and provide their date of birth to flag the correct patient record. This technology carries additional benefits beyond reducing patient record duplication. For example, a biometric scan can be used to identify a patient who presents at an emergency department unconscious or unable to communicate.

"We really saw the value of making sure the same palm-vein enrollment would only have to be done one time," Mr. Hill explained. "That it would work whether the patient presents at the ED, or urgent care, or their primary care physician. It should be seamless."

Carolinas HealthCare System chose palm-vein biometrics since it's a non-invasive biometric measure that maintains accuracy over time and can be used for children as young as 5 years old. "The vein pattern in the palm is set right at birth and doesn't change over the course of someone's lifetime," Mr. Hill said. "As time goes on, that vein pattern is very consistent."

2 factors for successful biometric deployment

1. Front-line staff training. Although the typical PatientSecure rollout takes roughly 90 days, the majority of this time isn't spent on technical implementation, according to Mr. McDermott.

"It's a very light lift from an IT perspective," he said. "The predominant amount of work to roll out something like this comes from the training of the registrars."

Since Carolinas HealthCare System enrolls patients at the point of registration, those behind the front desk are tasked with encouraging biometric adoption. Health system officials must train these front-line staff to present the option to patients, preferably with a well-crafted, succinct script.

"You need good buy-in from the front-line staff, patient registration team and clinic front-desk personnel to sell the benefits of the program and present this option to patients," Mr. Hill said. "That goes a long way toward patient adoption."

2. Patient interest. At Carolinas HealthCare System, enrollment in the biometric program is voluntary — which means advertising the benefits of positive identification to patients is of utmost importance.

To drive patient awareness, Carolinas HealthCare System invested in publicity materials to highlight the importance of accurate patient identification. The health system also sent representatives to community events, where they set up enrollment stations.

Upwards of 96 percent of patients have elected to enroll in the program at Carolinas HealthCare System, according to Mr. Hill. Across all patients who are offered the biometric scanning option, Imprivata has seen that roughly 98 percent choose to adopt it, according to Mr. McDermott.

"On occasion when we do a new implementation, the registration folks can be on the negative side, thinking patients don't want to do this," Mr. McDermott said. "But adoption has been good. Once patients understand what it's all about — safety, accuracy — there's very little pushback on enrolling in the system."

Listen to the webinar recording here.

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