National Association of Healthcare Access Management Presentation.

1. Diminishing the Impact of
Duplicate Records and Fraud for
Patient Safety & Quality of Care
Your Logo

2. Agenda
1 Patient Access Personnel: Key Team Member
2 Objectives of Patient Access Personnel
3 Goal: MPI Integrity Management
4 Causes of Poor MPI Integrity
5 How Big is the Problem
6 What is the Impact
✓ What are Solutions
7
8 Simplicity to Succeed
9 HIMSS Information, Articles & Resources
Nancy Farrington, CHAM
Based in part with NAHAM Special Projects, Policy
Development and Government Relations Committees

3. Patient Access Personnel:
Key Team Member

4. Objectives of Patient Access Personnel
Requirements & Solutions Requirements & Solutions
1 2
 Accurately Identify every  Practice techniques for
patient to their Medical Record reducing the creation of dups
for each visit or procedure as well as techniques to
across the system identify & resolve them
 Continuing education of  Review the adoption of
common causes, complexity industry Technology for the
and impact of duplicates & automation of patient identity
overlays on patient safety and and registration processes
cost containment

5. Goal: MPI Integrity Management
One Patient Identity
Authenticate Accurately authenticate
1
Patient’s Identity
patients identity for each
One Medical Record
visit or procedure and
2 Always Link Patient to
Correct Medical Record correctly link patient’s to
Technology their medical record
Explore technology to
3 help manage one
unique patient identity
across the Enterprise
for enterprise access

6. Causes of Poor MPI Integrity
Human Factors
 Registration is challenging, staff turnover is high
1
 Poorly defined, un-enforced standards
 Emphasis on speed, throughput
 Insufficient training on impacts
Historical Information System Limitations
2  Poor patient query tools, insufficient error reporting
 Search results ambiguous, non-intuitive
 Corrective measures difficult to perform
Other Factors
 Past System/MPI Data conversions
3  Decentralized registration
 Reference Labs, “temporary registrations”

7. How Big is the Problem?
Duplicates/Overlaps cost
Duplicates and Overlaps $100 or more Overlays: Catastrophic
1 2 3
 Industry estimate 8% to  Time & materials  Risk of Clinical Error
12% of a hospital’s wasted by researching,  Potential
records are duplicates identifying & correcting confidentiality
 Rates may rise to 20% “on demand” (in breaches
or more for multiple downstream
systems)  Cost of litigation
organizations that have
acquired or merged  Duplicate testing
with other facilities  Delays in billing & A/R
 Your Organization? (72 hour rule)

8. What is the Impact
A Patient’s Perspective A Physician’s Perspective
 Registration Delays  45% routinely found duplicate
 Blood sample taken again for medical record numbers
repeat test  30% re-ordered tests due to
 Medication changed after inability to find results in record
organism ID’d on 2nd test  25% felt duplicate records
 Sick for additional 2 days— impacted the quality of care
missed work, lost wages they were able to deliver
 Need to clarify billing with  Lack of Confidence in your
insurance company organization
 Dissatisfied Patient

9. Techniques to Resolve
Duplicate Records, Overlays and Fraud
 Raise organizational awareness and propose solutions
Identify Process  Create corrective action plans and execute procedures
Improvements for  Identify common issues, document and educate
Targeted Areas  Analyze all calls (to Help Desk, Call Center, etc.)
 Utilize reports (Distribute auto and manual combine
reports to management and team on a regular basis)
 Research with your IT Department for technology solutions
Consider  Review Patient Identity Vendors using Biometrics* and/or
Utilizing Vendor Smart cards*
Products…  Schedule webinar & follow up on-site demonstrations
 Schedule site visits with vendor clients

10. Simplicity to Succeed
Using Procedures & Technoligy to Simplify Complicated Processes
Incorporate Implement,
Educate Procedures & Train and
Technology Measure

11. THANK YOU!
HIMSS Information, Articles and Resources in Following Slides.
This presentation is for educational purposes only.
Nancy Farrington, CHAM
Based in part with NAHAM Special Projects,
Policy Development and Government
Relations Committeesfarringtonn@mlhs.org
www.NAHAM.org

12. HIMSS
Patient Identity Integrity
PI Integrity is the accuracy and completeness of data
attached to or associated with an individual patient. Data must
be reliable, reproducible, and sufficiently extensive for matching
purposes.
Completeness refers not only to having adequate data
elements present but also the correct pairing or linking of all
existing records for that individual within and across
information systems. PI Integrity is of central importance to
achieving quality of care, patient safety, and cost control
2009 Healthcare Information and Management Systems Society (HIMSS)

13. HIMSS
Patient Identity Integrity
Because of its potential for impacting quality of care
and patient safety, patient identity management is a long
standing challenge in the health care organization,
provider office, or anywhere patient databases are
collected. The increasing penetration of technology into
the healthcare environment only exacerbates the problem.
http://www.himss.org/asp/topics_Piitoolkit.asp

14. Articles and Resources
 http://www.justassociates.com/Practice-Briefs.html
(AHIMA practice briefs -focus on MPI)
 http://www.azumc.com/body.cfm?id=872
(from University of AZ Medical Center – presented as method to
encourage wide reporting of duplicates)
 http://health-information.advanceweb.com/editorial/content/editorial.aspx?CC=151146
 http://www.himss.org/asp/topics_Piitoolkit.asp
 http://www.smartcardalliance.org/pages/smart-cards-applications-healthcare
 Information on Smart card industry within healthcare
 www.lifemedid.com
 Patient Identity, automated registration and Smart card vendor (White Papers, Support Materials)
Nancy Farrington, CHAM
Based in part with NAHAM Special Projects,
Policy Development and Government
Relations Committeesfarringtonn@mlhs.org
www.NAHAM.org