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Despite EHR, Patient ID Problems Persist

Scott Mace, for HealthLeaders Media, July 31, 2013

A number of providers have turned to smart cards to solve the patient ID problem.

"It looks like a credit card, but it actually has a memory chip in the card," says Lawrence Carbonaro, director of patient access, purchasing, and HIM at Memorial Hospital, a 25-bed critical access hospital in North Conway, N.H. "You also have the patient's photo on the card, so when a patient presents anywhere [in the hospital], they have to have the card." A card swipe opens up the correct patient's EHR. "We have not had instances of anybody with a card where we've misidentified them by pulling the wrong medical record," Carbonaro says.

If patients forget their card, they can still register once they provide answers to pertinent questions. When it was installed in 2009, accompanied by smoother workflow processes, Memorial Hospital was about to reduce its headcount by 6.5 full-time equivalents, Carbonaro says.

Larger systems are also opting for smart cards. The Nashville-based Vanguard Health Systems operates in cities such as San Antonio, Chicago, Detroit, Boston, and Phoenix. A few of the company's markets are using LifeMedID, the same smart card technology Memorial Hospital uses, with plans to expand to other markets.

Since deploying the smart cards a year ago, nearly 22,000 patients in ambulatory service settings between the two Texas cities of San Antonio and New Braunfels use it, while Vanguard builds a new hospital in town, reaping the benefits of less overhead needed for ID matching, says Roderick Bell III, CIO of Resolute Health, a clinical integrated health and wellness enterprise owned by Vanguard that currently has a network of 150 physicians.

"I've been working with Life-MedID for maybe a year and a half, and I haven't had one duplicate record," Bell says. "I haven't had one patient identity theft, and I'm here in south Texas, where that happens a lot."

Vanguard is integrating LifeMedID technology with its EHR with the help of Allscripts, the EHR vendor, Bell says. "They love the idea that there's a card that will allow them their one-source solution, their Sunrise solution, meaning that there's one record in ambulatory, there's one record in acute care, throughout home health—everything is on one record. This card takes that to another level," he says.

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2 comments on "Despite EHR, Patient ID Problems Persist"


John Trader (8/1/2013 at 10:48 AM)
Although this is an informative article, it contains inaccuracies about the use of biometrics for patient ID in healthcare. First, the healthcare industry is not using fingerprinting and retinal scans for patient ID. Fingerprinting brings too much of a stigma of criminality for it to be a viable modality plus it requires physical contact with a hardware device which doesn't bode well for infection control in a hospital setting and retina scanning is too invasive and expensive to use as a means of identification. I think that perhaps what Scott meant to say was iris recognition biometrics, which is in fact being used by many hospitals across the country. Second, he mentions the use of palm vein biometrics for patient ID in the context that it is a biometric identification solution that will uniquely identify a patient which in fact, it is not completely. Palm vein biometrics rely on what is called 1:Few segmented identification which means that when a patient enrolls, and then is subsequently scanned when they come back into a medical facility, the back end search does not encompass the entire EHR system, but rather a segmented list of patients. This is not a true way of eliminating duplicate medical records and preventing fraud and medical identity theft at the point of service. When you mention biometric technology, it is vital that a factual explanation of the science behind the technology is properly presented so there isn't a continual perpetuation of misinformation and health care facilities can make educated decisions on what technology is the most appropriate to invest in. It's unfortunate that proper research and due diligence on biometrics wasn't conducted for this article, and what would have been more appropriate is not to even have mentioned biometrics at all if it isn't accurately described.

flp (7/31/2013 at 12:26 PM)
Great piece...and one of the reasons why systems in health care are more costly and complex. This issue first came up when hospitals installed IBM 1440 computers, circa 1960. And what if the patient uses an alias? Or shows up comatose in the ER? The real price (to the public) of a true EHR that can follow you everywhere is a unique person identifier – using biomarkers, cards, whatever. ONC is big on continuity /coordination of care, yet has not even ventured into this quagmire with any MU criteria...wonder why? It's not a technical problem, it's a political problem. Not an issue for other countries, but here in the USA it's a non-starter. So we probably spend hundreds of millions on technology and human work-arounds in the name of privacy. Then blame healthcare organizations for 'wasting' money running inefficient uncoordinated systems. And don't blame the vendors. As a former vendor I can guarantee you that if the feds came up with a unique identifier every one of them would have it in their system in a week. I have been in the HIT world for over forty years and I will say if you can 'solve' this one, you could knock an easy 2% of the cost of healthcare. Funny everybody wants it, but nobody is willing to 'pay' for it. Frank Poggio The Kelzon Group