Scan your way to a better bottom line

Hospitals' methods for gathering patient information remain largely imprecise, which can lead to costly, long-lasting ramifications for hospital finances downstream.

Many hospitals still rely on rudimentary oral registration processes to enter patients' information into sophisticated electronic systems. However, "vocally relaying and manually entering patient identification information leaves ample room for error by the patient, the staff at the registration desk or the computer system itself," Aaron Miri, CIO and vice president of government relations at Imprivata, said during a webinar Oct. 27.

Medical record overlays and duplicates are the most common byproducts of misidentification. Overlays occur when staff choose the wrong patient record from the master patient index, causing an intermingling of two patients' medical histories. Duplicate records, which are more common than overlays, occur when registration staff inadvertently assign a single patient multiple medical record ID numbers.

Mr. Miri was joined on the webinar by Justyna Evlogiadis, senior product marketing manager of Imprivata PatientSecure™, and Molly Drake, former senior director of corporate access management at Scripps Health in San Diego, to examine the scope of the patient misidentification crisis and the promise of biometric identification solutions.

The impact of misidentification
"Alarmingly, hospitals on average misidentify between 7 percent and 10 percent of incoming patients when registration staff search the EHR database for patient records," said Ms. Evlogiadis. Not only does this pose a serious problem for patient safety during medical treatment, but it also has a quantifiable effect on hospital cash flow and can lead to reduced reimbursement, inefficient administrative processes, drains on resources and liability concerns.

The fact that patient misidentification poses a serious threat to patient safety comes as little surprise. Misidentification accounts for 30 percent of radiation, medication and blood transfusion errors annually, said Mr. Miri. But misidentification also has a quantifiable effect on hospitals' financial performance.

When patient identification errors occur, hospitals must go through the expensive process of cleansing the inaccurate patient records from the EHR. "The process to cleanse a hospital EHR of one duplicate or overlaid medical record costs on average $1,000 and $5,000, respectively, in labor expenses and human capital," said Ms. Drake. Incorrect or inaccurate demographic or insurance information also requires scrubbing on the back end to prevent the payer denying the claim. Combined, these preventable mistakes can lead to a 5 percent annual net patient revenue loss per hospital, due to denied claims and bad debt.

"Patient satisfaction also suffers when misidentification occurs," Ms. Drake said. For instance, physicians who plan care or treatment based on a duplicate medical record are typically working with a fragmented patient medical history. This could cause patients to endure the trouble of undergoing unneeded tests and subsequently shoulder the cost of that care. Or, when the wrong patient's record is selected at registration, a patient may receive a bill for another person's medical treatment.

By ensuring correct patient records are retrieved at registration, hospitals mitigate the risk of adverse medical events and improve patient satisfaction by streamlining their medical experience.

How does misidentification happen?

Here are six ways patient misidentification occurs at hospitals.

  1. Patients cannot communicate. For many organizations, the emergency department generates a majority of duplicate records because unconscious, critically injured or confused patients cannot identify themselves to registration. Physicians who are unaware of a patient's medical history, allergies, medical conditions and other vital health information run the risk of delivering lesser quality care.

  2. Out-of-date information. Sometimes changes to patients' demographic or insurance information are not properly updated in their medical record. For instance, a patient might tell the registrar he or she still has Blue Cross Blue Shield insurance, but they may forget their policy ID number changed since his or her last visit.

  3. Registrars are rushed or poorly trained. Traditional patient identifiers, such as oral demographic data, Social Security numbers and patients' addresses, can be easily mistyped and cause preventable medical errors, particularly if registration staff are managing high patient volumes. Implementing well-developed patient access training for employees is key to standardizing registration processes to mitigate mistakes.

  4. Lack of accountability and conflicting priorities. Organizations should establish clear policies and protocol for registration, so each employee understands and abides by the same processes.

  5. Cultural variation in naming conventions. "Scripps is close to the border with Mexico," said Ms. Drake. "In Mexican culture, some people have multiple last names, and they may use a different name every time they visit the hospital." Cultural norms such as this can contribute to the creation of duplicate medical records under a series of technically correct patient names.

  6. Intentional medical fraud and abuse. "About 2.3 million patients were affected by medical identity theft in 2013," said Mr. Miri. "Patient privacy and cybersecurity issues can cost hospitals regulatory fines, as well as the trust of their patient community."

Biometric identifiers improve accuracy
Although patient misidentification is a pervasive problem, hospitals across the country have taken steps to significantly reduce these mistakes by investing in the right technology. Biometric identification tools offer one of the most promising ways to combat the patient identification crisis and protect hospitals' bottom lines.

There are a number of biometric modalities available in today's patient identification technology market. "Many hospitals and health systems use palm-vein biometric authentication for patient identification, as patients typically find this technique less intrusive than other biometrics, such as fingerprinting," said Ms. Evlogiadis.

This biometric of choice takes a scan of a patient's palm vein pattern. Since no two palms are the same, any misidentification issues are eliminated. "After implementing Imprivata's palm vein scanner technology, Carolinas HealthCare System reduced the average patient check-in time by 75 percent," said Ms. Evlogiadis.

Improving both clinical outcomes and data integrity are key strategic priorities for hospitals, especially in the transition to population health management. Improving patient identification rates is a crucial step to achieving these goals while optimizing revenue cycle operations.

Click here to watch a recording of the webinar.

Click here to download a copy of the presentation.

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