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Patient Identification in Healthcare with Nancy Farrington, CHAM, EMPI Administrator – HIM, Main Line Health System

Topics Covered in Podcast:

The #1 challenge in patient identification

Patient identification’s role in patient safety strategies

Real risks of patient misidentification

What can be done to prevent patient misidentification?

Patient Identification issues across health information exchanges

• No established standards on what to use for patient ID• Lack of consistency on how patient ID data is collected• Public perception that they don’t have to present ID when

accessing healthcare

#1 Challenge in Patient Identification

Key Points:

Did you know?

Nancy Farrington has over 30 years of experience in patient access and served on NAHAM’s board of directors.

Patient Identification’s Role in Patient Safety Strategies

• Joint Commission standard for 2 patient identifiers only applies to in-house patients (small subset of patient population), not at the point of registration

• Healthcare Information & Management Systems (HIMSS) working on developing positive patient ID documentation

• Congress is investigating the possibility of creating a uniform patient identification card among other options

• Clear lack of patient identification standards hampering industry• Accurate patient identification is essential in patient safety

Patient Identification’s Role in Patient Safety Strategies

(continued)• College of Healthcare Information Management Executives (CHIME) recently conducted study that 19% of hospitals that participated had an adverse patient mismatch in past year

Did you know?

Healthcare fraud is estimated to cost between $70 billion and $255 billion per year which

accounts for between 3% and 10% of total healthcare costs. – The Ponemon Institute

Risks and Costs of Patient Misidentification/Duplicate

Medical Records

• Conservative industry estimates indicate that duplicate medical records cost approximately $20 - $25 per duplicate for remediation

• Many believe that the cost of duplicate medical records are higher for healthcare than losses related to medical identity theft

• Patient misidentification sometimes leads to unnecessary additional testing & duplicate patient care that insurance won’t cover

• Time lost by patient and provider is often overlooked as a consequence of patient misidentification & duplicate medical records

• Lawsuits & loss of confidence by community are additional costs and risks borne by patient misidentification and duplicate medical records

Risks and Costs of Patient Misidentification/Duplicate

Medical Records (continued)

Did you know?

Accurate Patient Identification has been number

one on the list of the Joint Commission’s Hospital National Patient Safety Goals since 2003.

Duplicate Medical Records – Is Healthcare Addressing the

Issue?• Clearly not getting the attention it deserves• Issue may reach critical mass within next year partly because of push

to electronic medical/health records (EHR/EMR), healthcare information exchanges (HIEs), and Meaningful Use

• At the end of Meaningful Use round 2 is when many expect duplicate medical record issue to become more prominent

Did you know?

Healthcare fraud continues to be the top category for

arrests and convictions each year according to the Coalition Against Insurance Fraud.

Results of NAHAM’s Study on Duplicate Medical Records

• Conducted in 2008• Focused on contributing factors to duplicate medical records & what

is being done to prevent and resolve them, not the cost• More than 200 respondents• Respondents categorized into high and low performers:

• High performers – Those having less than 2% duplicate rate in MPI

• Low performers – Those having greater than 6% duplicate rate in MPI

• Most healthcare organizations underreport the number of duplicate records in their system

Results of NAHAM’s Study on Duplicate Medical Records

(continued)• What characteristics distinguished high performers from low

performers for patient data collection?• High Performers

• Collecting patient social security numbers• Collecting patient address & telephone number• Collecting other names and aliases

*(If you can check on previous variations of people’s names, you will have a higher patient match rate)

• Low Performers• Had higher rate of patient ID errors and problems found by

nursing and clinical departments (more expensive to resolve patient misidentification)

Results of NAHAM’s Study on Duplicate Medical Records

(continued)

• One conclusion from study is that the more data elements that are required during patient ID process, less likely that an error will occur

• Future studies will include more in-depth analysis on what types of technologies facilities are using (for example, biometric patient identification) and how this will impact the results

• Nancy predicts that more hospitals will use biometrics for patient ID in the future, helping to boost adoption and acceptance

• Organizations that have multi-disciplined approach to educate staff & resolve duplicates are more successful than those who delegate responsibility to strictly one department

Conclusions

What can be done to Prevent Patient Misidentification?• Adopting new technologies to assist in the patient ID process

• Examples• Smart cards• Biometrics• Advanced probabilistic matching software

• There is long term return on investment (ROI) for technology upgrades

Did you know?

Nearly half of all medical identity theft victims lost their health care coverage and only 10% of all medical

identity theft victims’ incidents were completely resolved. - The Ponemon Institute

What are Main Issues for Patient Identification Across

Health Information Exchanges (HIEs)?• Information is being exchanged without available contact

(conversation) with the patient for confirmation – i.e. electronic data exchanges will require more matching data points

• Size of database increases chances of misidentifying patients and creating duplicate medical records

• Patient access to data will uncover more identification errors and duplicate medical records

Thank you to Nancy Farrington for lending us her time and knowledge for this podcast!

John TraderPR and MarketingM2SYS Technology

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