The prescription for preventing patient misidentification

Inaccurate patient information can lead to medical record errors and dire consequences for both patients and healthcare delivery organizations. The good news? Biometric patient identification can deliver a proven solution for preventing patient misidentification.

The price of patient misidentification and medical record errors

Patient trust is – and always will be – a cornerstone of care quality. After all, that trust brings peace of mind based on the assumption that medical professionals are leveraging their full knowledge and expertise, as well as reliable information, to deliver positive patient experiences and the best possible outcomes.

But what if foundational data they’re relying on, such as medical records, are inaccurate? What happens when patient misidentification disrupts the connection between those being treated and their records? Beyond a breach of trust, the consequences extend to patient safety risks: misidentification leads to medical record errors, which can lead to treatment decisions based on incomplete or inaccurate information.

The effects also extend to healthcare delivery organizations, including potential financial loss, reputational damage, plus the risk of fines and penalties for non-compliance.

Findings from an Imprivata-sponsored Ponemon study underscore the impact of this troubling issue:

  • The #1 cause of patient misidentification is incorrect identification at registration
  • 86% of providers have witnessed or have known of a medical error due to misidentification
  • 35% of denied claims may be attributed to misidentification, a share that can cost an average healthcare facility $1.2 million per year

Inaccurate patient information: A closer look

“Knowing the patient” (or more accurately, not knowing the patient) is at the heart of the issue. It starts with onboarding during the registration process, and carries throughout treatment touchpoints along the entire patient journey.

At registration, three patient misidentification actions are typically the culprits that lead to medical record errors. These actions include the creation of redundancies and comingling of records:

  • Duplicate records, in which multiple medical records are inadvertently produced for the same patient
  • Overlay records, in which data for multiple patients is merged into the same record
  • Overlap records, in which a patient is assigned unique identifiers across multiple facilities

In turn, this lack of positive patient identification can bring a wide array of consequences, including harmful or even fatal medical errors, patient dissatisfaction, and lost or deferred healthcare delivery organization revenue. In addition, lack of adequate processes supporting positive patient identification opens the door for bad actors, including those committing medical identity theft and insurance fraud.

Tackling patient misidentification: Leadership pain points

Not surprisingly, all of this creates significant pain points for healthcare deliver organization leadership. IT, clinical, and compliance leaders are sharply focused on mitigating the many risks presented by patient misidentification, including data integrity, safety, and regulatory issues, respectively.

But many are doing that in the face of tight budgets and limited staffing. Given these resource constraints, some are forced to rely on manual processes to conduct positive patient identification. In addition to being extremely time consuming and costly, the approach carries inherent risks created by the potential for manual data entry errors.

The solution: Biometric patient identification

So, how exactly can healthcare delivery organizations prevent patient safety risks and many other negative consequences resulting from patient misidentification? How can they move past error-prone manual approaches to patient identification that cause data integrity issues and enable medical record errors?

A proven solution for knowing the patient during each step of the care journey is biometric patient identification. The approach automates patient registration and identification, streamlines workflows and care delivery, while also eliminating patient matching errors.

Biometric patient identification uses touchless palm-vein scanning to identify patients. The result is a fast, convenient, far more accurate method to create a 1:1 match between patients and their unique medical records. This is particularly beneficial in critical care instances where a patient is unresponsive. In addition, the solution directly integrates with ER, ADT, EMPI, and other HIS systems.

Benefits to patients and healthcare delivery organizations include:

  • Optimizing patient experiences through the automation and streamlining of enrollment and check-in
  • Improving patient safety and satisfaction by avoiding mismatched records and medical errors
  • Accelerating revenues and improving financial results by reducing billing mistakes, denied claims, and patient churn
  • Reducing IT expenses and freeing up staff to focus on strategic tasks by avoiding record clean-up efforts
  • Defending against medical identity theft and fraud by preventing impersonation and insurance card sharing

Traditional approaches to patient identification are clearly creating opportunities to jeopardize patient safety and satisfaction, while negatively impacting healthcare delivery organizations. An automated solution such as biometric patient identification can eliminate these issues, while supporting patient trust and better care outcomes.

To learn more about patient identification challenges and biometric patient identification, visit our page.

Coretek Services streamlines credential management, improves secure access, and drives efficiencies within its MSP practice with Imprivata Privileged Access Management
Mobile innovation supports care without barriers. Imprivata supports mobility without risk.

Mobile technology is playing an increasingly important role in enabling clinical workflows, but ensuring its security is still a concern for HDOs. With Imprivata, there’s a way forward.

Enabling workflow continuity and data security

It’s healthcare’ worst kept secret: mobile workflows improve care quality and the patient experience. So, for healthcare delivery organizations, supporting mobile workflows is no longer an option but a necessity.

In a recent article published by The Journal of Clinical Engineering, Sean Kelly, Chief Medical Officer and Senior VP, Customer Strategy, Healthcare at Imprivata, outlined the importance of mobile technology in supporting bedside care, real-time access to information, and satisfaction for both clinicians and patients alike.

However, unlocking the power of this mobile potential relies upon:

  • Workflow continuity | Access to all of the tools clinicians need, without barriers to use
  • Data security | Risk prevention centered on foundational access controls

Hear more from Sean on the role of mobile technology in clinical workflows:

 

Mobile workflows and digital identity

Finding the critical, but often elusive, balance for mobile workflows is what Imprivata has committed to achieving. Imprivata leverages digital identity to support security and compliance, directly within mobile workflows, eliminating friction that can impact usability while at the same time reducing points of exposure on mobile devices and applications. Imprivata reduces barriers to access to support care delivery with secure, real-time access to critical tools and information, from anywhere at any time.

We recently ran a webinar that detailed how the Imprivata Digital Identity Platform can specifically address these challenges for BYOD and shared-device environments.

To learn more, check out the webinar.

Stepping up to a proactive drug diversion prevention strategy

Fighting drug diversion takes a holistic approach aided by powerful technology.

In a landmark August 2022 lawsuit, a federal judge in Cleveland, Ohio, ordered CVS, Walgreens, and Walmart to pay $650 million for their role in flooding the community with opioids, saying they “squandered the opportunity to present a meaningful plan to abate the nuisance.” The trial featured a supply chain blame game, with fingers pointed at manufacturers, doctors, and, ultimately, the pharmacies on the frontline, for the way they dispensed highly addictive pain medications.

The case underscores the equally significant responsibility of health delivery organizations in safely and securely administering pain medications to combat the growing opioid crisis. And it highlights the need for better, more proactive solutions to recognize and prevent drug diversion, the act of illegally obtaining or using prescription drugs intended for patients.

A troubling problem

There’s no end in sight to the devastating abuse of prescription drugs, and opioids in particular. Contributing to the problem is drug diversion, which takes place 37,000 times per year, according to the Porter Research 2021 study. In addition to occurring at an alarming number of health delivery organizations, it’s happening at many levels of clinical and other staffing areas.

The widespread impact of drug diversion is similarly alarming. That includes a breach of security, privacy, and protocols. And of course, it directly affects patient care, safety, and trust. Plus, the negative effects extend to business operations, including financial impacts, regulatory and compliance issues, and the compromising of an organization’s reputation.

A proactive, holistic solution

Given the devastating effects of drug diversion, it’s vital that health delivery organizations move forward with a comprehensive, proactive drug diversion detection and prevention strategy. The strategy needs to be holistic, leveraging a multifaceted game plan that engages employees throughout the organization. Best practices of a holistic approach typically feature components including:

  • Ensuring adequate diversion management and investigation staffing resources
  • Providing learning opportunities focused on recognizing substance use disorders
  • Offering diverters resources including rehabilitation options
  • Leveraging diversion prevention automation tools

Powerful technology tools

The breadth and depth of this growing problem have led health delivery organizations to the realization that traditional, manually driven approaches are no longer adequate. Manual detection has proven to be ineffective and inefficient – a particularly crucial shortfall is the lack of expediency needed to minimize damage and support remediation.

In response to growing risks presented by drug diversion and the inadequacy of traditional approaches, more and more health delivery organizations are harnessing the power of drug diversion monitoring and detection technology. Featuring machine learning and artificial intelligence, these platforms are helping organizations manage the full lifecycle of a drug diversion program.

How exactly are they making a difference? The solutions are increasing visibility to help uncover suspicious trends and behavior patterns typical of diversion activity. This functionality enables the identification of discrepancies in high-risk scenarios, anomalous behaviors, and system access issues. The solutions also integrate with other apps and systems, creating enhanced visibility across the security landscape.

There’s no doubt that it’s a significant challenge. But meaningful strides can be made in fighting drug diversion with the help of a proactive, holistic approach that leans heavily on the power of advanced technology.

To learn more, see the Imprivata article in Forbes magazine, “Combatting the opioid crisis with artificial intelligence.”

What is drug diversion? A look at the problem, and what happens if you don’t prevent it.

Left unchecked, the devastating toll taken by drug diversion runs wide and deep.

Like the addictions that often drive them, drug diversions inflict a devastating, widespread toll. These actions represent a severe breach of security, privacy, and protocols for health delivery organizations. And just as importantly, they cultivate a breach of trust with patients – disrupting the most fundamental element of the healthcare relationship. Here’s some information that provides perspective on the issue, including its significant impact on healthcare organizations and those they care for.

What is drug diversion?

Drug diversion can be defined as any act or deviation that removes a prescription drug from its intended path between the manufacturer to the patient.

The diversion can be conducted by healthcare workers at all levels, from clinical staff, to EMTs, to nurses, and facility staff. Easy access to large volumes of highly addictive prescription drugs has made these workers vulnerable and motivated to act. And it’s led to a variety of creative diversion methods that have been increasingly difficult to detect.

The actions of drug diverters play a significant role in contributing to the nation’s abuse of prescription drugs, especially opioids and other controlled substances. In fact, drug diversion statistics show that some 37,000 diversions occur in the U.S. each year, a troubling impact felt across the healthcare system. It’s a problem that’s clearly on the radar for healthcare executives: 96% agree that drug diversion is occurring in hospitals across the country.

Inadequate resources and response

While the issue is significant and clearly front and center for healthcare executives, combating it has been a tremendous challenge. For instance:

  • 73% agree that most drug diversion goes undetected
  • 95% of drug diversion cases are not being investigated

Why has drug diversion prevention been so difficult? Not surprisingly, budget constraints and competing resource needs have played a major role in handcuffing organizations. As a point of reference, 38% of surveyed healthcare executives said that resources for recognizing and preventing drug diversion were reallocated due to budget cuts caused by the pandemic.

What also comes into play is the ineffectiveness of traditional approaches for how to prevent drug diversion in hospitals. Reliance on manual approaches for recognizing and preventing drug diversion has often resulted in a case of too little, too late. Typically driven by tips and observations, the effectiveness of these efforts has been spotty, and detection often happens too long after the fact to make a beneficial impact.

The effects of drug diversion on patients

The negative impact on patient care and safety has been deep and multi-faceted. When drugs are diverted, patients may be delayed access to pain relief. And diversions can leave patients exposed to bloodborne pathogens caused by exposure to contaminated materials. In addition, care can be compromised by the falsification of medical records. Perspective from healthcare executives reinforces the severity of these issues:

  • 100% said that employee drug diversion negatively impacts quality of care
  • 96% noted that drug diversion has an adverse impact on patient safety

In turn, these alarming effects result in a harder-to-measure but equally troubling problem: the erosion of patient trust. Collectively, the negative impacts of drug diversion can cause a very difficult to repair breakdown of trust between patients and care providers.

And the damage doesn’t stop there. Diversion creates a damaging ripple effect, extending well beyond the impact on patient care and trust. Interrelated business and care-critical challenges can include:

  • The financial impact of diverted prescription drugs
  • Regulatory compliance concerns
  • Data breach issues
  • Negative publicity

It’s a big problem that’s not going away, and no healthcare organizations are immune. Awareness of its devastating effects and the creation of a strategic game plan to combat it can make a significant difference. And a drug diversion intelligence program, which helps to spot diversion and anomalous behaviors, can help you do just that.

Learn more about what makes an effective drug diversion detection and prevention strategy.

How to prevent drug diversion using a holistic, tech-aided strategy

Drug diversion is a big problem. But a proactive, strategic approach can make a significant impact when it comes to recognizing and preventing it.

Drug diversion and its impact

What is drug diversion? It involves illegally obtaining and/or using prescription drugs intended for patients. While the targets can be virtually any prescription drug, the most common are opioids, antianxiety drugs, and stimulants.

Drug diversion plays a significant role in contributing to the nation’s prescription drug abuse problem. In fact, some 37,000 diversions occur each year. And it’s fairly agnostic – it happens at healthcare organizations of all shapes and sizes, and at all levels of clinical and other staff.

Its impact is deep and carries a far-ranging ripple effect, starting with a breach of security, privacy, and protocols. Importantly, it also negatively impacts patient care, while also eroding patient trust. In addition, the ripple effects extend to financial impacts, plus regulatory and compliance issues, as well as the reputation of the healthcare organization.

A strategic, holistic approach to drug diversion prevention

Why has identifying and battling drug diversion been so challenging? Clearly, tight budgets further constrained by the effects of the pandemic have played a role. But importantly, the playbook needs to change. Traditional, manually driven approaches just won’t cut it any more. They leave too many monitoring and detection gaps, and their timeliness is often ineffective.

So, what can health delivery organizations do to move the needle? They can implement a drug diversion intelligence program. And the good news is that a proactive, strategic approach for recognizing and preventing drug diversion can make a meaningful difference.

First and foremost, a drug diversion and detection prevention strategy needs to be holistic. That means incorporating a multi-layered approach to ensure security, privacy, and compliance, while leveraging an advanced technology platform.

Best practices for how to prevent drug diversion in hospitals include initiatives that engage all functions – and all levels – of the organization. These initiatives typically involve four main areas:

  • Culture – starting at the top with executive buy-in
  • Support – staff training, anonymous reporting, and rehabilitation assistance
  • Process – a drug diversion committee, investigatory staffing, and incorporation of findings into training and monitoring efforts
  • Technology – adoption of a monitoring and detection platform

Growing adoption of tech solutions

While all of the above best practices are vital to success in preventing drug diversion, the power of monitoring and detection technology in particular can prove to be a game-changer. Driven by machine learning and artificial intelligence, these platforms are now being more widely adopted: surveys indicate their use increased from 29% in 2019 to 44% in 2021. And they’re making an impact: 73% of healthcare executives rated them “effective” or “very effective” in diversion detection.

The platforms support drug diversion detection and remediation by increasing visibility to help uncover suspicious behavior patterns, enabling the identification and tracking of diversion activity. Comprehensive solutions enable the identification of:

  • Discrepancies in high-risk scenarios
  • Anomalous behaviors
  • System access issues

Importantly, this technology can also fully integrate with other systems, applications, and clinical workflows to further enhance visibility and eliminate monitoring gaps.

There are no easy fixes when it comes to drug diversion prevention. But a strategic, holistic strategy supported by advanced technology can make a real difference for patients, employees, and healthcare delivery organizations.

Wondering where to start? Check out our whitepaper: “Addressing drug diversion in healthcare: Where do I start?” You’ll find further perspective on the effects of drug diversion and get how-to information on creating a full lifecycle drug diversion monitoring program.

AI-aided drug diversion prevention solution supports patient safety and care quality
Sidestep the risks of mobile workflows
Solve Both Sides of the Equation: Secure and frictionless shared mobile access