Patient Misidentification: Just How Damaging Is It?

We have seen a lot of talk about how patient identification errors are harmful, why they happen, and how they take place. Today, let’s look at the numbers that will demonstrate just how big of a problem patient misidentification is for any given healthcare system and why everyone is clamoring for a solution to end it.

Some statistics

Let’s start right off the bat- according to a report in 2016, a whopping $17.4 million is lost by any given healthcare system per year due to denied claims, resulting from patient identification errors. The report furthermore states that 30% of the claims are usually rejected on average, and out of that number, 35% arise from patient misidentification or insufficient patient information. All of these lead to negative cash flows and have a detrimental effect on accounts receivable days.

What are the causes and problems?

According to an official from Certified Healthcare Access Manager (CHAM), delayed payments, claim denials, as well as potential appeals, take place as a result of patient misidentifications due to the usage of nicknames rather than legal names which were used during the registration for insurance. But that is not all- these duplicate records can sometimes force patients to undergo the same tests repeatedly just because the previous ones were recorded with a different identity. However, the insurance providers do not pay for the tests the second time, as they have already paid for them once, resulting in losses.

That is not where all the problems end for the healthcare system, unfortunately. They also have to pay a significant amount of money for each error correction as per the American Health Information Management Association (AHIMA) Foundation. These multiple records for an individual patient are known as overlaps and cause, on an average, $1000 to rectify. To make matters worse, overlays occur when there are two patients’ records combined instead of one, and these cost almost an eye-watering $5000 to correct as it requires a tremendous amount of time and effort to sort through data to correct these.

What can be the remedy?

CMS offers some samples of how to prevent misidentifications, which will help to maintain clean data for future use in its SAFER Self-Assessment Guide.

While a new record is being made, an algorithm for phonetics should be utilized to show a notification if the record already exists or if a patient with matching demographic data is available in the database.

While searching for a patient, the results can sometimes show there are multiple records with similar data available. During such occasions, the names should be displayed while highlighting the common demographic data.

If some demographics match, the system inspects for data like nicknames, altered last names due to marriage, separation, etc. or adoption.

A notification can provide other relevant information which the user, with the help from the patient, can use to deduce whether it is the same individual or not.

All this is fine, but it still is time-consuming, and the hospital employees are already inclined towards saving time by creating duplicate records. There is no guarantee that the staff will not do the same in this case, as these will take some extra steps.

Conclusion

A biometric patient identification system like RightPatient seems to be the perfect solution to all these problems. Healthcare systems, with the help of RightPatient, can very easily and quickly identify the right patient at the required time to ensure the smooth flow of the healthcare processes and enhance the patient experience as well as cut down costs, saving millions in doing so. Iris scanning ensures that it is safe, as no physical contact is required, thus ensuring patient safety as well. A lot of hospitals are already using RightPatient and are very satisfied with the results along with their patients, as it frees up time to focus on the most critical aspect- proper care of patients themselves, creating a win-win solution for all parties involved.