Maria Garcia was causing trouble in Texas. Not the person—the name. The Harris Health System in the United States’ Harris County had 2,833 Maria Garcias in its system, 528 of whom shared a birthday. It's not an isolated problem—matching patients to their actual records is growing more difficult for healthcare providers. And the consequences can be deadly: A patient may be administered the wrong medicine or even the wrong surgery.
Hospitals have long struggled to mitigate the issue, and recent trends are making the problem worse. Hospital mergers are expanding provider networks, creating even bigger databases. As patients move around or visit different providers, the chance for duplicate records—one individual having multiple versions of their record—increases, making it possible for large providers to have in excess of hundreds of thousands of duplicate records.
In response, hospitals have launched projects to implement biometric technology—including fingerprint, iris and palm vein scanners—for identification. In March, the Medicover Hospital in Warsaw, Poland became the first in the nation to implement biometric signature recognition. Imprivata, a provider of biometric systems, completed 23 biometric healthcare projects globally last year and has more underway.
“If you consider the very real risk to patient safety when duplicate records are created, this has the potential to save lives,” says Jack Cole, administrative director of IT, CoxHealth, Springfield, Missouri, USA. In February, CoxHealth, which partnered with Imprivata, introduced palm vein scanners across five of its six hospitals and most of its clinics. This was part of a project initiated in 2017 and scheduled to be completed later this year.
—Jack Cole, CoxHealth, Springfield, Missouri, USA
But for these projects to be successful, organizations need to get internal stakeholders on board to ensure patients will use the new technology.
Safe and Secure
While privacy concerns have hindered past efforts to establish similar patient identifiers, the growing ubiquity of biometric identification in everyday transactions, such as unlocking smartphones, is giving this latest batch of projects a greater chance.
“It's encouraging that people are becoming more comfortable with biometrics. Any issues they have are addressed with the project teams, which have systemized the process of implementation and put clear methodologies in place,” says Ed Ferguson, manager, PatientSecure Services, Imprivata, Lexington, Massachusetts, USA.
The major challenges remaining for project teams are coordinating the many stakeholders involved in the complex and far-reaching projects, and ensuring their buy-in. “Many hospitals outsource system management to a third company, so coordinating three teams becomes more of a challenge. We also need to deal with many departments within the hospitals, and getting each to agree on workflow changes can take time,” Mr. Ferguson says, noting that project delays can ensue when hospitals do not prioritize the projects and assign them sufficient staff.
Internal adoption by hospital staff is essential, as nearly all biometric systems are voluntary. It's up to front-line staff to encourage patients to use them, an issue CoxHealth struggled with initially.
“The single biggest challenge relates to hardwiring the process with the registration staff, who are frequently the touch point for registering patients in the system,” Mr. Cole says. “Because many of the staff didn't initially recognize the seriousness of the problems we are striving to prevent, some weren't proactively educating patients on the benefits of participating. In fairness to them, if they don't understand the importance, it seems we are just giving them more work.”
In addition to learning modules and on-site training for staff, Mr. Cole said the project team implemented continuing education, manager follow-ups and flyers to encourage staff adoption. On the education side, for instance, the team created online education to help the registration staff learn how to use the application, he says. “These things were planned in the initial rollout but were emphasized more as the project progressed. I don't think we realized how much they would be needed.”
Duplicated medical records come with high costs.
average portion of a healthcare provider's patient records that are duplicates
The average expense of repeated medical care because of a duplicated record:
per patient per inpatient stay
per emergency department visit
Source: Black Book Research, 2018
As more hospitals adopt these systems, Mr. Cole foresees another challenge: getting these proprietary systems to talk to one another. When patients visit hospitals owned by different companies, they can still face hurdles related to disconnected records.
For now, though, CoxHealth's project has seen staff better understanding the importance of the biometric process, with the net effect of more patients getting enrolled in the biometric system. So far, about 75,000 patients have joined, Mr. Cole says. “Staff has to understand the ‘why’ before it becomes hard-wired into their process.”—Ambreen Ali