Hospitals can't provide high-quality care if patient misidentification occurs, as the errors resulting from misidentification can have significant consequences for patient safety and the organizations' financial health.
This content is sponsored by Imprivata.
Patient misidentification is challenging for most hospitals. Patients are misidentified 7 to 10 percent of the time, based on a Rand Corp. analysis cited by The Wall Street Journal.
This widespread problem of misidentification led The Joint Commission to declare the issue a top patient safety goal for 2017. According to a 2016 Ponemon Institute report which surveyed more than 500 healthcare executives, most identification mistakes occur during registration. Further, 64 percent of respondents said patient misidentification errors occur frequently or all the time.
Misidentification can result in time-consuming and costly administrative setbacks as well as increased chances for medical errors. An ECRI report found that 9 percent of 7,600 wrong-patient events resulted in temporary or permanent patient harm or even death. And providers are aware of the correlation between misidentification and medical errors. In fact, about 86 percent of providers reported they have witnessed or were aware of medical errors caused by patient misidentification, according to the Ponemon study.
Due to the intertwined economic and safety consequences of patient misidentification, hospitals are finding it in their best interest to leverage technology to protect their patients and themselves. One such solution involves biometrics, a technology that verifies an individual's identity based on unique biological traits, such as an iris scan.
Economic impact of misidentification
Incorrectly identifying patients not only presents safety issues, but also jeopardizes a hospital's bottom line. The Ponemon Institute report revealed that the average hospital loses $17.4 million per year in denied claims stemming from misidentification.
Duplicate medical records serve as the likely culprit for claim denials. A duplicate record may not present the complete and accurate medical history, as it could lack vital patient information, such as a patient's blood type, allergies or past diagnoses. Physicians who make care decisions based on incomplete information may inadvertently order unnecessary tests, ineffective treatments, or incorrect medication and care, all generating excess costs for both the hospital and the patient. Along the same lines, overlaid medical records - which occur when two individuals’ records are merged - don't properly present a patient's medical history.
The American Health Information Management Association Foundation (AHIMA) found that an average EHR system contains 8 to 12 percent duplicate medical records each, costing up to $1,000 to correct, while it takes $5,000 to fix a medical record overlay. These costs accumulate during the "cleansing and unmerging" process, due to the excess administrative time required to sort through the medical databases.
Identity fraud also negatively impacts proper patient identification. If patients present fraudulent identification or insurance cards when registering, they are at risk of adverse events because their records will include erroneous medical information.
Medical identity theft presents a significant concern for providers across the country. Twenty-six percent of U.S. consumers have experienced medical identity theft, with 50 percent paying an average of $2,500 in out-of-pocket costs per event, according to a 2017 Accenture survey. Even more concerning is the Identity Theft Resource Center report that cited 179 data breaches in the healthcare industry in the first half of 2017. According to the 2016 Ponemon Institute survey, 61 percent of respondents think patients who suffer lost or stolen medical records are more likely to experience identity theft.
Identifying a solution
Manual identification processes are no longer sufficient. Few hospitals request Social Security numbers today due to liability concerns, and it is common for patients to have similar names or birth dates. Further, human error can lead to mistyped information.
Imprivata, a healthcare IT security company, introduced Imprivata PatientSecure® as a comprehensive solution. Imprivata PatientSecure is a positive patient identification solution that creates a 1:1 match between patients and their medical records based on patients' biometric identification. The solution is simple enough to be used at any point across the care continuum.
Imprivata PatientSecure offers multiple methods for biometric identification including palm-vein and iris scans. Providers can use the palm-vein technology in any workflow, including when the patient is unconscious. The iris technology allows a touchless identification process with single-step photo capture during enrollment.
Addressing some of the potential economic impacts of patient misidentification, the Imprivata solution proactively eliminates the creation of duplicate and overlaid medical records.
By integrating with a healthcare organization's ADT, EHR, kiosk, and EMPI systems, and eliminating duplicate medical records and overlays, Imprivata PatientSecure can help prevent medical errors and adverse events caused by misidentification. Additionally, the technology helps prevent medical identity theft.
"Industry-leading organizations employ technology, such as biometrics, to streamline the admission process and eliminate patient misidentification as well as the need for repeat proofing of a patient's identity," says Aaron Miri, CIO and vice president of government relations at Imprivata. "This focus on process, people, and technology will ultimately lead to a better patient experience and to higher reimbursement."
How Imprivata PatientSecure helped this hospital obviate risks
Community Hospital Anderson (CHA), a 207-bed licensed facility in Indiana, implemented Imprivata PatientSecure to boost financial performance and patient safety. Executives felt the hospital was exposed to various risks because it struggled to correctly identify patients.
"Patient identification is so important," says Beth Tharp, president and CEO of CHA. "It's the foundation of patient safety and quality." Moreover, whenever CHA misidentified a patient, the hospital lost money because of labor costs to rework the error and staff time to re-register the patient and re-do the patient record.
"Any time you impact care, it could be expensive, not just quality-wise, but from a litigation perspective," says John Harris, CFO of CHA. "You set yourself up for risk." CHA has been faced with the costly endeavors of sorting through duplicate medical records and handling stolen patient identities.
"Identity theft is very expensive; it's very labor intensive and a very sore spot in healthcare," adds Mr. Harris. "And those [patients] who get their IDs stolen are understandably upset with us; so we want to mitigate that."
Ms. Tharp emphasizes this critical aspect of patient trust and confidence in a healthcare organization. "If patients receive the wrong bill or they're registered incorrectly, they will question everything that we've done for them," she explains.
CHA's director of revenue cycle, Terri Rinker, agrees that hospitals' registering and billing processes have an outsized effect on patient trust. If patients can't rely on a hospital to complete tasks they view as simple, they won't have confidence in the hospital to perform complex medical procedures. As a result, proper identification impacts more than a patient's safety and a hospital's bottom line. It can make or break the relationship between a hospital and a patient.
To address its patient identification problems, CHA turned to Imprivata, whose mission is to enable healthcare securely by establishing trust between people, technology, and information.
"We really looked at this as a 'must have,'" says Mr. Harris. “We really feel passionately about [Imprivata PatientSecure], not just for quality reasons but also for confidence reasons, and for the cost of misidentification and duplicate medical records and identity theft. It's well worth the money and well worth the investment."
Conclusion
A hospital's health will suffer if patients' health is at risk due to highly preventable errors like misidentification. CHA believes investing in a patient identification solution like Imprivata PatientSecure positively impacts its bottom line while reflecting a commitment to patient safety and experience. CHA is one of more than 350 hospitals using Imprivata PatientSecure.
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