CMS Compliance Depends on Hospitals’ Patient Identification Methods

The COVID-19 pandemic has arguably been one of the biggest challenges the world has faced in recent times. It has been creating a lot of issues for everyone and almost every industry. While the biggest strain COVID-19 has caused is on the healthcare industries of the affected countries, it’s safe to say that the US healthcare system has been hit the worst. For instance, an overwhelming number of COVID-19 cases, huge losses due to the cancellation of elective procedures, and response rates impacted by issues like patient misidentification are just some of the consequences faced currently.

However, healthcare providers will have their hands full as they need to support e-notifications to ensure CMS compliance. While they might be already working towards that, many might overlook the fact that patient identification methods will make or break e-notifications. Let’s see what the rule is regarding e-notifications, how it will help with healthcare coordination, and how patient identification is required for it.

Patient Identification Methods

Checking patient identification – If you’ve been a follower of the US healthcare system, you probably know that interoperability is quite problematic. Interoperability refers to sharing patient information between healthcare facilities so that they can treat patients better, leading to better patient outcomes. However, that’s not the case for the US healthcare system. There are several reasons for that – one of the main ones are patient match rates, duplicate medical records, overlays, and the lack of an effective patient identity matching system. Fortunately, interoperability is getting a significant push.

The Centers for Medicare and Medicaid Services (CMS) have introduced some changes to the Conditions of Participation (CoPs) to boost interoperability and enhance coordinated care. Known as the “companion final rule”, it requires healthcare facilities such as acute care, psychiatric, as well as critical access hospitals to send out e-notifications during every admission, discharge, or transfer (ADT) event.

These need to be sent out to the other caregivers of the patients and is applicable for inpatient admissions and ED patients. Moreover, any caregiver using EMRs or EHRs needs to abide by this rule and have till May 1, 2021, to support e-notifications. With that out of the way, let’s take a look at how the rule will boost coordinated care efforts.

How E-Notifications Will Help Coordinated Care

Healthcare used to be much simpler and restricted by physical boundaries earlier. Patients went to their doctors, got treated, and that was it more or less. Nowadays, healthcare is much more complicated than that.

Patients can have one or multiple doctors or physicians treating them due to various illnesses and ailments. These caregivers may very well be spread out across different facilities. Since this has become a common practice, interoperability becomes a crucial part of coordinated care. With the newly introduced e-notifications, interoperability, as well as coordinated healthcare, will become easier. For instance, all the required caregivers of the patient will be notified during ADT events, making sure that everyone is getting appropriate and the most recent information regarding the patient. Thus, e-notifications will be significantly helping interoperability and coordinated care efforts.

Patient Identification

What caregivers are currently doing?

Since the announcement, caregivers, while busy with the financial and other strains that the pandemic is putting on them, are also planning on how to support e-notifications. While they are brainstorming whether to use third-party solutions or to build the solutions themselves, they might be overlooking one critical factor that will render e-notifications useless – patient identification. Let’s see how e-notifications are reliant on patient identification methods.

How patient identification methods impact e-notifications

As previously mentioned, patient identification has always been a significant problem for healthcare providers in the US. Even during the pandemic, misidentifications have been impediments – healthcare outcomes were adversely affected as misidentifications meant inaccurate patient data, informing wrong patients, and so on.

Experts are still demanding a universal patient identifier (UPI) to reduce patient misidentifications and enhance patient outcomes even during the pandemic. While that’s a topic for another day, let’s see how improper patient identification methods might lead to sending out wrong e-notifications or to the wrong caregivers.

Imagine this – patient misidentification is already common at a caregiver’s facilities due to various reasons. A patient comes in and the caregiver misidentifies the patient – someone else’s medical record is chosen. Naturally, the hospital will be sending out e-notifications to the wrong caregivers, creating a ruckus at every facility.

Moreover, these faulty e-notifications will create credibility issues for the caregivers that send them out. Delays in treatment, medical errors, and patient data integrity failures are just some of the common consequences of patient misidentification – these will be amplified when sending out wrong alerts. Thus, patient identification methods must include an effective way to identify patients.

Leading providers have integrated RightPatient into their patient identification methods

RightPatient is the industry’s leading patient identification platform. But what makes RightPatient stand out from the rest? Well, it uses a photo-based engine to identify patient records accurately from appointment scheduling and beyond – ensuring a hygienic environment by making the whole process touchless. After a patient schedules an appointment with their caregivers, they receive an SMS or email and are asked for a selfie along with a photo of their driver’s license. RightPatient matches the photos and ensures that the patients are who they say they are.

In the facilities, patients only need to look at the camera – the platform identifies them and provides accurate medical records within seconds. Prevent sending out false alerts, enhance coordinated care efforts, and ensure CMS compliance with RightPatient.

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Sophia Lee

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