patient identity and digital record matching: a new approach · 2016. 2. 19. · big data...
TRANSCRIPT
Patient Identity and Digital Record Matching: A New Approach
March 1, 2016
Tess Coody, CEO, Tenet Health
Roderick Bell, CIO, Tenet Health
Conflict of Interest
Tess Coody-Anders, CEO, and Roderick Bell, CIO have no real or apparent conflicts of interest to report.
Agenda
1. The Topic: An identity-centric, credential-based approach
2. Method of Analysis
3. The Problem: Mismatching, misidentification and fraud
4. Impact on Healthcare
5. Recommendations
Learning Objectives
• Learning Objective 1: Identify the negative impacts of the current
misidentification and mismatching problems in healthcare, such as
poor patient care, inconvenience for patients and providers, and
lack of patient safety
• Learning Objective 2: Evaluate the use of strong credentials for
fraud reduction based on their ability to strengthen transaction
processing and eliminate vulnerabilities in the healthcare payments
system
Learning Objectives
• Learning Objective 3: Initiate change in the way the U.S.
healthcare system identifies patients and manages care by
implementing an identity-centric, credential-based patient matching
and identity management model
• Learning Objective 4: Summarize the methods and solutions that
the healthcare provider in the session used to address their identity
management issues
• Learning Objective 5: Appraise the success of the implementation
case study detailed in the session and the extent to which identity
management challenges were overcome
http://www.himss.org/ValueSuite
Satisfaction: The identity-centric, credential-based model is more
convenient for patients, simplifies admissions, reduces the risk of errors,
and saves patients time and money by avoiding redundant tests and exams
S
T Treatment: Improved patient identification will reduce redundant tests
and adverse events caused by misidentification
E Electronic Information/Data: Improved patient identification will reduce
redundant tests and adverse events caused by misidentification
P Prevention and Patient Education: Smart credentials can provide
simplified and more secure access to patient records, increasing
engagement by patients
S Savings: Smart credentials can help health care organizations save
billions lost each year due to fraud and medical identity theft
Saving Lives and Money: Interoperable, Digital Identity
• Identity-centric focuses healthcare systems and
processes around the accurate, reliable and repeatable
identification of the patient’s identity
• Credential-based means that a trusted digital device,
most likely an identity card or smart phone is used by
the customer to verify his or her identity to healthcare
providers
Creating an Interoperable Digital Identity System
Deterministic Interoperable
ID Tokens
Source: LifeMed ID
Why Does Identity Matter?
• Doyle Wesley Coody Jr. and Doyle Wesley Coody, III –
two people, one MRN
012345
Method Analysis
• Cross-Industry Collaboration
– Six years of analysis by collaborative of payers, healthcare and technology providers through Smart Card Alliance
• Compare and Contrast
– Healthcare versus Financial Services, Federal Government best practices
• Insights from Workgroups
– WEDI, Identity Ecosystem Steering Group, HIMSS Identity Management
The Problem
• Awareness of the scope and scale of problem
• Technology and functional silos across disparate
systems
• Wait-and-see attitudes
• Noisy healthcare environment with many priorities
Impact on Healthcare: Patient Safety
• 12 percent of U.S. health records mismatched1
• 19 percent of CIOs report adverse events resulting from
misidentification2
• 198K deaths annually (2010)3
• 10 out of 17 deaths due to “wrong patient” errors4
S T E P S
Sources
1. & 2. According to Michelle O’Connor, director identity and information governance, QuadraMed
3. & 4. Death Statistics, according to the IOM
Impact on Healthcare: Fraud
One SSN on the
Black Market:
$0.43
One healthcare
record on the
Black Market:
$50 S T E P S
Impact on Healthcare: Fraud and Waste
• $77 billion in
Medicare/Medicaid fraud and
improper payments
• $13,450 out of pocket costs to
victims
• Duplicate records cost average
hospital $500k to $2.5M
Source: Medical Identity Fraud Alliance (MIFA), 2014
S S T E P S
Impact on Healthcare: Patients
• 45 percent of victims said the
incidents damaged their
reputation
• 19 percent said it cost them
career opportunities
• 3 percent said it actually caused
them to lose their jobs Source: Medical Identity Fraud Alliance (MIFA), 2014
S T E P S
Impact on Healthcare: Patient Experience and Education
• Automated registration experience
• Increased privacy and safety
• Assurance that their doctor is accessing
their correct information
• Prevents redundant paperwork and
testing
• Easy auto pay
• Easy access to personal medical record
S T E P S
Breaking Down the Silos
Automate Workflow
using Provider’s
Current Software
Validate Patient, Token
Photo, PIN, Biometric 17
Medicare, Medicaid,
CHIP, Debit, HSA Patient ID and Data Exchange Portal™
Bridging EMS
with Patient
Data and ER
Source: LifeMed ID
Big Data &
Analytics
Home Health
Government Payers-
Insurance
Hospital
Clinic/Physician
Education
Interoperable ID Tokens and Data Shared Between
Disparate Groups
Financial iServices
iRetail
Smarter
Retail
Smarter &
Safer
Healthcare
Smarter &
Safer Cities Social
Business
First Responders
Smarter Communities
Source: LifeMed ID and IBM
http://www.himss.org/ValueSuite
The industry is ready, now
S
T
E
P
S
The utilization of a unique identifier is
realized in all subject matters within
STEPS™.
Operational and clinical change starts with:
1. Positive patient identification
2. Accurate record matching
3. Workflow automation
Case study: Avg. admission time
was reduced from 4 minutes to
less than 1 minute
Assures a minimum
accomplishment of an
LOA of 3
Case study: Reduced
duplicate errors from
7% to less than 1%
White paper: Enabled the hospital to
work with community and local retailers
to help change overall health
The operating budget impacted by
utilizing authoritative digital identity:
$1,837,917.33
Questions?
Tess Coody-Anders
210-884-8060
Roderick Bell
505-659-8947
Smart Card Alliance
800-556-6828