Tag: fraud

Patchy patient data has plagued the healthcare industry for decades, but the pandemic opened the door to a whole new set of identity management challenges. As patients rushed to register for patient portals and book vaccines, many unwittingly created multiple accounts, having forgotten they’d already signed up. Fluctuating unemployment levels meant many individuals were forced to jump health plans, which meant their records were moved between various organizations. As a result, data errors crept in, and identity updates were omitted. Incomplete and inaccurate patient identification data leads to suboptimal clinical decision-making, poor patient experiences, and higher costs for patients and providers. A 2020 study found that one in five patients had spotted an error in their electronic health record (EHR). Many clinicians have also witnessed medical errors that stem from patient misidentification. Hospitals lose millions of dollars every year in denied claims arising from identity errors, which can easily be avoided with a standardized approach to identity management. In a recent survey conducted by Experian Health, we found that identity management emerged as a major challenge for healthcare providers. Almost half of the respondents said that having inaccurate and incomplete patient data hindered follow-up contacts and patient outreach. It matters to patients too – a 2020 survey for the Pew Charitable Trusts found that four in ten were more supportive of data-sharing efforts among providers because of the pandemic, and twice as many were open to the idea of biometric identity verification. "Patients still welcome proactive outreach by providers, but more say their providers fail to do this, and 45% of providers say inaccurate or incomplete patient data gets in the way." - Experian Health's State of Patient Access, June 2021 Providers know that a 360-view of their patients is essential for improving patient outcomes and delivering positive patient experiences; however, duplicate and incomplete data continues to thwart their efforts. With a unique patient identifier (UPI) and a robust identity verification solution, providers can achieve single, accurate, and current records, and solve for these data standardization challenges. Data standardization creates a single source of truth for each patient Despite bipartisan recognition of the need for a national standard for patient identities, statutory barriers have hampered the adoption of a nationwide UPI. In the absence of a national approach, providers must take the lead to ensure high-quality patient records and prevent duplication, gaps and errors. The first step towards data standardization is identifying the type of patient information your organization needs. What data must be collected from patients? Which form fields are required and which are optional? How should data fields be formatted when updating patient records? Standardizing data collection and ensuring content and format consistency will help create reliable records for every individual patient. Next, a Universal Identity Manager (UIM) can hold and protect that single view of each patient, creating a standardized approach when new data is added. The software assigns a unique identifier to each patient, which follows them throughout their entire healthcare journey. By drawing on referential and probabilistic matching techniques with Experian data and patient rosters, the UIM uses the unique identifier to accurately match the patient’s identification and medical history, to help both clinical and non-clinical staff offer optimal care and support. Confirming the patient is who they say they are Having an accurate picture of each patient is only the first step. Next, providers must feel confident that each record can be correctly matched to the individual who is trying to log on to the portal or sitting in the waiting room. A complete and current record is useless if clinicians are matching it to the wrong person. To solve patient matching challenges, most healthcare organizations assign employees or contractors to fix and clean up data records. Without a software-driven identity management engine, these teams are forced to rely on manual processes, which are time-consuming, costly, and still vulnerable to errors. Alongside the consistent approach to content and format mentioned above, providers should have a reliable way of checking and amending the patient’s records at every touchpoint in the healthcare journey, using cutting-edge identity proofing techniques, risk-based authentication, and knowledge-based questions. A tool like Identity Verification can easily identify every patient and help maintain a clean and accurate patient database. Each patient’s demographic data can be validated and corrected during pre-registration, so providers know that the person is who they say there. This is even more crucial as the pandemic leads more patients to opt for remote and virtual services alongside in-person care. Future-proofing patient identities as the pandemic prompts long-term change Since March 2020, many Americans have gone through major life changes. Whether it’s the loss of a loved one or loss of a job, a change of address or a change in attitude towards their health, patients’ lives are changing. The healthcare system must adapt to follow suit. Many more players are involved in delivering healthcare, with digital apps and tools growing in popularity. These developments mean more patient data is being generated and shared, and by more diverse and distributed sources. A robust identity verification system built on standardized data can help smooth out the bumps in patient records and offer better patient experiences and improved health outcomes. Providers don’t need to completely overhaul their records system, but by investing in incremental changes to improve the quality and governance of their data, they can accelerate the move towards data standardization. Talk to Experian Health about how our proven tools can help your organization deliver better patient data quality today, and build a universal identity management system fit for the future.

Healthcare data breaches are nothing new, but their size and frequency are increasing: CVS Health lost over a billion search records when a third party accidentally made an online database publicly accessible in March 2021. A ransomware data breach at prescription management vendor CaptureRx affected over a million patients at 17 healthcare providers in February 2021. More than 3.47 million individuals and at least 10 healthcare organizations were affected by a massive data breach at file transfer company Accellion, which spanned multiple global industries in December 2020.   Further illustrating the risks to healthcare organizations, Scripps Health in San Diego was hit with two class-action lawsuits that assert that the organization should have done more to protect patient data. If upheld, it will set a precedent for healthcare organizations to be held legally responsible for failing to protect data – to the tune of $1000 per patient. The direct monetary cost of fines and lawsuits, however, may ultimately be a secondary concern as damaged reputation is often a more difficult setback to overcome. Patients increasingly approach healthcare as “consumers” and a breach – or a poorly managed breach situation – might prompt them to look elsewhere for care. “Incidents happen every day. However, the real threat lies in how quickly and efficiently an organization can respond. This is what customers will remember. You need to be able to make prompt updates to your website, scale up call center capacity, and have answers ready when consumers need them.” The growing frequency and scale of health information breaches means it’s no longer sufficient to say, “we’re careful with our health data – this won’t happen to us.” Medical identities are extremely valuable, which makes them an attractive target to cybercriminals. In addition, the sudden increase in virtual care and remote working during the pandemic has created new vulnerabilities in data security.   A recent FBI alert that a major ransomware group is targeting the healthcare sector with phishing attacks is a cl reminder that healthcare organizations can’t relax when it comes to cybersecurity. It’s a case of “when, not if” a healthcare organization will have to deal with a breach. Prevention is the goal, but preparation is the smart strategy.   Shifting from data breach prevention to preparedness   During the pandemic, the volume of data being shared within and between healthcare organizations sky-rocketed, as providers offered more virtual care services and workforces became more distributed. While these innovations meant access to healthcare and work could continue safely, the shift to cloud-based data sharing and storage, means the data perimeter is much broader and tougher to secure – if there remains a perimeter at all. Data must be secured at the device- and employee-level now.   While prevention is better than cure, the hard truth for healthcare cybersecurity teams is that they’re increasingly likely to have to deal with a breach. Unfortunately, many organizations don’t have the technology, resources, or time to prevent breaches all the time, at every access point.   Chris Wild, vice president at Experian Health, says:   “We’re seeing an increased frequency of cyber threats across the whole industry. Hardly a week goes by that we don’t hear of a health system under attack from hackers or ransomware. The statistics show us there’s a health data breach nearly every single day, so it’s just a matter of time before it impacts any one provider, pharmacy, payer or physician group.”   Instead of focusing solely on prevention, healthcare organizations need a strategy to prepare for what happens when a breach occurs. If they don’t, they risk a long, public struggle to contain the breach, resulting in brand damage, patient loss, and financial consequences in the form of fines and lost revenue.   Building a data breach response plan   Recovering from a data breach requires a speedy and thorough response. With a plan in place, action can be taken as soon as the dreaded call comes in. Knowing exactly what needs to be done to meet HIPAA notification requirements, helps reassure consumers and regulators alike that every effort is being made to contain the breach. Not only will this help minimize fines, but it will also mitigate against the reputational damage caused by the security breach.   A breach is bad enough but compounding the negative impact of exposed data by failing to provide sufficient support to worried consumers is even worse. Wild says: “Incidents happen every day. However, the real threat lies in how quickly and efficiently an organization can respond. This is what customers will remember. You need to be able to make prompt updates to your website, scale up call center capacity, and have answers ready when consumers need them.”   A robust response plan calls for C-suite engagement, clear success metrics, and regular pressure-testing. Above all, it must be flexible to adapt to whatever size and type of breach occurs.   The best support for the worst-case scenario A data breach response plan isn’t going to prevent the breach itself, but it can help a healthcare organization take the right steps in the aftermath. Having serviced thousands of data breaches over the last 17 years, Experian Health’s Reserved Response™ program is based on real world experience and has evolved as the threats and consequences have increased. In a recent survey, clients using Reserved Response reported 15% fewer data security incidents than those who did not. Furthermore, any incidents that did occur tended to be smaller in scale.   Because the risk and impact of data breaches is trending upwards, this year Experian Health has introduced a new Reserved Response Hub. This digital, self-service tool helps to prepare and test a data breach plan, including: the new and improved 2021 Data Breach Response Guide downloadable readiness reading materials tried and tested notification templates a pre-breach incident checklist access to Experian’s full Reserved Response service, which provides support before or after a breach to ensure regulatory compliance and support for those impacted.   Reserved Response can help healthcare organizations put together a data breach preparedness plan in as little as three days.  

Editor's note: This blog post was updated on October 2, 2023.  In today's rapidly evolving healthcare landscape, the need for a standardized approach to patient matching and identification has become crucial. Not having a unique patient identifier (UPI) not only poses challenges to managing patient data but also hampers interoperability between healthcare organizations. A unique patient identifier (UPI) is a method for standardizing patient identification. Individuals are assigned a unique code, and that code, rather than a Social Security Number, name, or address, is what is used by healthcare organizations to identify and manage patient information. A standardized code like this not only protects sensitive health information but supports the exchange of data between healthcare organizations and states as it is a number and format easily read and recognized by all. Advocates for a coordinated approach to patient matching are continuing to make the case for a national unique patient identifier (UPI). In April 2023, healthcare organizations wrote to legislators urging them to reject language in the 2024 Health and Human Services appropriations bill that prohibits the use of federal funding for a national UPI standard. More than 150 healthcare and medical organizations signed the letter, including Experian Health. The coalition argues that a standardized approach to patient matching could save lives, avoid medical errors, reduce unnecessary costs and greatly improve operational efficiency. While federal funding currently remains off-limits, the industry is poised to move forward to develop a national patient identity solution that is cost-effective, scalable, secure and one that protects patient privacy. Let's explore how a UPI can revolutionize the healthcare industry and create a truly connected ecosystem. How a unique patient identifier is used in healthcare UPIs give providers and payers a way to link records for the same patient or member, so they have one complete record. Without a UPI, a provider may inadvertently create a duplicate patient record because a slight variation in the patient's name or address means their original record isn't accurately matched to them. A 2022 survey by Patient ID Now found that 6 in 10 healthcare organizations had estimated duplication rates of 4-8%, while 16% of organizations had more than 15 patients with the same name.  If there's more than one record for a patient, providers may miss important medical information that's not carried through to the version of the record they're looking at. Unreliable records can also lead to misidentification, where patients with a similar name may have their records incorrectly matched. According to the ECRI Institute, misidentification is one of the top ten threats to patient safety. Patients could be given the wrong treatment or medication, with life-altering or fatal consequences.  While patient safety is the top concern for providers, efficiency is another driver of attempts to improve records management. Organizations report spending $1.3 million per year on patient identity resolution, as resources must be redirected to figuring out who patients are and fixing errors. Being able to correctly link records for a complete view of an individual's identity can help circumvent these challenges.  A unique patient identifier is the key to interoperability Managing patient data across the entire healthcare ecosystem is a long-standing challenge. Many organizations rely on master patient indexes to match patients using demographic data. But these single-source databases are rife with gaps, overlaps, and outdated patient information. They can't keep up with simple name and address changes or easily identify and fix data entry errors.   A more effective solution involves combining data sets to create complete identities and profiles, where every piece of new data is instantly updated and verified. Experian Health uses referential matching technology to achieve a fuller picture of each patient's identity. The UPI then acts as a golden thread, linking each patient record correctly within and between systems.  For example, if a provider has a patient in their EHR twice under two spellings of the patient's name, a UPI would link those two profiles, creating a singular view of the patient. If a pharmacy has a patient listed under a birth name but the doctor has them listed under their married name, a UPI can ensure both systems match the patient correctly.  When combined with other patient engagement solutions, data and identity management tools  create the infrastructure needed for healthcare to truly become one cohesive, patient- and member-centric network.  It is important to note that the UPI is not a patient-facing number and is not known to the patient or provider. It does not collect or share any clinical claims or diagnostic information; its purpose is simply to link records together giving providers and payers a complete view of someone's identity.  Improving the patient experience with a unique patient identifier  Healthcare consumers are increasingly seeking digital-first, efficient processes, and they're sensitive to the need for robust data security. Healthcare organizations must demonstrate their ability to manage patient data properly from the patient's first interaction. If data management is inefficient, patients will find themselves being forced to fill out forms they've already filled out multiple times or undergo duplicate tests as they travel between facilities. Patients with similar names may be confused if they're shown someone else's details during the identification process.  In an ecosystem built around a strong healthcare network, these discrepancies can be avoided. The patient's unique identifier remains consistent across every healthcare facility they visit – including physicians' offices, hospitals, pharmacies, specialists and long-term care facilities – so all providers know exactly who they are.   While patients welcome a more convenient, coordinated experience, they'll also be reassured by the reduced risk of medical errors that comes with a well-connected healthcare network.   Efforts to improve patient identity resolution in healthcare  While there may not be a national UPI yet, the industry is trying to find workaround solutions. The Centers for Medicare & Medicaid replaced Social Security Numbers with Medicare Beneficiary Numbers as the primary means of identifying Medicare beneficiaries. But while this addresses the risk of data breaches, it doesn't resolve the interoperability challenge.   Another initiative is Project US@ (Project USA), run by the Office of the National Coordinator for Health Information Technology (ONC). This aims to create a consistent healthcare industry-wide specification for representing patient addresses, to improve address accuracy. This would ensure that, for example, the same street name written as “road” and “Rd.” is not mistakenly viewed as two different addresses by the software.   To support efforts to integrate disparate software solutions, Experian Health announced in 2019 that every person in the United States had successfully been assigned a unique UPI, powered by Experian Health Universal Identity Manager (UIM) and NCPDP Standards™ (the “UPI”).  Combining Experian's expansive data assets and innovative UIM technology along with NCPDP standards, each person who has received medical care or used a pharmacy has been assigned a UPI. As new patients enter the healthcare ecosystem, this number will continue to grow.  Dave Roberts, VP of Platform Products at Experian Health, says that “the technological foundation is already in place for data interoperability through the creation of UPIs that are maintained in a master person index. These solutions are vendor-neutral, meaning data can flow freely between disparate electronic health systems, regardless of size or location.” Utilizing Experian Health's Patient Identity Solutions The implementation of unique patient identifiers holds immense potential for creating a connected healthcare ecosystem. By standardizing patient identification and enhancing data management, a unique patient identifier can improve patient safety, reduce costs, and streamline processes across the entire healthcare industry. Find out more about how Experian Health's patient identity solutions serve as stepping stones towards a more efficient and patient-centric healthcare network.

  When a doctor pulls up a patient’s record, it should be a safe assumption that the information on the screen relates to the patient sitting in front of them. It should contain every detail of the patient’s medical history, along with their current address and accurate personal information. It certainly shouldn’t contain anyone else’s data! Yet all too often, patient records are plagued with inaccuracies. Around 30% of patient data in electronic health records is incomplete or inaccurate, and up to half of records are not linked to the correct patient. The ONC estimates that around a fifth of patients may not be matched to their entire medical record within an organization, while more than a half of records shared between organizations contain errors. Despite all of modern medicine’s ground-breaking achievements and our increasingly digitized world, the ability to share information between different payers and providers in a reliable and secure way remains frustratingly out of reach. Could a universal patient identifier unlock interoperability? Imagine a healthcare ecosystem where administrators and clinicians can safely exchange information without worrying about whether it’s inaccurate, incomplete, or incompatible with each other’s systems. Interoperability could make life easier for healthcare staff and patients alike. While regulations such as the Affordable Care Act introduced many carrots and sticks to drive up adoption of electronic medical records to support interoperability, they also revealed a critical gap in healthcare: the need for a universal patient identifier (UPI). This is an identifier that would help manage patient identification across the whole healthcare ecosystem. A UPI would allow providers and payers to follow patients throughout all their major medical and life events and be sure that the information they hold for their member or patient is 100% accurate, current and complete. Instead, the absence of a UPI, compounded by the sheer volume and fluidity of patient data, has created significant issues downstream. Billing errors, unnecessary treatment and testing, HIPAA breaches, prescriptions filled for the wrong patients and many other issues all play a role in the growing number of preventable medical errors (estimated to be the third leading cause of death in the US). Striving for truly interoperable patient information should be a priority across the entire healthcare industry. Still, while federal funding for a UPI is currently being considered by Congress, we’re seeing more and more industry-led responses to help improve patient identity management. 5 benefits of using a universal patient identifier for interoperability Improve patient safety How can physicians be sure they’re recommending the right treatment for a patient, when there could be a vital piece of information missing from their medical history or allergy list? How can a pharmacist feel confident handing over a prescription, when there’s a chance the patient in front of them isn’t the same patient named on the script? A UPI can help avoid ‘wrong patient’ events and allow providers to share information to spot trends in recurring errors so that action can be taken to prevent them in future. Lower healthcare costs The West Health Institute found that that medical device interoperability could save the U.S. healthcare system more than $30 billion per year. For individual providers, UPIs could improve productivity by reducing the amount of time clinicians and hospital staff spend trying to sort out inaccurate records. And with nearly a third of claims denied as a result of patient misidentification, this could mean savings in the region of $17.4 million for the average hospital. A better patient experience Patients are right to be frustrated when their physician doesn’t have up-to-date records about them, or their provider sends appointment reminders to an old address. Expecting patients to fill out multiple forms (often multiple times) is inefficient and hardly contributes to a positive patient experience. A tool such as Universal Identity Manager can help providers exchange timely data, eliminate duplicate records and coordinate care, so the patient is supported throughout their healthcare journey. Stronger privacy Electronic records linked with a UPI allow healthcare organizations to phase out manual processes—which is not only more efficient, but also helps minimize the risk of patient data falling into the wrong hands. It’s much easier to keep the data secure when it’s contained in a single record, compared to multiple versions of a record filled with scribbled notes and random updates that could easily end up attached to the wrong record. Experian Health’s Precise ID gives healthcare organizations a HIPAA-compliant way to authenticate patients and reduce the risk of a data breach during enrollment. Better data to tackle the social determinants of health As consumer data opens up new opportunities to improve population health, a network of shared data will be essential for identifying trends in the social and economic factors that affect medical outcomes. Interoperable data sets and technologies can enhance the way public health data is collected and used, for better patient outcomes and population health. Interoperability currently remains a challenge, but the tools exist to improve the way information is shared and used across the healthcare ecosystem. By integrating clinical data into the patient access workflow, you can increase productivity, reduce costs, and ultimately improve the patient experience. Contact our team to find out how this could help your organization achieve more efficient, accurate and actionable data sharing.  

  Medical identity theft is a growing problem for the healthcare industry: nearly 15.1 million patient records were compromised in 2018, an increase of nearly 270% on the previous year. While providers are busy rolling out patient portals and electronic medical records to better serve consumers, criminals are sneaking through the cracks to steal patient data and profit from vulnerable health systems. The rapid rise in medical identity theft is partly explained by the fact that it goes undetected for much longer than other types of identity theft, giving criminals more time to use stolen personal information for financial gain. It’s also a lot more lucrative. Medical identities can be used to access treatment and drugs, make fraudulent benefits claims and even create fake IDs to buy and sell medical equipment. This can be devastating for victims, both emotionally and financially. Unlike credit card theft, where victims aren’t considered financially liable, 65% of people who fall prey to medical identity fraudsters are left with hospital bills running into the tens of thousands. The compromised medical record is tough to reconcile, jeopardizing future medical treatment. For providers, a data breach can mean significant reputational damage and loss of trust, and huge financial consequences – each breach costs an average of $2.2 million. But what’s most alarming for providers is that more than half of data breaches originate within the organization. Unfortunately, many providers lack sufficient security protocols and detection tools to safeguard the data they’re holding. The good news is that the tools exist to help you protect your patient data. What can healthcare providers learn from other industries about identity protection? Banking and financial services have pioneered identity protection over the last twenty years, and healthcare can learn a lot by looking at what’s worked in those industries. For consumers, using digital technology to pay your bills, book flights and buy pretty much anything is the norm, all with reassuringly quick fraud detection and resolution. Healthcare has been a little slower to embrace digitization in this way. Despite the opportunities, fears around security, privacy and inconveniencing patients have stalled efforts to transform outmoded processes. Drawing on two decades of innovations in other fields, fast-paced technological developments mean many of the early challenges around implementing safe and secure patient portals have been overcome. 6 strategies to keep patient data safe Here are six smart ways to ensure your organization has done everything possible to safeguard patient data.     Tell your patients how you’re keeping their data safe Patient trust is at the heart of a successful patient-provider relationship. Share the steps your organization is taking to secure patient information, so patients feel reassured and confident in using their portal. Data security should be a key strand in your patient engagement messaging.     Verify patient identities to protect access to medical records To avoid HIPAA violations, it’s critical to ensure you’re giving access to the right patient. Secure log-in monitoring and device intelligence can help you confirm that the person trying to log in is who they say they are. When something doesn’t add up, identity proofing questions can be triggered to provide an extra check. In an exciting new development, the healthcare industry is also starting to see the use of biometrics to supplement existing identity-proofing solutions. Just as you might use facial recognition to unlock your smartphone, there are now ways to authenticate your healthcare consumers’ identity using the same technology.     Automate patient portal enrollment You want your portal to be as secure as possible, but not at the expense of your patients’ time and effort. An automated enrollment process can eliminate the hassle of long, complicated set-ups and reduce errors at the same time.       Arm your organization with a multi-layered security strategy There is no silver bullet for protecting patient information—it will require various tools. A robust data security strategy will be multi-layered, including device recognition, identity proofing and fraud management.     Educate staff on security threats and warning signs Data breaches aren't all malicious – human error is a massive component, from mailing personal data to the wrong patients, to accidentally publishing data on public websites or leaving a laptop behind after getting off the subway. Training staff on the potential pitfalls will help them help you in protecting confidential patient information.     Develop a robust device strategy ‘Bring Your Own Device’ arrangements (BYOD) are convenient for staff and patients, but personal devices need to be secured when accessing patient information across the network. Make sure your teams, patients and visitors are aware of how to log-on securely to WiFi and follow best practice to keep data safe. In a climate of ‘doing more with less’, healthcare leaders are turning to other industries to find ways to boost quality of care and streamline operational efficiency. Automation, digitization and consumer-centric approaches make good business sense across the board, but they’re sensible investments for your data security strategy too. Investing in secure patient identities is a way to prevent painful and unnecessary losses down the line – and it’s what patients have come to expect. ⁠— Find out what more you could do to shore up your data security and prevent medical identity theft.

In a recent healthcare information technology survey, more than 40 percent of chief information officers identified patient matching as healthcare’s top IT concern. And though a quarter of the respondents admitted it wasn’t a current priority for their organizations, they did say that it very much should be. There’s no shortage of reasons why, but the most pressing is the need to reduce medical errors, which account for over 250,000 deaths in the United States every single year. Case in point: Seventeen percent of CIOs acknowledged that errors in matching data with the right medical identities have led directly to adverse outcomes for patients. The numbers speak for themselves: Healthcare organizations must find more effective ways to manage the data within their networks. That begins with building a robust medical database that not only hoses data, but also knows how to match it with the proper patients. How robust EMPIs streamline workflows An enterprise master patient index (EMPI) is a database that can help you clean up your data and eliminate duplicate and inaccurate records. It uses algorithms to match exact data elements among disparate records, as well as elements that fall within an acceptable range of possible compatibility. Using technology that can apply an algorithm of probabilistic and referential matching methodologies will allow healthcare organizations to expand beyond the limitations of conventional single methodology matching, as both probabilistic and referential matching techniques provide a higher degree of likeliness. The system assigns these data points to unique identities that follow patients throughout the organization. Any new data generated within the network is also attached to this identity, meaning physicians, specialists, pharmacists, and other members of the patient’s care team can access and update it as needed. EMPI support tools and unique patient identities are building blocks toward creating a healthcare ecosystem that’s truly interoperable. According to an April 2018 survey by Black Book, hospitals with an EMPI report “consistently correct patient identification at an overall average 93 percent of registrations and 85 percent of externally shared records among non-networked providers.” Unfortunately, not all healthcare systems possess the IT infrastructure to support these programs. And as long as some organizations fail to integrate similar platforms, providers won’t reap the benefits of industry-wide interoperability — and patients will continue to suffer. Whether it’s a frustrating billing mix-up, privacy breach, or a detrimental (or even fatal) misdiagnosis, many errors can be successfully prevented with an EMPI. Filling in the holes The goal of such a system should be to standardize data entry and access within each healthcare organization, as well as across the entire industry. Such a network could protect, govern, and match unique patient identities across every discipline and every aspect of their care continuum. But in order for the system to achieve these goals, you need to be sure you’re feeding it relevant, recent patient information. To ensure you have enough patient data to build an EMPI that accurately matches profiles, ask yourself these questions: 1. What kind of medical care have my patients received before this visit? When patients enter a new hospital, they’re given a brand-new identity, or patient number, that’s only relevant to that healthcare system. The identity you assign them within your own organization doesn’t provide any insight about what they’ve experienced before their current visit — and that’s the crux of the matter. When patient information is siloed within a specific system, you have no view of the patient’s medical history. But when it’s shared across systems and fed into a more dynamic and interoperable data management system, patients will ultimately receive better care. 2. Who are my patients when they’re not “patients”? It’s important to understand who patients are when they’re not in the hospital. Yes, they’re husbands and wives, mothers and fathers, brothers and sisters. But some could be physically fit, while others haven’t seen the inside of a gym in years. Some might get regular checkups, but others cannot afford to see a physician regularly. All of these traits factor into your patients’ identities. With a comprehensive EMPI, you can tie them together to understand the environmental and socioeconomic factors that influence your patients’ health. You can then identify what social determinants of health need to be addressed or could potentially influence the efficacy of certain treatments. 3. Can we identify patients without a picture ID? Biometrics such as fingerprints and iris scans are more secure forms of identification than a photo ID. They’ll not only make it easier to identify patients, but will also offer heightened security against fraud. That being said, even biometric identification isn’t 100 percent secure unless it’s part of a database, such as the EMPI, that accurately matches patient identities with relevant medical data. Accepting that the healthcare industry needs better data management and patient-matching strategies is the first step to realizing those goals. EMPIs have shown organizations the value in universal patient identities. Now, they simply need comprehensive databases that are robust enough to keep patient identities consistent across the entire healthcare ecosystem.

Healthcare has always been driven by data, and today, providers have access to an unprecedented amount from a wide variety of sources. While this influx could be a blessing to the healthcare industry as a whole, it also poses a number of challenges, particularly when it comes to patient identity management. With a soaring volume of patient information coming in from numerous sources, identity errors become increasingly more likely, as well as the potential consequence of fatal mistakes. Keeping this in mind, the importance of effective identity management cannot be overstated. Every year, an estimated 195,000 people die due to medical mistakes. More than half of those deaths – 10 out of every 17 – are the result of identity management errors, such as duplicate records and mistaken patient identities. While current healthcare IT solutions attempt to tackle these discrepancies, they only succeed in identifying about 10 percent of all duplicate records. Consequently, patients often undergo repeated tests or receive incorrect treatment or medication that can result in adverse effects to their health. Also, there is limited coordination of patient data throughout the healthcare ecosystem. The main culprit of this is the lack of secure data transfers that compromise patient records and identity. This raises the question: How can healthcare organizations better manage the massive amounts of data related to each patient’s medical identity? Luckily, such issues can be improved with Experian Health’s Universal Identity Manager (UIM), which creates a single identity for individual patients across multiple disparate healthcare databases. Upgrade your identity management system The ability to share patient information across multiple healthcare organizations with different care management programs is at the core of optimizing overall patient care. Properly utilizing patient and population health data can dramatically improve an organization’s efficiency, raise its quality of care, and lower its readmissions rate. For patient data to be useful, however, providers require a robust infrastructure that allows for secure, precise, and accurate storage of patient data. The same framework should be able to assign patients unique identities across the entire network. In turn, a single, universal patient identity system allows for better analytical insights and more effective care personalization. This kind of management system also allows an organization to add relevant data to a patient’s medical profile faster and more accurately, creating an improved dynamic database that can develop personalized patient engagement and care plans. How Experian Health’s universal identity management software helps Administrative slip-ups in healthcare can have drastic consequences for a patient’s health and wellbeing. Eliminating these inaccuracies is the main goal of Experian Health’s UIM solution. Experian Health has the benefit of leveraging data assets available to us from being part of broader Experian. As a result, the identity management software generates and assigns a unique identifier to each patient that remains consistent across various healthcare systems, such as hospitals, therapeutic facilities, pharmacies, and healthcare payers. Drawing on decades of experience in identity management, Experian Health's multi-matching methodology approach eliminates duplicate and erroneous data through comprehensive search and alert processes. It provides a high degree of likeliness because it expands beyond the limitations of the conventional single-matching methodology that most health systems use today. Even records created on disparate healthcare systems can be automatically analyzed and assigned to the appropriate patient identity. In addition to eliminating discrepancies that could affect the quality of patient care, universal identity management also reduces medical and billing errors, ultimately minimizing an organization's risk of fraud. The solution also works in tandem with Experian Health’s suite of patient engagement and transparency tools, including its Patient Self-Service portal, to further optimize an organization’s ability to deliver personalized, high-quality care. Unique patient identifiers are critical for healthcare organizations to reduce the risks of inaccurate and duplicate records that lead to errors and low-quality care. Combined with Experian Health's suite of patient engagement and price transparency tools, its identity management software is a leap toward making efficient and reliable interoperability more possible across the healthcare ecosystem.

Experian Health was honored to host Frank Abagnale, one of the world’s foremost experts on identity theft, forgery, and embezzlement, during our #JointheConversation radio show at HIMSS17. You’ll know Frank from the great movie and book, Catch Me if You Can.  Frank has been a consultant to the FBI for over 41 years. He also developed a fraud detection technology called the 41st Parameter that Experian purchased in 2013 and it now operates in 80 countries around the world. Frank was honored to be selected by HIMSS this year to lead a presentation called “Stealing Your Life” where he focused on identity theft in healthcare and represented Experian Health to discuss this topic. His presentation focused on the significance of fraud in today's healthcare world; illustrating the enormity of identity theft crimes and how they affect an individual's life in many areas including health insurance, credit, income taxes including refunds, banking, just to name a few. Hear Frank’s assessment of healthcare’s susceptibility to breaches, the current state of cybersecurity, privacy and identity theft, as well as helpful strategies to personally avoid becoming a victim of identity theft. Listen to the complete podcast Learn about our Identity Management solutions

Frank Abagnale will present “Stealing Your Life” at HIMSS17 on Monday, Feb. 20, 2017 from 3pm – 4pm.   Session #58.  Location:  Room 320  at the Orange County Convention Center Frank Abagnale is one of the world’s most respected authorities on forgery, fraud, embezzlement, and secure documents. For over 40 years he has worked with, advised, and consulted with hundreds of financial institutions, corporations and government agencies around the world. Mr. Abagnale’s rare blend of knowledge and expertise began more than 50 years ago when he was known as one of the world’s most famous con men. Mr. Abagnale will bring his audience up-to-date with all aspects of identity theft, data breaches, medical identity theft and the means used to obtain peoples identities. He will discuss the importance of identity management healthcare organizations. After the presentation, Mr. Abagnale will be in the Experian Health booth #3503 to meet and greet HIMSS attendees.  We invite you come by our booth to meet Mr. Abagnale!  Click here for more information on the presentation.