The Very First Step in the Patient Care Process

The very first step in the patient care process is knowing who is sitting across the desk from you. Errors Found Early in the Patient Care Process Without accurate patient identification, it is impossible to have accurate, successful patient care. It seems like patient identification is a simple thing: a patient gives you their insurance card and photo id, then you look them up in your medical record system. But accurate patient identification can be – and often is – fraught with errors for a variety of reasons. Registrars can be rushed during heavy workflow times. Patients with foreign names are often misspelled on initial entry. Patients don’t always present with the same version of their name; Robert one time, Bob the next time. In a large healthcare system, patients with common names like Maria Garcia, can literally have hundreds of patients with the same name and even the same birthdate. A study on duplicate error rates by Johns Hopkins University found that 92% of duplicate records happened at registration. Since the healthcare industry has transitioned to digital health records, patient misidentification has become a widespread problem that carries significant consequences – particularly for patient care and the hospital’s financial performance. Patient misidentification can result in medical errors, financial loss, loss in clinical productivity and a negative impact on the patient experience. A recent survey conducted by the Ponemon Institute, the “2016 National Patient Identification Report,” cited the following errors as very common in most healthcare facilities: Inability to find a patient’s chart or medical record (68 percent of respondents) A search or query resulting in multiple or duplicate medical records for that patient (67 percent) A patient is associated with an incorrect record because [...]

25 Seconds Can Save Hospitals $30 Million with Patient ID Systems

Did you know that the average hospital system has a 10% duplicate error rate and it costs about $100 to correct each error? If your healthcare facility has 500,000 registrations each year, that’s 50,000 errors and you spend about $5M correcting those errors. Did you know that the average hospital loses $17M in billing errors every year, primarily due to patient identity errors? In the Ponemon Institute’s 2016 survey, hospitals stated that an average of 35%of all denied claims were a result of inaccurate patient identification. This represented an estimated value of over $17M per year per hospital. Did you know that patient mis-identification also contributes to lost productivity for clinicians? The Ponemon Institute’s 2016 survey also stated that the average clinician wastes almost 30 minutes per shift due to patient mis-identification. This misidentification costs the average healthcare organization $900,000 per year in lost productivity. Did you know that there are over 2 million incidences of medical identity fraud every year? With 5,627 hospitals in the US, that is 355 potential incidents of medical identity fraud in each hospital. The average cost of medical identity fraud is around $13,500 per incident, which calculates to around $4.8M per year per hospital. With modern absolute patient ID techniques, there is no reason why medical identity theft still exists. Did you know that spending 25 seconds with a biometric patient id system can save you almost $30M a year? 25 seconds is all it takes for a biometric patient id system to accurately identify a registered patient, preventing duplicate registrations and the need to correct them. Patient ID systems play a critical role in helping providers reduce billing errors and collection problems associated with patient identity mistakes. Absolute patient id systems can save your healthcare organization millions [...]

How Providers Can Help Eliminate Medical Identity Fraud

Per the Ponemon Institute, medical identity fraud occurs when someone uses an individual’s name and personal identity to fraudulently receive medical service, prescription drugs, and goods. It also includes attempts to commit fraudulent billing. Based on the Ponemon Institute 2013 study, an estimated 1.84 million adult-aged Americans or close family members at some point in time became victims of medical identity fraud. An estimated 2.3 million individuals were impacted by medical identity theft in 2014, a 21.7% increase over the numbers from 2013. Medical identity fraud is continuing to increase every year. How would I know if a patient has become a victim? Per the Federal Trade Commission, victims may: Get a bill for medical services they didn’t receive Be contacted by a debt collector about medical debt they don’t owe See medical collection notices on their credit report that they don’t recognize Find erroneous listings of office visits or treatments on their explanation of benefits (EOB) Be told by their health plan that they’ve reached their limit on benefits Be denied insurance because their medical records show a condition they don’t have Impact of Medical Identity Fraud on Patients Medical identity fraud can have severe and long lasting effects on patients. Here are some anecdotal examples of the consequences of medical identity fraud: A retired postal worker from Houston was arrested for purchasing over 1700 opioid drugs after her wallet containing her driver’s license and health insurance card was stolen at a gas station. Fortunately, she had reported the theft to the police and had a police report. In Utah, a pregnant woman stole a medical identity to gain medical care. When the baby was born with drugs in its system, the department of social [...]

By | 2017-10-25T17:44:32+00:00 Wednesday, March 15, 2017|Categories: Absolute Identity|Tags: , |0 Comments

Use of Smartcards for Healthcare

Smart cards for healthcare are well established in France, Germany and Taiwan, but they have received minimal attention in the United States. Benefits of a smartcard include faster registration of patients, absolute healthcare identity, portability of medical records and potential data support for existing electronic health records. History of the use of smartcards for healthcare outside the U.S. The history of large scale deployment of health cards in the healthcare sector goes back to the late eighties/early nineties, when France and Germany each started national programs on the nationwide introduction of health insurance cards. Since then, other nations, such as Slovenia and Belgium, have also introduced health cards, and various projects have been started all over Europe over the last 10 years or so. The objective of the European Commission's efforts is not the harmonization of the health systems but the achieving more cooperation and more convergence among the health systems and the finding answers to the open questions concerning cross border healthcare according to increasing patient’s mobility in Europe. France has more than 45 million people using smartcards for healthcare and almost all German citizens have and use one of these cards. Defining the Technology When used in healthcare, smart cards contain medical data for the patient they represent. Rather than a paper chart or an electronic health record stored and transported over the Internet, this wallet-sized card contains a computer chip loaded with pertinent medical information. The chip interacts with a computer system to make stored health information available. Smartcards in Healthcare in the United States Rather than actually carrying healthcare information, smartcards in the US have been used for identity authentication. The smartcards could be used to manage billing to various health-insurance companies [...]

How can you share data if you don’t know who your patients are?

That is a very good question. In Meaningful Use II there is a really big push for interoperable data. That is the sharing of data between healthcare facilities to provide a complete picture of an individual health record. It all sounds really great and would be if healthcare facilities had more accurate ways of identifying their patients. The current methods of identifying patients with demographics lead to misidentification of patients, duplicate records and the inaccurate merging of records. Healthcare provider organizations report that between 8 and 13 percent of their medical records are duplicated — and sometimes as high as 22 percent. In multi-facility environments, where disparate application systems are integrated, the percentage of duplicates can surpass 30 percent. Solving this issue can be frustrating, time consuming and expensive. Software packages are available to compare patient records from disparate systems and indicate the probability that two records are duplicates, unique or potentially duplicate. These packages use probabilistic matching algorithms that incorporate phonetic similarities, variances in typographical entries and dates, and aliases. By determining the relative “weight” of specific comparators, the patient identity process improves significantly. However, until you have absolute healthcare identification, you will never prevent duplicate records and will always be in a constant loop of data cleansing. By using a combination of smart cards and biometric identification, you can confidently identify the patient during the registration process. You don’t have to depend on what the patient tells you to verify who they are; the biometric will do that for you. You can record the time and dates that a patient receives care, preventing both identify theft and billing fraud. As I stated at the beginning, you can’t share data between systems if you [...]

Medicare’s Use of Smartcards for Identification

The Department of Health and Human Service (HHS) General Accounting Office (GAO) completed a study on the use of smartcards to prevent fraud in Medicare. Their findings were that the use of smartcards would completely or partially prevent 22% of Medicare fraud, which in their minds did not support the cost or inconvenience of implementing a smartcard program. They stated most Medicare fraud (about 68% of the cases) included more than one scheme with 61% including two to four schemes. The most common health care fraud schemes were related to fraudulent billing, such as billing for services that were not provided and billing for services that were not medically necessary. They determined that having a smartcard would not have prevented these types of fraud because the patient was present and did actually receive some type of care. The question that the HHS GAO study did not consider was patient safety. I realize there is a lot of Medicare fraud, that it is a great burden to our government, reducing the amount of funding available to support the Medicare program, but patient safety is also an important concern. The lack of standards for patient identification at the federal and state levels compromises patient safety and escalates health care costs. According to Healthcare Information and Management Systems Society (HIMSS), 8-14% of Electronic Health Records (EHR) have patient identity errors. The risk of an identity error increases 5% every time a record is shared among providers. Simply said, a physician relying on the wrong EHR and medical history due to an identity error can make a costly, if not deadly, decision. Having a smartcard, especially one paired with a biometric identifier like a pal- vein scan, would provide an absolute [...]

Healthcare Payers Need Absolute Healthcare Identity

Knowing who your patient is with a high degree of certainty has been a problem as long as healthcare has kept records. A more complete and accurate patient medical record delivered to the point of care would result in: fewer diagnostic and treatment errors; improved care coordination across facilities and healthcare providers; and a reduced number of re-admits.  The latest CDC study reveals that each year preventable adverse events (PAEs) lead to the death of 210,000-400,000 patients who seek care at a hospital. According to Fierce Healthcare news, hospital medical errors are now the third leading cause of death in the U.S. The 2013 Workgroup for Electronic Data Interchange ( Wedi ) Report recommends the following actions to address concerns over PAEs, Standardize the patient identification process across the healthcare system. Identify and promote effective and actionable electronic approaches to patient information capture, maintenance and dissemination that leverage mobile devices and "smart" technologies and applications. Identify and promote methods and standards for healthcare information exchange that would enhance care coordination. Another area of concern that is impacted by absolute patient identity is provider/patient fraud. Not all patient fraud can be eliminated but verifiable patient ID would reduce: filing of claims for services or medications not received; use of a false coverage or insurance card; providers adding charges for procedures or services that did not take place and patient “doctor shopping” or traveling from doctor to doctor for the purpose of obtaining more prescription drugs than they are entitled to. The FBI reports that healthcare fraud of 3% cost US $80B per year. A 2014 Aberdeen Research Report found that faster detection of fraud or potential fraud correlates with a lower total cost of fraud for the companies [...]

By | 2017-07-29T02:33:46+00:00 Tuesday, March 1, 2016|Categories: Absolute Identity|Tags: , , , , |0 Comments

Medical Identity Theft Continues to Rise

The Fifth Annual Study on Medical Identity Theft which was published in February by the Ponemon Institute states that from 2013 to 2014, medical identity theft incidents increased 21.7 percent. The key points identified in this study are: • Medical identity theft is costly to consumers. Unlike credit card fraud, patients can he held responsible for the fraudulent debt. The average cost to the patient to resolve the false claim in 2014 was over $13,000. • Medical identity theft is a complicated crime to resolve. Generally no one ever informs the victim that a fraudulent claim has taken place. It can be found months after the fact and is very hard to track down and know who to call to help you resolve the issue. • Resolution of medical identity theft is time consuming to resolve. The Ponemon Study found that only 10% of cases were ever completely resolves. This can lead to inaccurate medical records and harmful effects down the road. • Medical identity theft can have a negative impact on reputation. 45% of respondents said the medical fraud caused them personal or professional harm due to embarrassing personal data (often inaccurate) being revealed. 3% stated they lost their job over the fraud. • Consumers expect healthcare providers to be proactive in preventing and detecting medical identity theft. 79% Consumers said that keeping their health records safe was important to them and 40% said they would change healthcare institutions of a data breach occurred. Although Medical Identity theft cannot be completely prevented, both patients and healthcare facilities can and should take steps to prevent fraud from happening. Patients should make sure that friends and family do not have access to their insurance documents. They [...]

Congress looking at Smartcards for Medicare Recipients

Last March the General Accounting Office provided Congress with a study on the Potential Uses of Electronically Readable Cards for Medicare Beneficiaries and Providers.  Congress had asked for the study because currently Medicare recipients have paper cards which display Social Security Numbers, making them vulnerable to identity theft and fraud. Congress was asked to investigate the following questions for the report. What are the different features and functions of electronic readable cards? What are the pros and cons of using electronic readable cards for Medicare? What steps would be required by CMS and Medicare providers need to take to implement the cards? What are the lessons learned from the other countries who have implemented electronic readable cards for healthcare? The following is a synopsis of what the report found. CMS could use electronically readable cards for several purposes: Authenticating beneficiary and provider presence at the point of care Electronically exchanging beneficiary medical information Electronically conveying beneficiary identity and insurance information to providers There are two types of electronically readable cards, those with a magnetic strip or bar codes and those with a computer chip, called smartcards. Although both types have the capacity to store beneficiary and insurance information, the smartcards provide more rigorous authentication and security against fraud. Potentially presenting a card at the point of card could reduce certain types of Medicare fraud, but they felt it would not eliminate fraud as there would be legitimate reasons when the card could not be presented. As of May 2014, CMS was aware of 284,000 Medicare beneficiary numbers that had been compromised and potentially used to submit fraudulent claims. Authenticating providers at the point of care could potentially limit fraud schemes in which individuals or companies [...]

4 Reasons Why Smart Cards and Biometrics Make a Great Team

Smart cards have been used for patient access for a number of years around the world, but adding a biometric component to the card is a new twist. Adding the biometric increases the level of security associated with the card. The winning combination has begun to produce measurable financial benefits for healthcare institutions. 1.  Smart card with biometrics and Meaningful Use: Measure 1) Eligible hospitals that transition their patients to another setting of care or provider of care and refers their patient to another provider of care provides a summary care record for each transition of care or referral. Measure 2) More than 10% of these summaries a) electronically submitted or b) via an exchange facilitated by an organization that is NwHIN exchange participant or in a manner that is consistent with the governance mechanism ONC establishes for the nationwide health information exchange. Measure 3) Conducts one or more successful electronic exchanges of summary of care document. Without precise patient identity standards, the exchange of these records can be compromised. Smart cards/with biometrics ensures a unique and absolute identity and that the patient’s identity is precisely the same wherever the patient receives care. This unique identity is the foundation for record exchange and eliminates the patient safety and financial risk of providers basing clinical decisions on the wrong patient record or patient records that have been incorrectly merged. It should be noted that the present demographic based patient identification techniques for health information exchange have a 5% error rate. I don’t think any patient wants to be included in that 5%. 2.  Smart cards with Biometrics eliminates duplicate records. Once implemented, every patient is issued a unique identity that is contained in the combination of [...]