Universal patient identifiers can safely enhance efficiency to connect patients to their healthcare records. Although, many patients evade the anguish from adverse events due to a misidentification from the existing patient-matching technology, however misidentification in patients can have inflated financial ramifications to hospital systems. “Denied claims can become a huge waste of time and money for any practice manager; per a recent MGMA Connection article the average cost to rework a claim is $25. When you multiply that cost by dozens of denied claims, it quickly adds up”. (Taufen, A., MA., 2014). Moreover, organizations associated with healthcare risk squandering money due to patient misidentification consequently resulting in claim …show more content…
The following paper will debate and itemize how UPIs can judiciously enrich healthcare proficiency through its technology for patient information distribution. The paper will detail how a functioning UPI system will produce reduction in unnecessary cost to hospital systems, circumvent health record duplication, guarantee healthcare providers that they are handling patients with precise and modernized medical information, and expand interoperability and information sharing amongst health facilities. Additionally, strategies will be comprised as approaches to surmount barriers or healthcare stakeholder uncertainties. Universal Patient Identifiers and Connecting Patients to Health Information Universal Patient Identifiers encompasses assigning a personalized tailored number to individuals that will then be sourced to distinguish a patient within the entire U.S. healthcare network, pointedly this will permit patient data sharing. Sharing data amongst networks is sheltered through policies that unambiguously protect patient data. Protection of personal health information (PHI) is the foremost component in the healthcare industry. It is momentously obligatory to conform to the policies of …show more content…
Its determination is to associate patients to their data to improve the capability to generate a simplicity in sharing this data amongst the multiple health facilities patients visit. UPIs engendered by Electron Health Records (EHR) data can be manipulated by other healthcare systems including hospitals, pharmacies, insurance companies, patients, clinical research firms or diagnostic medical devices. These entities allocate data to be encapsulated, assembled, managed and then interconnected together universally. According to the article, Registries for Evaluating Patient Outcomes: A User 's Guide, “PIM has become crucial in order to (1) enable health record document consumers to obtain trusted views of their patient subjects, (2) facilitate data linkage projects, (3) abide by the current regulations concerning patient information–related transparency, privacy, disclosure, handling, and documentation,2 and (4) make the most efficient use of limited health care resources by reducing redundant data collection.” (Gliklich, R. E., & Dreyer, N. A., 2010). Currently, UPIs have previously become embedded into the U.S. healthcare system to some degree. An existing example of UPIs today are the medical numbers
With ICD-9 in place now in the health care industry there is a huge volume of fraud being committed in the coding and billing department. Patients are being over charged for procedures that cost half the price, or charged for procedures that were never performed on them. This is costing health insurance companies
Health Information Exchange Providers across the U.S. are turning to the Health Information Exchange also known as HIE. HIE provides secure online access to patients charts among a network of providers, hospitals, clinics, doctor’s offices, and pharmacies who join in the exchange, so they can have timely electronic access to records their patients will allow them to share. For patients this means having their medical records available no matter where they go and for providers it means having instant access to life saving information when seconds count
Since many health information infrastructure systems are relatively new, there is still variability in the implementation stages that different organizations have achieved. Additionally, most systems will have more than one capability that provides value, so the relationship between the system’s functionality and the resulting impact to patient care must be analyzed in order to determine the value it provides (Einstein, Juzwishin, Kushniruk, & Nahm, 2011). Value of health information infrastructures can be assessed in many different ways, including whether the technology allows the availability of useful information, how that information is utilized by staff and patients, and its impact on health outcomes. For information to be of value and influence medical decision making, it must be comprehensive, accessible, useful, and valid (Fitterer, Mettler, Rohner, & Winter, 2011).
The focus of this paper will be geared toward the impact that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Health Information Technology have on the cost of health care. The regulations connected to HIPAA have an impact on cost through enforcement, noncompliance, and implementation. HIPAA is a vital tool in the protection of PHI of patients and the improvement of the Medicare and Medicaid programs (Cleverly). Trying to contribute to the improvement of Medicare alone can be a daunting and expensive task alone, but to add the addition of protecting the health records of millions of patients adds to the rising cost. Health Information Technology (HIT), aids in the enforcement of HIPAA and helps with billing patients accurately for services that they have received (Wizemann).
There is No One-Size-Fits-All Electronic Medical Records (EMR) Solution Every medical organization has a unique rhythm and workflow patterns. That’s why best-in-class EHR software and PM solutions designed by healthcare professionals, for healthcare professionals offer superior functionality and flexibility to adapt in diverse environments. When physicians, clinicians and facility administrators actively participate in software design and development, the result is an electronic tool that supports efficient, productive administrative task management and improves patient experiences throughout the provider/patient relationship. MediPro Offers Best-Fit EMR Software Solutions Ideally, software features meet practice-specific needs while improving record accuracy, streamlining
Career Current Issue Current Issue Background HIPAA (Health Insurance Portability and Accountability Act), was put in place in 1996. It’s main objective, stated by McGowan (2012), is to “...improve continuity of health insurance coverage, combat health care waste and fraud, and simplify the administration of health insurance” (p. 61). The Privacy Rule was added in 2003; it protects demographic information, including individuals past/present/future condition, care given, payment information, their address, date of birth, etc. Therefore, nurses, doctors, and other health care providers must pay special attention to what they are sharing.
Therefore, security and protection is dictated by where the healthcare data is initiated within the healthcare delivery system. Futuristically, the concept of security and privacy is determined by where patient’s data begins which creates a huge question of how to protect data exchange since today’s healthcare is so patient centric. Presently, the healthcare community is promoting increased patient involvement in their care via technology such as patient portals. Furthermore, implementing HIPAA and HITECH can seem restrictive and cumbersome to the patient thereby creating opposing forces between two very important goals of the future healthcare system: increased patient involvement as well as increased healthcare information
This includes creating, managing and following patient data. The American Health Information Management Association (AHIMA) defines information governance as “an organization wide framework for managing information throughout its lifecycle and for supporting the organization’s strategy, operations, regulatory, legal, risk, and environmental requirements.” In today’s healthcare system, it is more important than ever to know and understand how healthcare information is created, transferred and used. Due to the development of systems such as electronic health records and clinical decision support systems it is important that health information maintains its reliability and validity throughout its
All individually identifiable health information (transmitted or held by a covered entity in any form, whether oral, electronic, or paper) is protected under TPR. This information under TPR is referred to as protected health information (PHI). “Individually identifiable health information” is information which pertains to: • The future, present, or past payment for the provision of health care to the individual which identifies the individual. Some examples of this include Social Security Number, address, name, address, and birth date. • The individual’s present or past mental or physical condition or
Introduction Since 1928, the American Health Information Management Association (AHIMA) has been at the forefront in improving healthcare information management. Health Information Management (HIM) is the practice of the acquirement, storage, and protection of crucial information concerning patients’ health and other personal data. Widespread computerization has introduced Electronic Health Records (EHRs), which has continued to replace the traditional paper-based records. AHIMA’s History and Mission
When using EHRs the focus on the total health of the patient is going far beyond the standard clinical data that is being collected when it comes to the provider’s offices and the patients care. Electronic health care (EHRs) are designed to collect and compiles of patient information. They are also built to share information with other health care providers, laboratories, and specialist so they can able to retrieve information that involves the patient care. The National Alliance for Health Information Technology stated that EHTR data needs to be created and managed and consulted and has to be authorized by provider and staff and more than one healthcare
In its report on patient safety, The Joint Commission (2016) mandates that a minimum of two patient identifiers should be used when caring for patients, including but not limited to the administration of medication, collecting blood samples, performing medical treatments and procedures, etc. Patient names, birthdates, telephone number, assigned identification numbers, or other person-specific identifiers can be used to identify individuals for who care or treatment is to be provided. The rationale behind this policy is twofold: it identifies the person who the procedure or treatment is intended, and it matches the procedure, treatment, and/or service to a specific individual (The Joint Commission, 2016). Per The Joint Commission (2016), outcomes for the use of two patient identifiers will result in less patient errors during the course of diagnosis and treatment.
This service offers the opportunity for subscribers to better engage in care coordination and make sure that proper follow-up care is received. The AHIMA report that was released in 2012 also stated some ways that would help data integrity be at its best. They suggested that there be oversight and accountability mechanisms, acceptance criteria and patient identification practices as part of an internal review processes, and an understanding by exchange participants on how and when corrections will be made to patient data. To facilitate data quality, the ultimate goal of any HIE should be accurate identification of the patient. HIE patient identity and administration has three patient identification profiles: (1) the patient identifier cross-reference profile that matches patients by cross-referencing IDs; (2) the patient demographics query profile queries a central patient information server; (3) patient administration management has knowledge on the status of the patient which means they know where the patient is, was, or is
This is called protected health information or PHI. Information meets the definition of PHI if, even without the patient’s name, if you look at certain information and you can tell who the person is then it is PHI. The PHI can relate to past, present or future physical or mental health of the individual. PHI describes a disease, diagnosis, procedure, prognosis, or condition of the individual and can exist in any medium files, voice mail, email, fax, or verbal communications. defines information as protected health information if it contains the following information about the patient, the patient’s household members, or the patient’s employers, Names, Dates relating to a patient, i.e. birth dates, dates of medical treatment, admission and discharge dates, and dates of death, Telephone numbers, addresses (including city, county, or zip code) fax numbers and other contact information, Social Security numbers, Medical records numbers, Photographs, Finger and voice prints, Any other unique identifying
Health Insurance Portability and Accountability Act of 1996 The writer will be discussing the health Insurance Portability and Accountability Act (HIPAA) of 1996, its principal element of the law, how the law is communicated to health care providers and the institution, and what providers are likely to be the most impacted by the laws. The Health Insurance Portability and Accountability Act (HIPAA) adopted by Congress in 1996 (PL. 104-191), aims to protect the privacy, confidentiality, and security of patient information (Pozgar, 2013, p. 245). The Health Insurance Portability and Accountability Act (HIPAA) is dramatically broader in scope than privacy protections for health care information, a provision for