Trendsetter: Re-envisioning Patient Identification

Most healthcare organizations rely on registrars to register patients for care. These individuals ask patients for certain information, including their name, date of birth, and Social Security number, and then search for any corresponding patient records. Unfortunately, this approach lends itself to human error, and it can be common for staff to inadvertently select the wrong record, or, if they can’t find a patient, create a new record, leading to duplicates or overlays. “If registration is rushed, mistakes can happen,” says Sean Kelly, MD, chief medical officer for Imprivata. “Similarly, if a patient is confused or hard of hearing, or there is a language barrier, the chances of incorrectly gathering patient information also go up. Add this to the fact that there is a lot of turnover in the patient access and registration departments, and you could have a situation where there is a relatively inexperienced person performing a critical task that is prone to error.”

Fallout from a faulty process

About 10 percent of patients are misidentified when they present for care, including at hospitals, and these misidentification events can have detrimental consequences in terms of cost, quality, patient safety, and patient satisfaction. Take, for example, when a registrar unintentionally creates a duplicate medical record. “On the financial side, cleaning up a duplicate record requires someone from health information management to research the problem, find the duplicate, and correct the issue—and this can be quite costly,” says Carl Bertrams, vice president for Imprivata PatientSecure^®. “From a quality standpoint, a duplicate also increases patient safety risks because you are entering the patient’s clinical information in two different spots, and, thus, key patient details can be missed—potentially causing incorrect diagnosis, unnecessary treatment, inadvertent allergic reactions, and so on.”

The effects of overlays can be even more extreme. An overlay occurs when one patient is confused for another, and diagnosis and treatment information for the one patient is entered into the record of the other. “This can be a nightmare to undo, and everything from the costs of unwinding the problem to the potential patient safety issues makes overlays a serious concern,” says Bertrams. “A patient could receive the wrong medicine or be given one to which he or she is allergic, and there could be life-threatening complications. Moreover, an overlaid record could result in an insurance company thinking a patient has a condition like AIDS, diabetes, or high blood pressure when he or she does not, resulting in unnecessary treatment, medication risks, and HIPAA violations.”

In addition to the errors that occur during registration, patient medical information is also prone to identity theft and insurance fraud. “This issue can be complicated, time-consuming, and costly to resolve,” says Bertrams. “It can also negatively affect patients’ perceptions of the organization.”

Reimagining patient identification with biometrics

To mitigate the plethora of risks associated with poor patient identification, organizations must equip the people involved with better tools to do their jobs by engaging technologies that dramatically reduce the likelihood of error. “In this context, biometrics can be a game-changer,” says Kelly. “Organizations that implement these kinds of solutions can increase accuracy and speed while preserving safety and decreasing costs. Ultimately, they can elevate the positive quality of the patient encounter and boost patient and staff satisfaction. That’s a lot of downstream impact stemming from one change.”

Imprivata is on the forefront of using biometrics. Although the company is pursuing a variety of modalities, a key focus is palm vein technology.

A nearly foolproof system

Imprivata’s palm vein solution uses near-infrared light to read the vein pattern in the palm of a person’s hand and then creates a one-to-one link between the pattern and the patient’s medical record. “Note that this is not the palm print, but the subcutaneous network of veins in a person’s palm, which is unique to every individual,” says Bertrams. “The pattern is set at birth and doesn’t change across a person’s lifetime, making it more reliable than a fingerprint.” To use the technology, the registrar has a patient put his or her hand on a scanner, and within seconds the correct medical record pops up in the electronic health record (EHR).

One of the benefits of this system is that it’s virtually impossible to create a duplicate record or overlay,” says Kelly. “The technology has about a one in 10 million false positive rate, meaning it is essentially 100 percent accurate. Being able to have complete confidence in the data is a tremendous advancement, setting up the potential for significant cost savings and quality of care improvements.”

The technology is especially groundbreaking when it comes to identifying unresponsive or incoherent patients. “If a previously enrolled individual arrives at the emergency department and is unable to communicate for whatever reason, the hospital could bring this technology to the bedside, scan the patient’s hand, and immediately identify the person,” says Kelly. “This allows the treatment team to quickly understand the individual’s medical history, allergies, current medications, and so on, facilitating faster and more accurate care and avoiding mishaps.”

Because the individual’s palm must be present for the system to read it, it is nearly impossible to steal a patient’s identity. “If someone tries, the system flags the inconsistencies between palm vein patterns, raising an alarm for staff,” says Bertrams. “The vein pattern also is encrypted and stored as code—as opposed to as an image—further limiting theft.”

Although palm vein technology was originally developed for the banking industry more than 10 years ago, the healthcare applications for it have gained momentum only recently. Imprivata has been leading the way in deploying biometrics in health care, specifically with regard to positive patient identification.

Leveraging an acquisition they made in 2015, the Imprivata PatientSecure division piloted the use of palm vein biometrics with a large independent delivery network in the Southeast. “Prior to the implementation of PatientSecure, the network experienced a duplicate medical record rate ranging from 4 percent to 8 percent. At its best, that was still 40,000 duplicate records per million,” says Bertrams. “Now, fast-forward to today with millions of patients having voluntarily enrolled their palm veins in the system, the duplicate medical record rate has dropped to a fraction of 1 percent.”

Imprivata is uniquely suited to bring biometric technology to health care. “Whereas companies introducing similar solutions have come from other industries, Imprivata is a healthcare company first, so we bring a unique perspective to the table,” says Bertrams. “Because of our revenue cycle experience, we have been able to co-develop user-friendly interfaces with several major EHR vendors. We work in concert with technology that a hospital already has in place, allowing us to enable a better user experience. We also have an emergency department doctor among our executives who leads a team of clinical workflow specialists, all of whom bring a deep understanding of hospital workflows and the challenges faced by clinicians in treating patients.”

Committing to long-term innovation

Imprivata plans not only to expand the reach of palm vein technology, but also pursue other modalities. “One area we’re planning to explore is smartphone technology because that is the direction in which the industry is going,” says Kelly. “Although it’s still in the early stages, this eventually may involve scanning people’s photo IDs, using facial recognition, and so on. Ultimately, Imprivata is committed to a variety of solutions that enhance the consistency and reliability of patient identification. Our goal is to offer different options that support and enable all manner of healthcare workflows.”

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About Imprivata

With deep knowledge about healthcare operations and extensive technology experience, Imprivata is transforming the process of patient identification, leveraging next-generation biometric solutions to ensure accuracy and improve efficiency.