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'Natural next step' for access: Biometrics
(Editor's Note: This is the second part of a two-part series on patient identification processes used by patient access departments. This month, we report on new biometric technology being implemented by a growing number of hospitals. Last month, we covered processes used to verify a patient's identity, the expected impact of healthcare reform, and involving patients in the process.)
Linking patients to their specific medical record is "an age-old problem," according to Katherine H. Murphy, CHAM, vice president of access solutions at Nebo Systems, a division of Passport Communications, an Oakbrook Terrace, IL-based provider of software and solutions to hospitals and health care providers.
"I have heard of patient access experiences which involved fraudulent use of identity, insurance information, as well as misidentifying a patient at admission," she says. "This can carry on throughout their entire hospital episode of care, including the unfortunate circumstance of an incorrect death certificate completed at the hospital."
Medication, treatment, and transfusions associated with this misidentification can be deadly, says Murphy, and using biometrics significantly reduces or eliminates these risks. There are many types to choose from, including fingerprint, finger vein, vein/palm, retinal, facial recognition, and voice recognitions.
"There are hybrids, too," says Murphy. "There was a time when we scoffed at telemedicine and use of kiosks, yet we don't any more. Biometrics is a natural next step in the technology evolution in patient access."
What is the cost to implement this new technology? David Wiener, president of HT Systems a Tampa, FL-based healthcare technology company, says, "In terms of a ballpark figure, if I'm a 200-bed hospital and have 15, 20, or 30 points of entry that I want to cover, you're probably talking about $100,000 to $150,000 as a one-time cost, with an annual maintenance fee beyond that."
The annual maintenance is based on the percentage of the license fee, from 16-20% per year, says Wiener. It covers hardware, software and interfaces, including full replacement of any biometric device, USB cables, hand-guides, or kiosks that might become defective and/or damaged. Registrars at ValleyCare Health System in Pleasanton, CA, have experienced no downside to implementing palm vein reader technology, according to Rogel B. Reyes, director of patient access services. "Patient wait times have been reduced," Reyes reports. "This has increased patient satisfaction and productivity in registration areas." Outpatient lab wait times of seven minutes or less increased from 75% in March 2009 to 92% two years later, he reports.
ValleyCare worked with HT Systems to develop the palm vein biometric technology that is being used in its patient registration areas: PALM (Patient Access Lifetime Match). Patients must provide a government-issued photo ID to be enrolled in the PALM system, Reyes explains. "This has reduced the number of duplicate medical records," he says. "It is particularly useful for persons in the same family who have the same name." Fathers and sons previously could be mistaken for one another, but this isn't possible with the palm vein reader, he says. "For authentication, patients provide their date of birth and place their hand on the scan box," says Reyes. "The medical record comes up on the hospital information system instantly."
Little training needed
The vendor conducted training onsite for two days, with most staff needing a 30-minute session to become proficient, says Reyes.
"Registrars are instructed on the process of scan enrollment and for subsequent scans," he says. "There is little ongoing or refresh of training needed. The system is very straightforward."
At Carolinas HealthCare System in Charlotte, NC, biometric scanning allows staff to easily identify patients on future visits after initial enrollment, says Lisa Grodevant, assistant vice president of patient access. "It has also helped identify red flag cases and patients who may be providing false information," she says.
Carolinas Medical Center-Patient Access Secured System was developed as a joint endeavor between Carolinas HealthCare System and HT Systems, and it uses Fujitsu's PalmSecure technology, says Grodevant.
The Master Patient Index (MPI) includes patients and guarantors from 12 facilities, which is about 7 million records, says Grodevant. "With an MPI this large, there are entries with the same name and date of birth even though they are two individuals. PASS helps us separate them."
Registrars discovered the similarities as a result of registration errors prior to the PASS implementation, she explains. If a patient changes their mind after they enroll, staff are able to remove the scan from the record quickly through the IT department. "Although infrequent, we do have patients decide after enrolling that they would like to be removed," Grodevant says.
Initially, some patients had concerns that the system was too invasive, Grodevant says. "However, over time they have become more and more accepting," she says. Their refusal rate, which is at 4%, continues to decrease.
Grodevant says that the most difficult part about the training is scripting. "Staff was initially uncomfortable requesting the enrollment," she says. "Once they realized the public was accepting, it became much easier." (See related story, p. 72, on marketing the new technology to patients.)
For more information on palm vein technology, contact:
Lisa Grodevant, Patient Access, Carolinas HealthCare System, Charlotte, NC. Phone: (704) 512-5401. E-mail: email@example.com.
Katherine H. Murphy, CHAM, Vice President, Access Solutions, Nebo Systems/Passport Communications, Oakbrook Terrace, IL. Phone: (630) 916-8818 Ext. 234. Fax: (630) 620-9328. E-mail: Katherine.Murphy@passporthealth.com.
Rogel B. Reyes, Patient Access Services, ValleyCare Health System, Pleasanton, CA. E-mail: firstname.lastname@example.org.
PalmSecure is a biometric authentication system based on palm vein pattern recognition technology. For more information, contact: Fujitsu Frontech North America, Foothill Ranch, CA. Phone: (877) 766-7545. E-mail: PalmSecure.email@example.com. Web: http://us.fujitsu.com/palmsecure.
PatientSecure links a patient's biometric palm vein pattern to their medical record in any health information registration or electronic medical record system. For more information, contact: HT Systems, Tampa, FL. Phone: (888) 224-6359. E-mail: Sales@PatientSecure.com. Web: www.patientsecure.com.