First Pst after migration to Cloud in Health care Blog

Patient identity is the backbone of the healthcare system. However, when patient records are mismatched, overlaid, or incomplete, it can lead to serious and wide-ranging consequences. Patients may receive incorrect drugs or treatments, while clinical staff face increased workloads trying to locate missing information and overcome delays. Billing teams may issue statements with incorrect amounts or send them to the wrong address. Moreover, data breaches expose providers to both financial and legal vulnerabilities. It's a wicked problem. And it's an expensive one – a survey by Patient ID Now found that healthcare organizations spend an average of $1.3 million per year attempting to resolve the issues. Identity management involves multiple individuals, teams and systems that are constantly changing. Solutions can be hard to pin down in such a dynamic environment. While there's no single cause, understanding the contributing factors is the key to preventing mismatched patient records to ensure safe, effective and efficient patient care. Common causes of mismatched patient records Misidentification occurs for several reasons. Some of the most common operational pitfalls include the following: The patient is linked to the wrong record during registration. Queries result in multiple or duplicate patient records, or no record at all. Time pressure means staff are forced to work quickly and may miss important details. Insufficient training and awareness mean staff aren't following identity management protocols properly (in one evaluation of 60 patient transfers, not one transfer was carried out according to the hospital's patient identification policy). Identity management protocols are non-existent or substandard. Inefficient information-sharing between departments leads to gaps or duplication in patient records with no easy way to verify patient details. Over-reliance on DIY solutions fails to deliver robust, lasting results. Human error – staff may accidentally enter the wrong details into the patient's record. Beyond the operational factors, patients themselves play a role in misidentification. Usually this is inadvertent: they may give a slightly different version of their name or address than the one listed in their record. Sometimes it is deliberate, when patients submit false information to access treatment or medication that may be otherwise unavailable to them. Most errors do not occur because providers or patients are being careless. Patient data is complex and changing: people change their name, address or contact details many individuals share the same names and birthdates (one Houston-based health system reported 2833 patients called Maria Garcia, 528 of whom had the same date of birth) data can be formatted in different ways, so one person's details look like they belong to different people. To add to the challenge, the volume of data being created, accessed and exchanged within and between health systems is increasing exponentially, complicated by greater use of remote devices. It's no surprise that organizations have an average of 10 members of staff devoted to patient identity resolution. How to avoid and fix mismatched patient records The most effective way to manage and match patient data would be with a national unique patient identifier. This would assign a bespoke code to each patient that would follow them throughout their healthcare journey, ensuring the integrity and security of their data. Healthcare organizations (including Experian Health) have advocated for such an approach for many years, though federal funding currently remains out of reach. In the absence of a national UPI, healthcare organizations must rely on alternative solutions. Many use traditional matching tools, such as an enterprise-level master patient index or manual verification processes. However, these tools are often a feeble response to the challenges associated with the “4 Vs” of big data – volume, variety, velocity and veracity – which make patient records so difficult to manage. Experian Health's Patient Identity Management solutions help providers build a more connected data ecosystem, using universal patient identifiers. This approach creates the most complete view of patients from reliable health, credit and consumer data sources, to reduce the risk of mismatched records. Universal Identity Manager spans hospitals, health systems and pharmacy organizations, processing more than 550 million health records. Integrating patient information from sources beyond an organization's own enterprise-level data makes it possible to accurately match, manage and protect patient data, and root out the causes of misidentification before it occurs. Prevent patient misidentification with proactive identity management solutions According to the Patient ID Now survey, just under half of healthcare organizations are planning to implement new identity management processes and solutions in the next 12 months. Alongside a more robust software solution, providers should also cultivate a culture that encourages proactive risk assessment, rather than waiting until after a serious mistake occurs before acting. With the right workflows, training and identity matching software in place, patient misidentification is preventable. Learn more about how to address the most common causes of patient misidentification with patient identity management solutions.

Since the Health Insurance Portability and Accountability Act (HIPAA) heralded the mainstreaming of electronic medical records over two decades ago, healthcare organizations have been slowly making the shift from paper-based patient information to online records. Digital records are more efficient, no doubt, but the transition hasn't been smooth. There are challenges and risks in managing and protecting patient data online. With patient information flowing through multiple systems, devices and facilities, it can be extremely difficult to guarantee the accuracy and freshness of the data. Patients move to a new house, change their name or switch doctors. They may go for years without any interaction with the healthcare system. How can hospitals and other providers be sure that the records they hold are correct for each patient who walks through the door? Incorrect patient matching is a major source of revenue leakage for many providers, with around a third of claims denied on the basis of inaccurate patient identification. When it costs $25 to rework a claim and around $1,000 for each mismatched pair of records, that's a lot of lost revenue. In 2017, the total lost revenue for the average hospital was around $1.5 million. Clearly this a financial headache for providers, but it's also a major patient safety issue. How can patients get the right treatment at the right time, if their physician is looking at an out-of-date record, or worse, the record of a completely different patient? Good health outcomes rely on good data. Matching patient records: the old way Traditionally, healthcare providers might use a patient matching engine (an enterprise master patient index or EMPI) to identify patients and match up their records from different parts of the health system. These work by checking demographic data to compare the details on each record and combine the ones that are likely to refer to the same person. This can usually handle a simple change of name or address, but for anything more complex, it'll likely hit a roadblock. EMPIs are limited by their reliance on a single data source – the data that's visible to them in patient rosters. So what happens if that demographic data is wrong? What if there are typos or spelling mistakes? How do you differentiate between a misspelled name and a completely different person? Any errors in the data are inherited by the matched record, and as a result, EMPIs are often plagued by gaps, mistakes or outdated patient information. A new solution for patient matching: Universal Patient Identifiers A better solution is to combine the information in patient rosters with comprehensive reference and demographic data held by data companies such as Experian, to create a more complete picture of each patient. A universal patient identifier (UPI) can be assigned to each patient and stored in a master identity index, so that whenever and wherever they pop up in the health system, the referential matching technology knows exactly which data is theirs. When health systems implement UPIs, you can connect disparate data sets and have confidence in the fact that every new data point will be instantly checked and updated. You'll know that the Maria currently seeking diabetes treatment in Austin is the same Maria who was treated for asthma in Houston last year. You'll know that Thomas sometimes goes by Tom. You're far less likely to have a patient turn up at the pharmacist and be given a prescription that belongs to another patient with the same name. It's more efficient for clinical and admin staff, and copes more efficiently with patient mobility. Highlighting the importance of reliable patient matching technology, Karly Rowe, Vice President of Identity Management and Fraud Solutions at Experian Health says: "When you send us your patient demographic information, we will provide you with the insights and identifiers that you need to better manage your patient identities. The benefits are improved patient safety, better care coordination, better patient engagement, and overall driving better efficiencies and financial benefits." Not all reference data is created equal Of course, referential matching is only as good as the data it’s trying to match. Some vendors repurpose data matched for credit checks, using patients’ Social Security Numbers. But this data can be equally vulnerable to inaccuracies. Experian offers access to the industry’s broadest and most trustworthy datasets and provides ongoing monitoring to constantly check the accuracy of that data. Our healthcare-specific algorithm is finely tuned to meet the data needs of the healthcare industry, without any risky repurposing. With this in mind, ValleyCare Health System in California used Experian Health's Identity Verification solution to give patient access staff the freshest demographic information, including more accurate names and addresses, leading to a 90% reduction in undelivered mail. Janine Edwards, Patient Access Services Quality Assurance and Training Coordinator at ValleyCare told us: “Since implementing Identity Verification, we’ve improved the accuracy of patient demographic information throughout ValleyCare Health System. More valid data up-front means better revenue cycle results on the backend.” The entire health ecosystem relies on knowing who patients truly are. With the highest quality reference data and powerful unique patient identifiers, Experian goes beyond the limits of conventional methods to give providers the highest confidence in matching and managing patient identities. To start resolving your patient identities today, contact us to see how many duplicate records we can fix.

The President, members of Congress and consumer advocates are all demanding price transparency within the healthcare universe.  The major push of late is President Trump’s executive order that will be issued in June 2019; while critics hope this initiative will fade, the topic has been on the industry radar for many, many years. How did we get to today’s scenario? We have a robust perspective on this subject at Experian Health because we’ve been working with healthcare organizations offering various solutions that inform consumers about the costs of their care for more than 10 years. We brought to market the first iteration of our current Patient Estimates product back in 2008, responding, in part, to the growing issue of medical debt and inherent risk to providers not getting full payment for services. The challenges presented by medical debt are well documented, but the important point to focus on is that as long as Americans continue to lack the ability to pay for their care and health organizations struggle with collections, the push towards price transparency will continue. Perhaps this is much needed progress? Since 1957, nearly 75% of Americans have consistently reported being insured but unable to pay their medical bills, according to a study by the Centers for Disease Control. Now, more than 50 years later, many legislators hope mandated price transparency will alleviate the surprise factor of medical costs and spur a more competitive environment. In 2008, helping patients understand their costs was intended to improve providers’ collections success. The term ‘price transparency,’ with additional connotations (e.g. better experience for the patient, improved efficiencies), popped up about the same time as the introduction of very high deductible health plans. The phrase started gaining traction following passage of the Affordable Care Act, and as patients were responsible for more of their medical costs. Add in the rise of consumerism within healthcare and Americans’ digital lifestyles, and it’s no surprise there are calls for pricing to be as easy to understand as they are in the retail space. We harness the power of data and analytics to fulfill these needs in the marketplace. The healthcare industry was ripe for change more than a decade ago, as evidenced by the desire of organizations to leverage what we could offer. While there is continued debate on the transparency topic, the good news is today’s data-driven technology can create a patient financial experience that is friendly, understandable and accessible, delivering the good-faith estimates many consumers, legislators and the industry-at-large wish to see. Consumerism drives price transparency expectations Ultimately, the financial aspect to care is a key component to consumers’ satisfaction with a provider. This realization began to bubble to the surface over the last several years. In fact, Experian Health conducted research last year to understand consumer pain points during the healthcare journey. Consequently, it was no surprise when the study revealed consumers’ biggest frustrations and challenges – above clinical areas – is dealing with the financial aspects of healthcare: 90 percent of respondents ranked worrying about paying their medical bills as a very important to extremely important pain point. 30 percent acknowledged the challenges of determining what financial support options (e.g., payment plans, government grants, and hospital charity care programs) are available 90 percent reported significantly underestimating the costs associated with major medical procedures (e.g., knee replacement) The takeaway from this study is clear: consumers want a streamlined payment process that builds confidence and provides peace of mind. We know that healthcare providers want to increase the efficiency and success of their collections efforts. Ultimately, everyone benefits from clarity around pricing. So whether government-mandated or not, there is no denying that price transparency, in some form, is here to stay and a transformation in the industry is taking hold. Experian Health is leading the way to innovations that will help healthcare organizations thrive in this new era. By leveraging our expertise in data and analytics and our understanding of healthcare costs, we can help patients successfully navigate their financial obligations from primary care appointments through subsequent diagnostic procedures and surgeries. The potential is there for everyone to benefit from an evolved, modern system. Related Articles: How Blessing Health System personalized estimates to improve patient satisfaction