Tag: identity management
“Precise ID satisfies both your security officer and your groups who are dealing with patient efficiency and happiness.”— Kevin Romero, Director of Clinical Systems, AdvantageCare Physicians of New York To help deliver on its mission to provide a 5-star patient experience, AdvantageCare Physicians implemented a patient portal. While a valuable enabler of patient self-service, the portal offered no true verification process for patients signing up to use it. This resulted in patients having trouble logging in, duplicate records and online issues that required assistance from IT help desk support. AdvantageCare Physicians, one of New York’s largest medical groups, turned to the same technology trusted by banks, retailers, government agencies and more: identity proofing. With PreciseID from Experian Health, the organization was able to quickly and confidently authenticate patients and reduce risk during portal enrollment. Every patient in AdvanceCare Physician’s medical record has been assigned a universal patient identifier (UPI), which is used to identify and match patients with other organizations that are not affiliated with AdvanceCare Physicians. The improved matching and data exchange not only satisfies security and patient engagement needs but has helped the organization make a lot of progress towards improving patient satisfaction. Automating the patient portal enrollment process allowed the organization to remove manual processes and optimize resources while securing patient information and supporting a positive patient experience. To date, AdvantageCare Physicians has: Reduced the amount of time spent managing password reset issues by 75 percent Reduced overall call volume to its IT desk by 25 percent Reduced time spent by IT validating patient IDs on the backend by 80 percent Learn more about PreciseID and how we can help.
They used to be little more than clunky messaging platforms, but today, patient portals are the key to a frictionless digital healthcare experience. Consumers can check their medical records and test results with a few clicks. They can schedule appointments, pay bills and renew prescriptions whenever they want. Shifting patient information to portals also increases staff productivity and smooths out several sticking points in the revenue cycle. And with improvements in engagement and efficiency leading to better health outcomes, no wonder 90% of healthcare organizations are putting portals at the heart of the patient experience. But these benefits aren’t without risks. Privacy and security are big concerns for consumers and organizations alike. Patients want to feel reassured their data is safe, while providers want to avoid any reputation-killing headlines about data breaches. Identification and authentication can’t be too complicated though, or the patient experience will suffer. The safest strategy is to use a risk-based multi-layered approach, including identity proofing, fraud management, device recognition and even biometrics. Different levels of security checks can be applied, depending on the likelihood of the person being an imposter. If the information being accessed is particularly sensitive, or when the log-in information doesn’t quite add up, your system should trigger additional checks, such as identity proofing questions. But what are the right questions to ask? The right questions balance risk, trust and proportionality There’s no point seeking security information that could be easily guessed, obtained through a quick Google search or stolen from a patient’s wallet. You need questions only the true consumer would be able to answer – “out of wallet” questions, or knowledge-based authentication. This means the traditional “mother’s surname” question would not be a great choice, as it’s easily discoverable by potential fraudsters. Better questions might relate to the consumer’s city of birth, first car model, first pet’s name or previous address. Of course, these identifiers could still be obtained by nefarious parties, but when used in combination with other identity proofing tactics, it’s a significantly reduced risk. The sweet spot lies in the difference between the consumer’s ability to answer correctly and that of a potential fraudster. Your questions should also be relevant to the consumer and appropriate to the context. For example, a common out-of-wallet question used by financial institutions is to confirm a recent transaction. This ticks the box for security, as only the true consumer would likely know the answer, but in the context of a healthcare portal it could seem odd and out of place. It might make the patient wary and actually do more harm than good in terms of building trust. Progressive questioning lets you use smart logic to select a range of appropriate, varied questions, rotated over time and layered up for additional checks when a certain threshold of risk is perceived. In this way, the patient experience will be flexible, seamless and reassuring, without the burden of excessive admin. How Sutter Health System used better questions to increase enrollment and reduce help desk contacts With around 1.8 million patients actively enrolled, Sutter Health System wanted to offer easy access to their self-service portal, but without accidentally giving anyone access to someone else’s information. They had no true identity proofing process for patients, which led to cumbersome checks, errors and high numbers of calls to the help desk. Introducing the PreciseID® identity-proofing tool meant the team could authenticate users more quickly and reliably, using knowledge-based questions without an arduous process. Now, patients have just four or five simple questions to answer, which are checked against a robust dataset. An online risk assessment verifies the patient’s device and determines whether additional checks are required, balancing security with convenience. Tom Mitchell, Applications Manager at Sutter Health System Office describes working in partnership with Experian Health to find the right set of questions: “It took about a month to really hone in on the types of questions and the frequency of questions needed to achieve a level of accuracy that would equate to properly identified patients. You need to select what is important to you and Experian will work with you to make sure you ask the right questions.” Not only has this increased the number of positive patient matches, it’s also reduced the number of people trying to contact the help desk with password issues. Tom says: “We’re always trying to reduce the number of contacts to the help desk. Before integrating with self-service enrollment, patients would have to fill out a paper form or call our contact center, in which case a live person would have to go through some validation processes of our own. It was a fairly cumbersome, long process without this piece of validation.” And they’re not alone: AdvantageCare Physicians in New York introduced a similar new approach, enabling them to reduce overall help desk calls by 25% and cut the amount of staff time spent on validating patient IDs by 80%. What could better identity proofing do for you? Find out more about how PreciseID could help you ask the right questions for better portal protection.
It’s amazing to look back at how far medical science and digital technology have come – and how those two worlds are increasingly intertwined. Ten years ago, the idea of managing your healthcare bills or making appointments through an app on your phone would have been unthinkable. Now we take it for granted! But having all these tools at our fingertips means there’s more data being shared between different services and platforms. As a healthcare provider, you might be accessing and sharing patient data multiple hospitals, primary care services, pharmacies, patient portal providers, payers and more. It’s vital to make sure that data is accurate. Research by RAND Corporation revealed that between 8-16% of patient records are duplicates. Trying to provide care on the basis of unreliable data is inefficient and expensive for providers, who lose staff time and revenue trying to match up records and reconcile the data on file with the patient in front of them. According to RAND, a mid-size health system absorbs as much as $96 for each duplicate. What this means for patients is even more worrying. According to the US National Institutes of Health, “195,000 deaths occur each year because of medical errors, with 10 of 17 being the results of identity errors or wrong patient errors.” In a value-based system where patients are covering more of the costs themselves, the financial impact of having unnecessary repeat tests or longer-in-patient stays due to delayed treatment is an added pain. Currently, standard health IT products have some catching up to do, as only 10% of duplicates are spotted. But looking ahead, the future of patient identities is promising. Unique patient identifiers are key to unlocking value-based care The twin trends of value-based care and healthcare consumerism are bumping up patient expectations. They expect a seamless experience. They expect their records to be updated immediately. They’re confused when one department doesn’t have access to information that was just shared with another. And they definitely don’t want to see different services working off different versions of the same record. The answer for many high-performing health systems is to introduce unique patient identifiers (UPIs). This allows a patient’s record to follow them throughout their healthcare journey, ensuring that at every touchpoint, clinical and admin staff are confident in the accuracy of the information they hold. But transitioning to any new system can involve a bit of culture shock for those involved, and so careful planning is essential. What steps can providers take to make sure they implement a patient identity management strategy that’s built to last? How to future-proof your patient identity platform 1. Make sure everyone’s on board with the plan First, whatever solution you’re using to manage patient records, it’s essential that your patients, staff, payers and any other parties involved all buy in to the new approach. Changing the way you handle data and introducing new digital tools such as UPIs can often call for a mindset shift in the way your team and consumers think about data. Be sure to communicate the benefits of UPIs to patients, payers and staff. For example, UPIs can: improve patient safety, by preventing duplicate and inaccurate recordslower healthcare costs, by eliminating inefficiencies and errorssafeguard patient privacy, by keeping records securecreate a better patient experience, by supporting patient-centered carehelp staff access up to date information about their patient’s healthcare situation 2. Choose a UPI system that works within and outside your network Some providers use hospital- or practice-based patient identifiers, where a master patient index is used to link all versions of a patient’s record held within a single organization. An enterprise master patient index (EMPI) does the same, but across several facilities or services. A cross-enterprise solution makes it much easier to manage patient identities across your entire network, without having to wrangle disparate records that don’t interface well with each other. When this system is based on ‘referential matching’, which uses wider data sources and UPIs to build a more connected and accurate data ecosystem, you’ll get a much more complete view of your patients and far fewer inaccuracies. 3. Use data analytics to improve decision-making UPIs bring another advantage: they enable you to analyze health, credit and consumer data for a single patient, giving you useful insights about your patient population as a whole. A network of interoperable data can help you spot trends in the social and economic factors that affect health and wellbeing, so you can target your resources more effectively. As the world of public health data matures, it’s highly likely that UPIs will become the norm. Data-sharing remains a challenge, but by using digital tech to your advantage, you can improve the way patient records are managed in your health ecosystem. Learn more about how UPIs could help close the patient data gap in your organization.
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 concern for healthcare organizations in the digital age. In 2017, healthcare data breaches accounted for 24% of all data breaches, rising to 29% in 2018. In just 12 months, the total number of personal medical records exposed jumped from 5.3 million to 9.9 million. In fact, healthcare data breaches tend to expose many more individual records than other industries. For example, according to the Identity Theft Resource Center, 43.9% of breaches in the first half of 2019 were in business, while only 36.9% were in healthcare. But for healthcare, this meant exposing a staggering 77.4% of all records left vulnerable to identity theft, compared to just 9.5% by business breaches. The potential impact of a healthcare data breach seems to be further-reaching than in other fields. At the same time, healthcare is slightly behind other industries when it comes to data security. Financial services have a two-decade head start to refine their anti-fraud strategies. This, coupled with the fact that medical identities are worth 20 to 50 times more to fraudsters than financial identities, means medical identity theft is increasingly appealing to criminals. It’s a big concern, but healthcare organizations can use data to fight data theft. When you’re armed with the right information, you can put in place the right strategy to protect your patients. What is medical identity theft? Medical identity theft is when someone uses another person’s health-related identifying information without them knowing. This could include their name and address, Social Security number, health records, or insurance information. Fraudsters can use this information to access medical services without paying, submit false insurance claims, or buy drugs. They pretend to be someone else to access services illegally. In addition, that personal information could be used for other kinds of identity fraud or blackmail. What are the consequences of medical identity theft? Karly Rowe, Vice President New Product Development, Identity & Care Management Product at Experian Health, says: “For patients, the impact of having their personal information stolen, and then possibly used to make false claims in their name, can be hugely violating. When someone’s record becomes overlaid with a thief’s record, this can have massive consequences for that person’s future treatment. It’s a major stress to sort out – both administratively and financially. And for organizations, there’s obviously the reputational hit. The relationship between provider and patient is based on trust. When you fail to secure your patients’ most personal information, you risk losing that trust for good.” It’s also a major cost. Medical fraud in the U.S. is estimated to cost somewhere between $80 billion and $230 billion, with the cost to individual providers and payers coming in at around $2 million per breach. To tackle the problem, healthcare organizations are stepping up their security practices across the board. A HIMSS survey, in partnership with Experian Data Breach Resolution, reported that data security strategies have improved. Ninety-two percent of those asked had performed a formal risk analysis, and more than half had increased their patient data security budget. A number of organizations also teamed up to form the Medical Identity Fraud Alliance, to mobilize the industry to tackle the problem. Still, there’s a ways to go. 3 ways to leverage data insights to prevent medical identity theft Protecting patient data calls for a data-based solution. Here are three ways to leverage consumer data and technology to protect your patients and keep their information safe: Resolve patient identities. Accurate patient data is the cornerstone of data management. If your records aren’t entirely reliable to begin with, keeping them safe and secure will be much harder. Put preventative measures in place to minimize the risk of duplicates and errors. Assigning a Universal Patient Identifier (UPI) will let you follow the entire patient journey, so you have a complete, accurate and secure picture of each patient. Protect patient identities. Patient portals allow people to access their health information from their personal devices. It’s convenient and can improve engagement and health outcomes. Unfortunately, they can also become vulnerable to breaches by data thieves. You have to make it easy for patients to use portals, but difficult for fraudsters to get their hands on that personal data. As patient portals gain popularity, you must have the right technology in place to validate and protect patient identities. Automating patient enrollment with a tool like Precise ID® can help authenticate patient identities from the start using identity-proofing, fraud management and device recognition. Enrich patient identities. With data insights, you can check that your patient is who they say they are the moment they arrive in reception. Using the broadest and most trustworthy datasets, identity verification solutions make constant checks, so you have a single, accurate and 360° view of each patient. Not only is this ‘golden record’ the cornerstone of patient care and experience, it’ll let your staff update patient data during intake without manual corrections. Medical records contain some of the most sensitive personal information, so it’s vital to safeguard it with the strongest security that exists. — Download this free eBook to learn how to evolve today\'s patient matching technologies or find out more about how to protect your patient data and prevent medical identity theft.
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.
“Build it and they will come” might work for 1980s movie characters, multinational coffee franchises and beloved sports teams, but it’s not a great engagement strategy for most consumer-facing organizations – especially in healthcare. Take patient portals, for example. Giving your patients a way to access their health records can help improve their health outcomes, increase compliance with care plans, and create a more positive healthcare experience overall. But do your customers know the portal exists? Do they know how it could serve them? Do they trust it? You’ve built it, but how many patients are actually logging on? In 2017, over half the US population had access to a patient portal. Around half of those people used it at least once in the previous year. Of those who didn’t, 59% said it was because they didn’t feel they needed to access an online medical record, and 25% were worried about privacy and security. This tells us two things: If healthcare providers want to increase the number of patients using their portal, they need to proactively communicate the benefits to those patients, and healthcare providers could do more to reassure patients they take portal security seriously. If patients discover that using the portal is better than not using it, and that they can do so securely, they will be more likely to log on. You can address both in your patient engagement and marketing strategies. Perhaps the better mantra is: “if you solve their problem and tell them about it, they will come”. Balancing portal security and patient convenience Your patient portal is more than just a platform for patients to access test results, sort out bills or schedule appointments. It’s a way to nurture the patient-provider relationship. And at its heart, that relationship is about trust. One way to build trust is to ensure your portal meets the strictest of security measures without creating an excessive admin burden for patients. You can do this with a security strategy that layers up several protective measures to help you tackle common areas of vulnerability, including weak ID verification, over-reliance on password-protection, and failure to encrypt sensitive data. A few practical ways to keep your patient portal secure include: using ID verification when someone signs up for the portal using device intelligence and identity proofing when a user signs in to the portal deploying extra security checks where the risk of identity fraud is higher putting systems in place to flag and respond to security breaches as fast as possible. A solution like PreciseID® can help you take care of your patients’ privacy and security behind the scenes. They’ll see just enough to reassure them that you’re taking their security seriously, without any protracted log-in process that puts them off using the portal altogether. Marketing your patient portal so more patients benefit from it Solving your patients’ concerns about security is just one route to boosting portal utilization. Another important way to ensure more patients use and benefit from the patient portal is to actively encourage them to access their online records regularly. Research suggests individuals who are encouraged to use their online medical record by their provider are almost twice as likely to access it, compared to those who weren’t actively encouraged. So how do you convince your patients of the benefits of regularly logging on? That it’s not just a convenient way to manage their medical journey, but could result in better health? The answer lies in consumer data – the lifestyle, demographic, psychographic and behavioral information that gives you a fuller understanding of what drives your patients. Experian Health’s ConsumerView data analytics can capture insights that let you reach out to your consumers with the right message, in the right way, at the right time. Do they live a busy lifestyle? Reassure them that the portal can save them time. Are there lifestyle factors that may hinder their adherence to medication? Encourage them to use the portal to make sure their prescriptions are up to date. If you discover your consumers are big social media users, you might target your portal engagement campaign through those channels. Equally, if a consumer doesn’t have any social media accounts, there would be no point investing in Facebook ads. Personalization makes your patients feel taken care of, leading to greater trust, loyalty and satisfaction. Increase patient portal engagement today In the wake of consumerism and IT transformation across many other industries, a tailored and digitally secure healthcare service is a must. “Consumers now expect to be provided with a turnkey, individual experience that is fast and seamless,” said Kristen Simmons, Experian Health’s senior vice president of strategy and innovation. Your patient portal must be seen to provide a valuable and secure service. While there’s a way to go to increase the number of patients making full use of portals, the tools exist to support healthcare providers’ engagement goals. Learn more about how your organization can leverage consumer insights to improve patient retention and engagement.
Patient identity is the backbone of the entire healthcare system. It\'s how the pharmacist knows they\'re handing over a prescription to the right person. It\'s how the physiotherapist knows what happened during a patient\'s knee surgery a few months earlier. It\'s how the hospital’s billing office knows they\'re mailing a patient\'s bill to the right address. In short, it\'s how you know who your patients are. When something goes wrong with patient identities, the negative impacts can be far-reaching: from a bad patient experience or worrying patient safety issues, to an operational nightmare or avoidable expense to the provider. Incorrect and mismatched patient records can lead to patients getting the wrong medicine or treatment, delayed treatment, or missed follow up. Clinicians may be forced to make medical decisions without seeing a 360° view of the patient in front of them. And potential data breaches arising from misidentification can leave providers exposed to both financial and legal challenges. All of this is compounded by the fact that providers often don\'t know the scale of the problem. A healthcare IT survey in 2018 found that while 66% of Chief Information Officers in healthcare organizations considered patient matching among the highest priorities for their leadership team, only 18% actually knew the figures for mismatched and duplicate records within their own organization. That\'s not including the potential for identification errors being passed between different healthcare providers. In fact, up to half of all patient records may not be linked correctly. So why do these identity mismatches occur and how can you prevent them? Understanding the root causes is the key to solving for patient misidentification. Top 9 reasons for patient misidentification According to a Ponemon Institute study of more than 500 nurses, clinicians, IT staff and finance leads across the US, common causes of patient misidentification include: Incorrect patient identification at registration, where the patient is linked to the wrong records throughout their interaction with the service provider Inability to find the correct record for the patient, when queries result in multiple or duplicate records, or no record at all Time pressure when treating patients – clinicians can waste up to 30 minutes per shift searching for correct health records for patients Insufficient training and awareness, with staff failing to follow protocols correctly, or those protocols being substandard in the first place Too many duplicate records in the system, with misidentification occurring when the search query returns multiple records with the same name or date of birth Human error Inefficient information-sharing between departments or workflows Over reliance on DIY solutions, which may not quite meet the mark in identity management Patient behavior, where patients themselves may submit false information in order to access treatment not otherwise available to them. How to avoid and fix mismatched patient records Writing in the Patient Safety and Quality Healthcare journal about the need to create a culture that encourages proactive risk assessment to prevent patient misidentification, Patricia Hughes, Robert Latino and Timothy Kelly say: \"Too often, patient identification errors only receive their due attention after a serious mistake occurs, such as one that results in patient harm. These “sentinel events” persist despite numerous technological advances and initiatives to focus attention on the issue... The good news is that patient identification errors are highly preventable with the right identification analyses, workflows, and safeguards in place.\" Providers need to look at past errors and understand why they happened, implement safeguards such as the Safety Assurance Factors for EHR Resilience (SAFER) checklist, and support staff to use identity matching and verification tools with confidence. Using the right tool for the job Traditional matching tools (such as manual processes, an enterprise master patient index, or a homegrown data matching solution) are no longer sufficient, due to the volume of data to be matched and the varying quality from each source. As patient records are increasingly spread across multiple systems and departments, all with different systems and reliability, providers should explore how Universal Patient Identifiers can build a more connected data ecosystem. This approach creates the most complete view of patients from reliable health, credit, and consumer data sources, and can significantly reduce the challenges arising from mismatched records. For example, Experian Health\'s Universal Identity Manager platform spans hospitals, health systems and pharmacy organizations, processing more than 550 million health records. By integrating patient information from sources beyond your own enterprise-level data, you\'ll be able to more accurately match, manage and protect patient data, and root out the causes of misidentification before it even happens. Learn more about patient matching methodologies and how you can improve your data records.
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.
