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Analysis

If You Can't Properly ID Your Patients, You Can't Properly Bill Them

By Alexandra Wilson Pecci  
   August 31, 2018

Mobile phones and apps may help improve healthcare record matching.

Mobile technology, like phones and smartphone apps, may help to ensure that patient medical records are matched correctly when shared between healthcare providers, according to a new RAND Corporation report sponsored by the Pew Charitable Trusts.

Exchanging healthcare data electronically has its advantages, but its value is lost when the data that's shared is incorrect. Mixing up patient details, like phone numbers and the correct spelling of names, is costly to hospitals.

For instance, 33% of all denied claims result from inaccurate patient identification or information, according to April 2018 Black Book data. That cost the average hospital $1.5 million in 2017 and the U.S. healthcare system over $6 billion dollars annually.

The Black Book data also showed that the average expense of repeated medical care because of duplicate records cost an average of $1,950 per patient per inpatient stay and more than $800 per ED visit.

RAND researchers were tasked with investigating patient-empowered approaches to record matching. They looked at several approaches, such as creating a voluntary national identifier, incorporating biometric data, and using health record banks.

They found that the wide saturation of mobile phones and smartphones might provide a solution.  

For instance, mobile phones might be used to verify a patient's phone number with providers. Apps could be part of a check-in process before a medical appointment to send patients updated identity information.

The researchers recommend a three-stage solution. It includes:

  • Developing, pilot testing, and refining technical specifications for verified data fields, and establishing best practices that allow healthcare providers to verify mobile phone numbers
     
  • Developing, pilot testing, and refining application programming interfaces and best practices for establishing bidirectional communication between a smartphone app and healthcare provider registration systems at the point of care
     
  • Developing advanced app functionalities to further improve record matching and increase the value of apps to patients and providers
     

The RAND researchers also say additional efforts to improve record matching are needed, including establishing or designating an organization to oversee national progress in record matching and conducting more rigorous research into why record matching errors occur and how severe the problem is.

They also call for creating ways for healthcare providers to objectively benchmark their record-matching performance.

Alexandra Wilson Pecci is an editor for HealthLeaders.


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