Startup Insider: CrossChx

Data tell stories, and sometimes those stories can lead to big ideas. CrossChx, a Columbus, Ohio-based startup, began as one of those ideas, according to Sean Lane, the company's co-founder and CEO.

After he and fellow co-founder and president of CrossChx Brad Mascho completed their undergraduate studies at Miami University in Oxford, Ohio, the two went on to pursue different careers in the Baltimore-Washington, D.C. area. But in 2011, they reconnected and returned to Sean's small hometown in southeastern Ohio to help with the city's economic development. One of the biggest problems in that town at the time was prescription drug abuse. As two technology-minded individuals, they asked to take a look at the local health system's data to gain insight on the problem.

"When we did, we realized very quickly that there was an identity problem in healthcare, that there was no unique ID for every single person across the country," says Mr. Lane. "There were oftentimes duplicate records inside one EHR and no good authentication mechanism for identity when patients walk into hospitals."

Mr. Lane took time to speak with Becker's Hospital Review about building a solution to the patient identity problem.

Question: When did you realize you wanted to come up with a solution for what you'd seen in the data?

Sean Lane: When we started looking into the problem on a grander scale we found that there are about $42 billion in costs attributed to just identity theft each year. A couple million instances of identity theft have occurred in healthcare, and that number is growing. When patients enter hospitals, they often give their last name and date of birth, and mistakes can result in multiple records and other problems across a system.

We decided to build a prototype of SafeChx, our identification system, which took all the patient information in a system and created one ID for each of them. I have a background in biometrics, so we used a fingerprint reader that could be installed at every point of registration throughout a health system. Once the patient had a biometric template assigned to their identity, the next time they came in they'd just swipe their finger and it would pull up their profile.

That was in 2013, and we spent the better part of that year building out the technology. In 2014, we made it our goal to sign up 100 health systems for SafeChx in a year. People said healthcare moved too slowly to do that, but we pulled it off and signed 102 systems, went live in 88 systems and had about 11 million patients in our database. We currently have over 250 health systems signed up for CrossChx and are live in over 785 locations in more than 25 states.

Q: How does the SafeChx database work?

SL: We link the unique ID that we create for patients to their medical record number at the hospital where they receive care. We find that about 10 percent of patients have multiple records, so we show the registrar all of the records a patient has at that facility and create the unique ID based on that. It's kind of a like a hyperlink between our unique ID and their medical record number.

Every hospital or health system that signs up to CrossChx automatically enters something we call CIRC — our CrossChx Identity Resolution Coalition. That allows us to use the patient's identifying information at a global level. All the data is obfuscated and encrypted, so none of it's ever stored in the raw format, and we're able to identify problems with identity at a global level, which is very unique to our system. Doing that, we can find twice as many errors as the typical system. So if we see a Social Security number being used in four different facilities, we can alert them that the number on file may be inaccurate. One important piece of that is we don't share any of the PHI with any other hospital.

Another important aspect of our identity management system, our foundational capability, it's that it's absolutely free for hospitals: Hardware, software, support and training is all free. Another aspect of CrossChx is we put an app store in every one of the health systems that uses our products, which has other apps the system can purchase and use to build our their solutions. It's really the first healthcare app store that is agnostic to any EHR systems, our idea being that smart developers can build applications and we can distribute them to hundreds of health systems very quickly. Now that adoption has been successful we're rolling out premium products, such as Queue, which goes live [Dec. 22, 2015].

Q: What is Queue?

SL: It's a system to help streamline the patient check-in process. The way it works today is a patient walks into a hospital, there's a clipboard or sign-in sheet that they have to put their name down on. They then sit down in the waiting area and they're unsure of how long their wait is or how many others are going to be seen before them. Then at some point they're called up to start the registration process. Queue is designed to make that process more modern and a better experience for the patient. It's basically a touchscreen tablet that sits on a stand in the lobby. Patients come in and enter a few pieces of information into the tablet and it immediately checks them in. As soon as that information is entered a partial version of their phone number is put up on an LCD monitor and they get to see where they are on the list, how many people are in front of them and what the wait times are. The information matches to the hospital record so the registrar can begin the registration process. As soon as they're ready, the lobby screen notifies the patients and they come to the desk to complete their registration. It's a new product but we have launched it at 24 health system pilot sites around the country. So far the system has processed a little over 220,000 patients so far and from a data perspective we've noticed a 75 percent reduction in wait times at most of the facilities that have the system. We attribute that both to the workflow being streamlined and wait time data being exposed to everyone in the hospital, so managers in one lobby see the wait times of other lobbies and there's a sense of healthy competition to reduce them.

Q: What will CrossChx focus on in 2016?

SL: In 2016 we're really focusing on making the patient experience better. Queue is the first of the 2016 rollouts focused on that. Now that we have 36 million patients in our system and more than 20,000 are being added every day, we have a really great opportunity and an advantage to help make all of those individual experiences better.

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