More hospitals using fingerprint scans for patient ID

To identify patients, some hospitals are exploring the use of biometric technology – specifically fingerprint recognition – and the approach has both benefits and drawbacks. 

Biometric technology is growing in popularity. At first, it was only seen in sci-fi movies. But now, this technology is common in several aspects of modern life.

For example, many companies use biometric timekeeping systems for payroll purposes. And some of the newest smartphones come equipped with the ability to identify users based on their fingerprints.

Now hospitals are jumping on the bandwagon, too.

Reasons for trend

Healthcare blog Future of You, published by KQED Science, discussed the trend in a recent post.

In absence of a national healthcare identifier, which is used in many other countries to distinguish patients from each other, hospitals are scrambling to find an easier way to identify their patients.

It’s especially confusing to keep track of patients when they have multiple last names or change residences frequently.

To make identifying patients easier, facilities have started partnering with companies specializing in biometric fingerprint identity recognition. Specifically, the blog post mentions hospitals working with SafeChx, a system designed for the healthcare industry.

SafeChx links patients’ fingerprints to the personal information a hospital has on file for them, including their health records. The system is free of charge for hospitals to use. CrossChx, the company that created SafeChx, also sells various healthcare apps facilities can integrate with the system to enhance it.

Right now, 178 hospitals are using the SafeChx system, and most are small and medium-sized facilities. CrossChx plans to start marketing its system to larger, teaching hospitals soon.

Both sides of systems

Because biometrics are becoming more common, other systems besides SafeChx are sure to spring up in due time.

Not only do they make it easier for hospitals to identify patients, supporters say biometric fingerprint identification is also an excellent way to guard against patient identity theft, as well as the “doctor shopping” that often happens with prescription pill addicts.

However, critics think biometric fingerprint identification systems can create more problems than they solve. Here’s why: Although it’s true that fingerprints are unique to each person, there’s still a possibility the system can be compromised.

If hackers figure out how to simulate a patient’s fingerprint, they’d have access to all the person’s protected health information. In that regard, it’s just like any method where a single factor is used for identification, such as password protection.

But unlike a password, which can be quickly changed if it’s stolen, a person’s fingerprint can’t be altered.

Protecting data

With that in mind, hospitals would need to make sure the information stored in their systems is effectively protected with methods such as encryption in case a data breach occurs. And facilities would need to have a different protocol in place to identify patients should their biometric identifying data be stolen.

There are alternatives to identifying patients via biometrics or through standard demographic information if this need arises. One example from the Future of You post: Kaiser Permanente is starting to keep a photograph of each patient on file in the medical record.

Whatever strategy your hospital uses to identify patients, internal security is still of utmost importance. Biometric fingerprint scanning technology means nothing if your network and IT infrastructure aren’t secure from outside threats.

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Avoid ‘sundowning’ in elderly hospital patients

It’s a serious concern at many hospitals: the “sundowning” phenomenon. In the evening hours, elderly patients, disoriented by their surroundings, start behaving erratically – yelling, rambling, wandering away from their hospital beds. This behavior can take a serious toll on their recovery. 

ThinkstockPhotos-122552779An article from Boston’s NPR outlet, WBUR, discusses sundowning in detail. According to the article, many experts agree that older patients are more prone to this behavior during the nighttime and early-morning hours. But few explanations exist as to why.

There’s also debate about whether this behavior is another form of delirium. Some say it’s related, while others consider sundowning its own separate condition.

Whatever the cause, it’s tough for facilities to get a handle on it.

The condition’s most prevalent in elderly patients with memory problems or dementia, but it can strike any older person. It’s likely the biggest trigger is being in unfamiliar surroundings.

And per Dr. Sharon Inouye, an expert on aging quoted in the article, biological factors that play a role in sundowning include “disruptions in circadian rhythms, nadirs in cortisol, stress hormones, sympathometic neurotransmitters, melatonin or fluctuating cytokines.”

In other words: Changes in sleep patterns and hormone fluctuations may lead to big problems for hospitalized older patients.

HELPing hand

The best strategy for hospitals to decrease the likelihood of sundowning in older patients (or to identify problems more quickly) is to take a preventive approach.

Some hospitals have specific protocols in place to keep elderly patients from developing any signs of sundowning or delirium. For example, Dr. Inouye developed the Hospital Elder Life Program (HELP), which is currently being used in over 200 hospitals worldwide.

Under HELP, clinical staff members are specifically trained on caring for older patients. HELP mainly focuses on making sure the elderly are aware of their surroundings. Staffers are told to regularly remind patients that they’re in the hospital, along with what day it is, the specific date and the time of day.

Other tactics used to keep patients oriented with their surroundings include:

  • making sure glasses and hearing aids are within their reach
  • getting them out of bed and walking regularly
  • ensuring they’re hydrated and well fed
  • avoiding the use of medications known to cause confusion
  • managing their pain, and
  • reducing hospital noise to improve their sleep.

HELP’s been beneficial for hospitals where it’s been implemented, according to another WBUR piece.

In fact, a study of the program showed that patients were 50% less likely to develop delirium or symptoms of sundowning than patients who weren’t treated using the program. Patients also had a 62% lower chance of falling while in the hospital.

Need for elder-care standards

Your nurses may be using similar tactics with elderly patients. Regardless, it’s beneficial to have a formal program in place at your hospital for elder care.

Creating a standardized protocol ensures your clinicians are on the same page regarding elder care. And chances are, having a formal process in place will improve patient outcomes – an important component of the value-based care initiatives affecting hospital reimbursement.

Plus, it’s easier to get families involved in the process if it’s standardized. They can play a critical role in keeping sundowning at bay by reinforcing the efforts of staff. In addition, they can let clinicians know about the patient’s normal behavior, which can help doctors and nurses spot any sudden changes.

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5 healthcare technology trends to watch for in 2016

ThinkstockPhotos-491119888Trends about where an industry is headed, especially one as large and complex as healthcare technology, should best be thought of as trajectories rather than binary “did/did not happen” events. But make no mistake, a lot can happen in a year – even in healthcare technology. In this guest post, Mark Ott, director of product at a cloud-based care management system provider, highlights five trends hospital executives can expect to see unfold in 2016.


1) Value-based train picks up steam, especially for those slow to embrace alternate payment models.

We all know the official timeline the Centers for Medicare & Medicaid (CMS) laid out in early 2015 – 90% of payments would shift from fee-for-service to value-based payments by 2018. Despite the clear, unambiguous move to value, some in the industry have been slow to transition their organization. However in 2016, expect to see these organizations finally make clear moves to alternative payment models. The significance of this shouldn’t be understated, especially as it pertains to technology adoption.

2) Care Management/Coordination Record rises in importance, as team-based care models expand.

Some call it a Care Management Medical Record and others call it a Care Coordination Record. Regardless of the term, the concept is essentially the same. Electronic medical records (EMRs) excel at capturing in-person encounters, but as care expands beyond those encounters, capturing and tracking what happens between patient visits will be of utmost importance. In addition, enabling care teams to stay on the same page about a patient’s care plan, track action steps and reduce the friction of working together, will be crucial to succeeding in a value-based world. Expect to see the Care Management Record concept start catching fire in 2016.

3) Terms ‘care coordination’ and ‘patient engagement’ continue to be abused, misused and watered down.

These terms by themselves have become almost meaningless. There are countless healthcare vendors claiming to deliver on one or both of these capabilities. Seemingly, most companies use these terms “in name only” in an attempt to capture market interest. The onus is on every product company to be very clear just how it enables patient engagement or care coordination. In 2016, the market will start weeding out those products that are patient engagement and care coordination in name only, while rewarding those companies that are actually able to deliver clear value.

4) Integrating devices and device data into care delivery processes will remain a niche activity.

The enthusiasm around wearables, trackers and remote monitoring is exciting, and there’s enormous potential for device data to impact the delivery of care in ways that benefit both patient and provider. But the technology hasn’t caught up with the promise of what it can be, and that won’t change in 2016. Not only is the technology not yet able to deliver, but the incentives and processes to support wide-scale deployment aren’t in place yet. Although all signs point to wearables becoming an integral part of delivery of care, this won’t happen next year.

5) Demand increases for consumer-grade user experiences in healthcare enterprise software.

For so long, clinicians on the frontlines of care delivery have struggled with software that’s hard to use, difficult and downright frustrating. The biggest culprit for poor user experiences in healthcare software has to do with the enterprise purchasing process. Often, vendors build for buyers who aren’t the end users. If the end user and the buyer were the same, you’d see healthcare software vendors value user experience like what we see in other B2B industries, not to mention B2C industries. Regardless, in 2016 we will see more buyer-value products with consumer-grade user experiences. Much of this has to do with end users’ reluctance, and sometimes outright resistance, to adopting technology in their work life. Clinicians often get a bad wrap for being technology averse. But in reality, it’s not that they’re averse to technology; it’s that they’re averse to bad technology.

Mark Ott is director of product at RoundingWell, a cloud-based care management system provider.



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How cloud computing tech can improve hand hygiene

Monitoring whether doctors and nurses are following best practices for hand hygiene can be an inexact science. But new technological innovations are changing the game, making it easier to track just how often staffers are washing or disinfecting their hands. 

ThinkstockPhotos-476703610These developments are coming about due to the rise of the Internet of Things (IoT), a concept where ordinary items are upgraded to include Internet connectivity. This gives them the ability to communicate information in real-time.

A project designed by Microsoft and Gojo, the company that makes Purell hand santizer, measured how often hospital workers were washing their hands using IoT technology. Their experiment was detailed in an article from Time magazine.

How it worked

The experiment took place at John Peter Smith Hospital, located in Fort Worth, TX.

As part of the project, the system installed at the hospital had two components:

  1. a ceiling-mounted sensor to monitor the flow of foot traffic, and
  2. soap and hand-sanitizer dispensers with sensors to track when they were used.

These two devices sent their data to Microsoft Azure, a cloud-based computing service, via the Internet. The software stored and analyzed the information, as described in a video about the project. This gave researchers a clear picture of how many times people washed their hands upon entering and exiting the area.

Researchers performed the project in phases, according to the Time article. During the first phase, the devices collected baseline data to see how often workers washed their hands without knowing they were being monitored. At this time, the hand-washing compliance rate was only 16.5%.

In the next phase, researchers made everyone in the hospital aware they were conducting a study about hand washing, even patients and visitors. The result: Compliance rates nearly doubled, climbing to 31.7%

Researchers stopped reminding people about the project during its last phase to see whether they got the message about remembering to wash or disinfect their hands. While compliance was lower than it was during the second part of the project, hand-washing rates were still at 25.8% – much higher than they were initially.

Effective tracking

Overall, the cloud-connected system was able to detect 90,000 instances where people should’ve washed their hands. It’d be extremely difficult for a facility to make similar observations without an automated system in place.

And because the data was stored in the cloud, researchers were able to easily access the information using an Internet browser on a computer or mobile device.

Similar technology could boost your hospital’s hand-washing rates. While Microsoft and Gojo haven’t announced plans to take this particular system public just yet, innovations like these are happening faster due to growing advancements in IoT technology and cloud computing.

With that in mind, you may want to get together with IT and find out whether your hospital’s existing network infrastructure is able to accommodate more Internet-connected devices and tools down the line.

If not, you can start brainstorming about what you’d need to do to make that possible. This’ll help you ensure your facility’s a step ahead of new technological developments, which means you can take advantage of them more easily in the future.

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Details announced on CMS bundled payments for joint replacement

It’s official: The Centers for Medicare & Medicaid Services (CMS) has set a date for when bundled payments will begin for hip and knee replacements. The agency’s also released the new structure it’ll use for reimbursement – and there are quite a few changes from its initial proposal.  

487098007Hospitals can mark their calendars for April 1. That’s when bundled payments will start.

The CMS announcement, which will be available on the Federal Register on Nov. 24, was discussed in-depth in an article from U.S. News & World Report, as well as in a news release from the Department of Health & Human Services (HHS).

Under the new payment system, officially dubbed the Comprehensive Care for Joint Replacement (CJR) model, facilities will face more financial risk regarding patient outcomes for each procedure.

Originally, CMS planned to implement the CJR model in January. But, due to several comments from hospitals and other healthcare providers asking for an extension, the agency pushed back the start date to give them more time to get ready.

Purpose & objectives

According to CMS, the ultimate goal of the new CJR model is to test whether giving hospitals one lump-sum payment for hip and knee replacements will improve quality while reducing Medicare costs. The agency is also looking to:

  • improve the coordination and transition of care
  • encourage more provider investment in changing care processes to boost quality
  • improve the coordination of items and services that are reimbursed through Medicare, and
  • incentivize hospitals to provide higher value care to patients from admission to post-discharge.

As of now, CMS plans the CJR model as a pilot program. It’ll evaluate the model’s effectiveness over a four-year period (or five CMS “performance periods”), ending Dec. 31, 2020.

But unlike other CMS bundled payment pilot programs, which asked hospitals to volunteer, the agency is requiring all hospitals in the targeted geographic areas that provide hip and knee replacements to participate. It’s hoping to gather data about improving quality of care in all kinds of facilities, so it wants a wider range of participants.

CMS did, however, scale back the scope of the program slightly. Instead of requiring participation of all hospitals in 75 metropolitan statistical areas, facilities in 67 of these areas will be paid via the CJR model.

Another big change: CMS won’t be using a “target price” methodology for determining how much hospitals will be paid for joint replacement.

Instead, it’ll base payments on whether hospitals measure up with meeting a yet-to-be-determined quality score methodology. This way, reimbursement will be tied more closely to quality, further emphasizing the shift to value-based payments.

Gradual repayments

Under the CJR model, CMS will also implement a more gradual transition for hospitals to assume higher financial risk than it proposed in its initial announcement. This is designed to make the adjustment even easier. Per CMS, the limits will be as follows:

  • No repayment responsibility for hospitals in performance year one
  • A stop-loss limit of 5% in performance year two
  • A stop-loss limit of 10% in performance year three, and
  • A stop-loss limit of 20% in performance years four and five.

And in years two and three, CMS will allow hospitals to be eligible for a reduced discount percentage for repayment responsibility. So they may not be on the hook for the full repayment penalty.

Rural hospitals, Medicare-dependent hospitals, rural referral centers and sole community hospitals will be exempt from these stop-loss limits.

Hospitals’ next move

Although the CJR model is technically a pilot project, hospitals across the country should be prepared for similar initiatives from Medicare and other payors as time goes on.

Value-based care is quickly becoming the norm. And bundled payments won’t be far behind. So it’s critical to start working on improving your hospital’s quality of care for joint replacements and other procedures, even if your facility isn’t located in one of the targeted geographic areas for the CJR model.

Laying the framework for high-quality, low-cost care right now will make your facility better poised to survive in the future healthcare climate.