Enhancing the patient experience with positive patient identification

Company

  • Sentara Healthcare
  • Locations: Norfolk, VA
  • EHR: Epic
  • Beds: 3,739

Industry

  • Healthcare

Challenges

  • Need to reduce duplicate medical records and maintain low rate

  • Desire to manage patient medical records across disparate and integrating EHR systems 

  • Behavior change required to implement technology in fast-paced, high pressure environments from registration to ER

Results

  • Development of staff engagement strategies and effective messaging to patients

  • Instituted “pivot process” in ED where registration and triage nurse partner on efficient registration process

Sentara Healthcare is a 130-year-old health system headquartered in Norfolk, VA, with 12 hospitals and 445,000+ members in their health plan. Sentara implemented Imprivata PatientSecure in 2013 and to date has enrolled nearly two million patients. Sentara has learned valuable lessons about change management efforts that are required to make technology implementations successful, and Sentara leadership is committed to continuous improvement, innovation, and enhancing the patient experience.

The challenge

Like many healthcare organizations, Sentara has experienced wide-spread growth due to mergers and acquisitions. One of the challenges accompanying such growth is the need to manage patient identification in an expanding, but connected, ecosystem, with patient records generated in various electronic health record (EHR) systems. On average, 10% of patients are misidentified when they present for care at a healthcare facility – an issue that is compounded if newly acquired facilities don’t have access to health records from other sites. Misidentification has various downstream financial and clinical consequences, including the creation of duplicate and overlaid medical records.

Growth over time has not hampered Sentara’s commitment to patient safety, which is among five values that are integral to Sentara’s philosophy and operations. The others are people, quality, service, and integrity.

Thinking about the challenges of patient identification and their patient safety goals, Sentara leadership was looking for a solution to accomplish the following:

  • Reduce overlays
  • Prevent identity theft
  • Maintain a low duplicate rate even when the health system expands
  • Improve patient experience
  • Protect patient safety

Moving towards biometric-based patient identification

To address these various goals, Sentara turned to Imprivata PatientSecure®, a positive patient identification system that allowed them to implement palm vein scanning as a biometric option. Imprivata PatientSecure generates a single biometric identifier for every patient, creating a 1:1 link between individual patients and their unique medical record. Once enrolled, patients who return to any Sentara site need only scan their palm to identify themselves and bring up their correct medical record.

New technology is often met with resistance, and there were some initial barriers at Sentara. First, patient access staff initially resisted the addition of another task to the patient registration process. Patient Access can also be a high turnover environment, making it difficult to ensure that all staff members received the same message and understood the benefits of Imprivata PatientSecure. Efforts also had to be made to make sure that Imprivata PatientSecure integrated smoothly with clinician and patient workflows.

Connecting Imprivata PatientSecure to Sentara’s larger mission of patient care

Sentara understood that a successful implementation would require strong leadership involvement at multiple levels. To do this, they engaged with the presidents at every hospital and reminded them of the Sentara commitment: “Always keep you safe.” 

Tara Slone, IT Operations Manager at Sentara confirmed, “We found that going straight to hospital leadership and connecting Imprivata PatientSecure with our patient safety mission helped them reinforce the importance of the technology.”

At a department level, managers had access to the reporting tools necessary to effectively coach their teams. Managers also coordinated monthly registration workgroups to discuss utilization strategy, success stories, and recommendations surrounding Imprivata PatientSecure. To make sure they were getting the desired engagement, Sentara project managers revisited hospitals with low participation to see if there were any software or hardware issues affecting utilization and satisfaction with the system. 

Patients were a critical group to have onboard. Sentara staff organized and participated in public events at their facilities to explain the importance of Imprivata PatientSecure as a vital tool in identity theft protection. Another aspect of the message was that quick, secure registration could help patients see their doctors faster. 

Under the slogan of “Give us a hand,” Sentara saw a rapid uptick in enrollments in Imprivata PatientSecure. Between 2013 and 2017, Sentara went from 92,000 enrollments to 540,000, and from an annual activity of 38,000 to almost 2 million people using the system.

Driving a culture change

Reflecting on the most important factors in implementing Imprivata PatientSecure, Slone acknowledged that the need for a shift in thinking and behavior around how patients at Sentara are identified and registered was significant: “We really needed that message to come from the top down, and to be consistent across employee and patient education. Everyone who “touches” patients should understand exactly what the system does and the benefits it brings.” 

Sentara also found that revisiting the basics of the system was necessary to remind teams about the benefits Imprivata PatientSecure provided. They provided scripts to the registration staff until they were comfortable with being direct with patients and saying: “Hi, let’s get you identified today,” instead of “Would you like to put your palm down?”

Success stories

Sentara has measured their successes with both numbers and stories. In one case, Sentara was treating a patient suspected, and then convicted, of identity theft. After hearing about Sentara’s use of Imprivata PatientSecure, a judge mandated that the patient be enrolled in the system, which effectively curtailed his theft while still allowing him to receive proper treatment. 

In another case, a patient arrived while having a stroke, unable to identify himself. The ER nurses used the Trauma Search function of Imprivata PatientSecure, which allows clinicians to apply search criteria to reduce the size of the database being searched, and placed his palm on the scanner. They identified the man, who had previously been enrolled in Imprivata PatientSecure, which allowed the clinicians to confidently provide the proper care.

According to Slone, the benefits of being able to identify an unresponsive patient in the ER are immeasurable. “If patients are unable to communicate with clinicians,” she says, “we’re unable to identify them and understand what treatment options are the best and most safe. With Imprivata PatientSecure, we simply place a patient’s palm on the scanner and, if they have been enrolled in the system, they can be immediately identified, saving time and lives.”

The ER was initially a difficult area for implementation, but Sentara staff developed something they called a “pivot process,” which involved the registration staff and ER nurses working in tandem. The registration staff would use the palm vein scanner to identify the patient as the ER nurse took vitals, which allowed the urgency of ER care to seamlessly flow with the necessity of hospitals preventing patient misidentification – a truly revolutionary process. 

Sentara has successfully implemented Imprivata PatientSecure in eight of its hospitals with plans to add two more this year. 

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