Northwell Health launches an iris recognition technology with the hope of enhancing the patient experience.
This article appears in the January/February 2019 edition of HealthLeaders magazine.
In the not-too-distant future, patients entering Northwell Health facilities will be recognized and logged into the system before they are ever greeted by a human, touch a computer keyboard, or handle a piece of paper. Northwell anticipates that with biometric facial recognition technology there will be minimal need for data entry or exchange, offering the potential to enhance the patient experience.
One of the primary reasons hospitals explore biometric technology to identify patients is to reduce duplicate patient records, a pervasive conundrum, which costs large systems like Northwell millions of dollars each year to rectify. Duplicate records also pose patient care and safety issues, cause unnecessary testing when providers are unable to access a patient's complete record, and delay reimbursement.
Northwell has already taken the first steps to deploying the technology behind this digital initiative. Earlier this year, at two practice locations, it tested a system that takes high-resolution photos of patients and uses iris recognition to match patients to their record on subsequent visits. Throughout 2019 the biometric solution will roll out across 600 practices in the 23-hospital system based in New York.
While biometrics represents a significant leap into a new era of identity management, what is less obvious is that it does not replace the need for backend patient record matching—a process that will diminish but will continue to remain necessary for a number of years.
Keely Aarnes, PMP, associate vice president of revenue cycle management at Northwell Health and the vendors behind the initiative, explain why there is a need to combine biometrics with patient record matching and the value this solution brings to the process.
If you are thinking about implementing biometric technology to help with patient identity, here are four things you need to know:
1. Biometrics Improves Patient Experience and Protects Data Integrity
Biometrics is used in many industries for security, safety, and time loss prevention, and it is now making inroads in healthcare. Just as fingerprints are unique to an individual, so are other physical characteristics, such as the iris of the eye, palm vein patterns, and the face. The technology takes images or scans of these identifiers and then uses machine learning or artificial intelligence to recognize the individual in subsequent encounters.
Hospitals are exploring which modality works best. Northwell selected RightPatient, an Atlanta-based company. The platform is able to recognize patients through a number of different modalities, including the iris and palm vein. The health system launched its program by taking high-resolution photos of the face, including the iris. Initially, it is using the iris to recognize patients, but the system also offers the opportunity for Northwell to evolve into facial recognition. The health system is in the process of setting up a pilot to test that capability.
"It's just one click with multiple uses," says Aarnes. "Once you're enrolled in RightPatient, we should be able to pick up your facial image by tapping into a webcam or CCTV as you present to the practice. There are many other uses if we send it all downstream to our EHRs." One potential use: Physician have expressed an interest in being able to access a picture of the patient before each encounter, she says, and this would fulfill that need.
Looking at the bigger picture, resolving patient record matching issues also protects data integrity, says Michael Trader, co-founder of RightPatient. "Healthcare providers, especially larger providers like Northwell, for example, are investing large sums of money in areas like big data analytics and population health," Trader says. "These platforms rely heavily on the quality of data that's fed into them. When that data becomes corrupted because of mistakes that happen on the front end of the process, then you dilute those investments. At the end of the day [biometrics] is a platform that helps ensure higher levels of data integrity, which helps to keep those other large-ticket investments and increases the value that you're getting from platforms that rely on that data."
2. Biometrics Will Not Eliminate the Need for Patient Record Matching
While biometrics address numerous needs, in the near-term it only partially eliminates duplicate patient records.
Mark LaRow, CEO of Verato, which performs referential patient record matching for Northwell to resolve record duplication, explains why: "It's indisputable that biometrics are an important part of the identity strategy," says LaRow. "The conclusion hospitals might jump to is that it solves the identity problem. It only solves half of problem. There's a 50% probability that even if you capture the person's identity at the moment of presentment with biometrics, you still might fail to map it [correctly] to their medical records."
The new biometric record must be matched to multiple legacy records that exist within the health system, including the pharmacy, laboratory, the emergency department, the billing system, and more.
"It'll take a couple of years to be able to really start to leverage the full capabilities of biometrics," says Aarnes. "It's quite an investment of time, capital resources, operational workflow, and change." She sees patient identity and management of patient identity as "two separate and distinct things. We're using biometrics to help us identify you as a person, but we still have to be able to link that biometric accurately to your master patient number, which goes across our enterprise."
LaRow estimates it will take a generation—at least 20 years—before the current form of patient record matching is no longer needed because once current patients are fully integrated into a hospital system's records, others will continually migrate and transfer from other hospital systems. Ongoing merger and acquisition activity will create further demand. Eventually, he says, the need to match patient records will be replaced by a need to match biometric numbers and other identifying numbers across the healthcare industry.
3. Biometrics Saves Money
Meanwhile, whittling away at the duplicate records over time results in a significant return on investment. Aarnes estimates that Northwell has to address about 650 duplicates a day across the organization. Half of those are resolved through automated processes; the other half has to be manually addressed at a cost of about $100 per record, according to industry standards, says Aarnes. Referential matching through Verato has sped up the process, dropping staff research time from about 107 seconds to about 17 seconds per record.
"We're really getting good at cleaning [duplicate records] up, but we want to get into the business of prevention," she says. "If we can link a patient record to their biometric, we hope in the future we're not creating those duplicate or erroneous records because we're able to recognize a patient's identity accurately from the beginning."
4. Biometrics Has Broader Implications
Fraud prevention is another problem that biometrics addresses. This is particularly a problem in emergency rooms, says Aarnes, where one patient might attempt to use another identity to obtain medical service. It also will limit activity related to narcotic-seeking patients who may assume another person's identify to obtain drugs.
In addition, there are much broader implications, related to enhancing the digital experience.
"Northwell is in the middle of a large digital transformation," says Aarnes. "Today, you have to stand in line, register, and write your name on a clipboard. Tomorrow, we'll know a patient has arrived before they've even spoken to somebody because we've picked up on their facial image. That's game-changing. It really changes the way we look at healthcare; it becomes more of a concierge service. We'll welcome you before you've even told us who you are." In addition, biometrics also will prove helpful as patients more frequently connect with providers through apps and virtual care services.
Mandy Roth is the innovations editor at HealthLeaders.
Photo credit: Shutterstock
Biometrics offers an opportunity to enhance the patient experience.
The need for patient record matching will not go away for at least a generation.
These solutions help ensure data integrity and increase the value of investments in population health and data analytics initiatives