In most other developed countries around the world, smart cards are the predominant means to identify patients and share health data. However, for some reason, the technology has yet to catch on in the U.S. Some argue our lack of a single payer system and core medical record makes implementing smart cards a difficult proposition from an integration perspective. Others simply believe the lack of adoption is further evidence of the American healthcare system being a technology laggard. In any case, Resolute Health wasn’t about to wait for smart cards to go mainstream stateside before seeing how the technology could benefit its organization and patients.
A smart card solution has helped Resolute Health reduce administrative labor and claims denials while improving the overall patient experience.
In most other developed countries around the world, smart cards are the predominant means to identify patients and share health data. However, for some reason, the technology has yet to catch on in the U.S. Some argue our lack of a single payer system and core medical record makes implementing smart cards a difficult proposition from an integration perspective. Others simply believe the lack of adoption is further evidence of the American healthcare system being a technology laggard. In any case, Resolute Health wasn’t about to wait for smart cards to go mainstream stateside before seeing how the technology could benefit its organization and patients.
Repetitive Paperwork Aggravates Patients
Resolute Health is an ACO (accountable care organization) owned by Tenet Healthcare, the third largest healthcare provider in the country. Resolute Health consists of more than 250 physician practices and several family urgent care centers that serve nearly 250,000 patients in Texas counties stretching from San Antonio to Austin. The ACO will also open a hospital and wellness campus in 2014 to broaden its portfolio of service offerings.
Five years ago, Resolute Health was researching ways it could better serve its patient population. Through a series of interviews, the provider learned that the single biggest complaint among its patients was the seemingly endless number of paper forms they were required to complete during office visits.
“Our patients were irritated that they had to fill out the same forms and provide the same medical information over and over again,” says Roderick Bell, CIO of Resolute Health. “They didn’t understand why they had to fill out one set of paperwork for their PCP, and complete similar forms at a Resolute Health specialist office or a partnering hospital. Our patients felt that they should only have to provide this information once and it should be shared throughout our network.”
Bell and his team believed the best way to address this demand was to provide a means for patients to take their health data with them. However, this was easier said than done. Resolute Health needed more than a simple PHR. The solution it selected would need to integrate with the 15 different EMR systems in use throughout the Resolute Health network. Furthermore, the solution would need to provide both patients and physicians with quick and easy access to the same health data. Resolute Health found the answer to its problem in a smart card-based patient identity system from LifeMed ID.
Smart Cards Validate ID, Automate Clinical Workflow
The LifeMed ID solution, called SecureReg ID, consists of access to the SecureReg ID cloud software application and smart card printers from Zebra Technologies. The solution sits on top of Resolute Health’s registration system, and automatically identifies and authenticates patients for each office visit and procedure throughout the Resolute Health provider network. The product also links the patient’s identity to their multiple medical records and ADT (Admissions/Discharge/Transfer) applications using HL7 protocols. Automating these workflows was particularly attractive to Resolute Health.
“Validating an ID is easy,” says David Batchelor, CEO, LifeMed ID, Inc. “However, this capability provides limited value until you can validate an ID at the point of registration and bridge the connection electronically to the correct medical record. That’s what SecureReg ID provides.”
![Roderick Bell CIO Resolute Health]() |
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“Smart card security has already been proven out. This is the same type of technology our federal government and military uses for identification and access. It definitely meets the requirements necessary to secure health data.” – Roderick Bell, CIO, Resolute Health |
The SecureReg ID solution is currently in use throughout the Resolute Health network. Now when patients arrive at any Resolute Health location, they are asked to fill out the familiar set of paper forms one time. This information (e.g. insurance information, medical history, allergies, etc.) is used to create and populate the smart card that is ultimately issued. A photo of the patient is also taken on site using a web cam, and the patient is presented with their smart card before being seen by a doctor that day. After the patient is examined by a physician, the smart card is then invoked by the receptionist and all of the encounter information for that visit populates the card. The patient then takes the smart card with them and uses it to check in and check out of all future Resolute Health appointments.
Smart Cards Reduce Claim Denials, Improve Provider Visibility
The SecureReg ID smart card solution provides numerous benefits to both Resolute Health and its patients. For the provider, first and foremost, the solution has significantly reduced the labor administrative staff must dedicate to managing paper forms. Secondly, the technology has provided Resolute Health physicians with greater visibility into the care continuum of its patients.
“LifeMed ID really serves as a perfect MPI (master patient index) for us,” says Bell. “Whenever a smart card is invoked, our doctors can see when, where, and by whom that patient has been treated in the Resolute Network. This includes details for each encounter.”
Because SecureReg ID ensures all Resolute Health offices capture patient information the same way, the solution has also helped to enhance the consistency and accuracy of health data. “The smart card solution ensures the patient information we collect on the front end is correct,” says Bell. “We know we have the right insurance data, social security number, etc. Because of this improved data accuracy, we’ve seen a dramatic decrease in our claims denial rate.”
Smart Cards Put Patients In Control
Resolute Health patients also enjoy a wealth of benefits by using their smart card. For example, patients with a smart card are no longer asked to repeatedly fill out forms. After the initial registration process, patients simply present their card to a receptionist upon each subsequent visit to any Resolute Health facility, greatly enhancing the speed and efficiency of the check-in experience. The smart card even doubles as the patient’s insurance card.
Another benefit is the control the smart card gives patients over their own health data. The card provides patients with a portable version of their medical history. It also allows patients to securely access their medical records via an online portal. Patients can also use the web application to change the personal information associated with the card (e.g. address, insurance information, medication list, etc.).
Another interesting perk for patients is the fact that there is an affinity program tied to the Resolute Health smart cards. Patients can use their smart cards to receive discounts at participating merchants in the region (e.g. pharmacies, health food stores, fitness centers, etc.). They can also amass points that they can redeem for goods and services at participating vendors and throughout the Resolute Health network (e.g. a massage or smoothie at the upcoming Resolute Wellness Center).
The affinity program is not simply a bonus for card users, it also helps drive patient participation in the smart card initiative. “We’ve had patients walk into our clinics to sign up for a smart card that aren’t in need of any medical attention,” says Bell. “They simply want to get their card, so they can start benefiting from the affinity program. This is great because the more patients we convert to smart cards, the more we benefit as a provider.”
What About Security?
One of the biggest concerns surrounding electronic PHI (protected health information) is security. Smart cards are not immune to scrutiny in this area. In fact, given the recent Target credit card breach, many IT folks may be thinking twice about pursuing card-based health ID and registration options. However, Bell contends that security is one of the strong suits of smart card technology.
“Smart card security has already been proven out,” says Bell. “This is the same type of technology our federal government and military uses for identification and access. It definitely meets the requirements necessary to secure health data.”
LifeMed ID’s Batchelor adds some technical details. “Smart cards offer triple DES (data encryption standard) security,” he says. “Moreover, the technology offers more than just a DES algorithm, it also includes a megahertz requirement. Overall, the technology is more secure than biometrics, given the false positives that technology has been known to produce.”
Extending Smart Card Use Throughout The Enterprise
SecureReg ID is currently in use at each of Resolute Health’s 250 provider locations. The initiative has been so successful, the provider continues to look for additional ways to leverage the technology. For example, Tenet Healthcare (owner of Resolute Health) is currently planning to implement the technology in some of its other hospital systems including its MetroWest hospital network outside of Boston and several hospitals outside of Chicago. Resolute Health is also partnering with all of its skilled nursing facilities to implement SecureReg ID.
Resolute Health is also working with EMS (emergency medical service) providers in its region to accept and read LifeMed ID smart cards. This capability will not only allow EMS technicians to access important medical information about a patient while transporting them to a hospital, but will also help improve patient care in the event of a natural disaster. For example, one of the biggest medical challenges during Hurricane Sandy was the inability of providers to correctly identify patients when hospital systems were down. If EMS personnel could support LifeMed ID smart cards, it would ensure all patient information would be at their fingertips during a disaster.
Finally, Resolute Health is working with two local school districts to provide its students with LifeMed ID cards. These cards will serve as both a medical ID card and school ID, and connect school nurses to the Resolute Health network. In other words, if a sick child goes to see a school nurse, that nurse can invoke the card, send a list of symptoms and vitals to the child’s PCP, and get e-prescriptions approved and forwarded to a local pharmacy — all without the student having to leave school.
Most U.S. healthcare providers are still behind the eight-ball when it comes to smart card solutions, but Resolute Health is proving how powerful the technology can be. For the time being, the provider is more than comfortable in its role as early adopter. However, if Resolute’s experience is any indication, the entire healthcare industry would be well-served to warm up to smart card technology sooner rather than later.
