Top strategies to decrease costs and improve patient safety through improved patient identification
As healthcare providers continue to invest in electronic medical records, protecting patient identity and maintaining the integrity of patient records are their top priority. In a recent webinar hosted by The Healthcare Financial Management Association (HFMA), David Feldman, SVP and CMO at Hospitals Insurance Company (HIC), Jim Schwamb, former VP, Patient Financial Services at BayCare Health System in Clearwater, FL, and David Wiener, GM of Imprivata PatientSecure Products Group, highlighted the challenges posed by commonly practiced patient identification processes, and discussed best practices for positive patient identification to improve revenue cycle efficiency and patient safety.
“You have to get patient identification right each and every time or your organization will suffer the economic impact.” – David Wiener
At the start of the webinar, a poll revealed that 87 percent of participants consider patient identification high to top priority to mitigate safety risks in their organization. However, 22 percent of them do not have a patient identification process in place in their organization to identify patients accurately and retrieve the correct patient information every time, and 25 percent of them are not sure if their organization has such a process in place.
Patient misidentification creates healthcare hazards
From Feldman’s malpractice insurance company perspective, healthcare is more hazardous than the airline and railroad industries, and associated with more fatalities than bungee jumping and mountain climbing. Where the airline industry relies on aviation teams to report near misses in order to study and prevent reoccurrence, healthcare registrants, who often work part time, with little training, continue to repeat the same errors that lead to patient misidentification, and the industry hasn’t done its part to decrease the potential for human error.
“Unfortunately in healthcare, we focus on the bottom of the hierarchy and rely on training to fix the problem, but we really need to focus on system changes to prevent humans from making mistakes,” Feldman said.
Misidentification caused by human error at the registration desk can have an adverse impact later in the care delivery process, resulting in medication and diagnostic errors. But, simple changes can make a big impact on reducing human error. Feldman suggests clear labeling and consistent layouts for clinical tools and medications in anesthesia and surgery to ensure that everything will be in the right place at the right time. He also suggests tracking tools and medical supplies, such as sponges, with bar codes or chips.
In addition to reducing human error, healthcare organizations need to simplify processes with minimized steps, and take corrective actions to improve the patient identification process. With multistep processes, healthcare organizations have to look at the reliability of each step. While one step may be 90 percent reliable, if you have four steps at 90 percent reliability each, you get only 66 percent reliability overall. So, the process becomes more reliable with each step that you are able to eliminate. Arming providers with mobile tools to, for example, book a patient’s testing directly in front of their hospital bed, is one way to cut steps, but Feldman stressed that:
Patient identification is a key component of patient safety and risk management
Positive patient identification can be achieved successfully with two unique patient identifiers, typically the patient’s date of birth combined with an ID band, bar code, radiofrequency ID, or biometric identifier. Feldman and Schwamb both stressed the value of adding biometric technology to the patient identification process.
Feldman and HIC worked with a group of HIC member hospitals in New York to implement biometric palm scanning technology for radiation oncology. Palm vein scanning technology is used to identify a patient with their date of birth at the registration desk, eliminating the need for registrants to locate records manually. The technology is used again to reconfirm the patient’s identify before they receive radiation.
The initiative has successfully mitigated multiple medical record risks. Twenty percent of all errors in radiation oncology are attributed to incorrectly identifying the patient and with utilization of palm scanning technology, these HIC hospitals have eliminated that to zero.
As precise patient identification process improves patient safety, it also improves hospital revenue cycle results
Without a positive identification solution, hospitals are exposed to many liabilities associated with identification errors, including duplicate medical records, overlays, and fraudulent patient information, which cause business issues in addition to the safety issues discussed by Feldman. According to Schwamb, these liabilities result in unnecessary hours of work and rework, insurance denials, bad debt, and incorrect billing and coding, among other issues that negatively impact the revenue cycle.
To address patient misidentification issues in his hospital system, Schwamb made the decision to implement Imprivata PatientSecure, the biometric patient identification solution. At BayCare, biometric patient identification allows providers to seamlessly verify insurance, collect copay and deductibles, authorize treatment and continued stays, share information with other providers, and facilitate finance assistance for uninsured patients, all of which have improved revenue cycle efficiency.
“A biometric solution helps to simplify the process to reduce human errors. It gives registrants the tools for quick and accurate identification. Patients love the extra security and the clinical team reaps the full benefits from the EMR” – Jim Schwamb
Wiener ended the webinar by encouraging participants to know their duplicate medical records and overlay rates, and employ positive patient identification solutions that match the patient to the correct health record every time. This simplifies the registration and care delivery process, reduces human errors, and optimizes EMR integration.
“Biometrics stops the hemorrhage of duplicates and overlays, so that medical record cleanup sticks and no more issues are created,” Wiener said.