Diminishing the Impact ofDuplicate Records and Fraud forPatient Safety & Quality of Care You...
Agenda1 Patient Access Personnel: Key Team Member2 Objectives of Patient Access Personnel3 Goal: MPI Integrity Manag...
Patient Access Personnel:Key Team Member
Objectives of Patient Access PersonnelRequirements & Solutions Requirements & Solutions1 ...
Goal: MPI Integrity Management One Patient Identity Authenticate Accurately authenticate1 Patient’s...
Causes of Poor MPI Integrity Human Factors  Registration is challenging, staff turnover is high1  P...
How Big is the Problem? Duplicates/Overlaps costDuplicates and Overlaps $100 or m...
What is the Impact A Patient’s Perspective A Physician’s Perspective Registration Delays  ...
Techniques to Resolve Duplicate Records, Overlays and Fraud  Raise organizational awareness and prop...
Simplicity to SucceedUsing Procedures & Technoligy to Simplify Complicated Processes Incorpora...
THANK YOU! HIMSS Information, Articles and Resources in Following Slides. This presentation is for ed...
HIMSS Patient Identity Integrity PI Integrity is the accuracy and completeness of dataattached to or ...
HIMSS Patient Identity Integrity Because of its potential for impacting quality of careand patient sa...
Articles and Resources http://www.justassociates.com/Practice-Briefs.html (AHIMA practice briefs -focus on MP...
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National Association of Healthcare Access Management Presentation

National Association of Healthcare Access Management Presentation.
Published on: Mar 3, 2016
Published in: Technology      Health & Medicine      Business      
Source: www.slideshare.net


Transcripts - National Association of Healthcare Access Management Presentation

  • 1. Diminishing the Impact ofDuplicate Records and Fraud forPatient Safety & Quality of Care Your Logo
  • 2. Agenda1 Patient Access Personnel: Key Team Member2 Objectives of Patient Access Personnel3 Goal: MPI Integrity Management4 Causes of Poor MPI Integrity5 How Big is the Problem6 What is the Impact✓ What are Solutions78 Simplicity to Succeed9 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 PersonnelRequirements & Solutions Requirements & Solutions1 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 authenticate1 Patient’s Identity patients identity for each One Medical Record visit or procedure and2 Always Link Patient to Correct Medical Record correctly link patient’s to Technology their medical record Explore technology to3 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 high1  Poorly defined, un-enforced standards  Emphasis on speed, throughput  Insufficient training on impacts Historical Information System Limitations2  Poor patient query tools, insufficient error reporting  Search results ambiguous, non-intuitive  Corrective measures difficult to perform Other Factors  Past System/MPI Data conversions3  Decentralized registration  Reference Labs, “temporary registrations”
  • 7. How Big is the Problem? Duplicates/Overlaps costDuplicates and Overlaps $100 or more Overlays: Catastrophic1 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 proceduresImprovements 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/orUtilizing Vendor Smart cards* Products…  Schedule webinar & follow up on-site demonstrations  Schedule site visits with vendor clients
  • 10. Simplicity to SucceedUsing 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, CHAMBased in part with NAHAM Special Projects,Policy Development and GovernmentRelations Committeesfarringtonn@mlhs.orgwww.NAHAM.org
  • 12. HIMSS Patient Identity Integrity PI Integrity is the accuracy and completeness of dataattached to or associated with an individual patient. Data mustbe reliable, reproducible, and sufficiently extensive for matchingpurposes. Completeness refers not only to having adequate dataelements present but also the correct pairing or linking of allexisting records for that individual within and acrossinformation systems. PI Integrity is of central importance toachieving quality of care, patient safety, and cost control2009 Healthcare Information and Management Systems Society (HIMSS)
  • 13. HIMSS Patient Identity Integrity Because of its potential for impacting quality of careand patient safety, patient identity management is a longstanding challenge in the health care organization,provider office, or anywhere patient databases arecollected. The increasing penetration of technology intothe 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

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