Access Feedback: Maine admitting director outlines patient ID concerns
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Maine admitting director outlines patient ID concerns
'It's a big problem in the ED'
Like many health care providers across the country, Maine Coast Memorial Hospital in Ellsworth is struggling with the challenge of ensuring accurate identification of patients — especially those who come for treatment in the emergency department, says Kristen Stiles, director of admissions for the rural, 64-bed facility.
Stiles says she would like feedback from her counterparts in other hospitals on whether they are dealing with the same problem, and if so, what policies or protocols they have put in place.
In hospitals, the nationwide problem of identity fraud often takes the form of someone who is seeking drugs or has bad credit, she notes. "It's a big problem in the ED, because the person has to be treated and [information] is often taken at face value."
It's not that difficult to know a neighbor's address and give it to the registrar to get treatment, Stiles adds. "We are actively working on it — it's come up over the past year — but it's pretty easy to get a [fake] driver's license or some other form of identification, and you don't have the ability to turn them away."
While getting a handle on the patient identity issue in the ED remains difficult, she says, physicians involved in the treatment of inpatients have become "very proactive."
"If we can't identify the patient, and something is not right, and if the person has been stabilized," Stiles says, "[physicians] will no longer continue a treatment plan."
In one case, hospital personnel have actually called the police department to have a license-plate check run on an inpatient, she adds.
"He had given too many people too many conflicting reports." The man arrived complaining of chest pain and pressure, and while being questioned about his medical history mentioned having surgery in Ireland a few years back, Stiles recalls. "We couldn't find him under the name he had given, and we couldn't appropriately treat him without a history."
The patient was at the hospital for two nights, she says, "and every time an admissions person went to see him he was sleeping or out of it, but he was very good with the clinical staff."
When hospital staff refused to do any further treatment until they could determine his identity, he said that all of his identification was about three hours away, Stiles says. At that point, she adds, given concerns about proof of insurance and his driver's license, hospital staff told police what had happened.
The registration information on the motorcycle he was driving didn't match any of the names he had given, Stiles says. "We had the police work with us, and his description didn't match what they had on record."
Police didn't share all the information they found on the man, just what was needed to show that he was lying about his identity, she says. Once physicians confronted the man, and he realized he would get nothing more from them, Stiles adds, "he was pretty quick to get better and leave."
"That has probably been our worst case as far as what could happen [with a false patient identity]," she says. "If he had truly had a history of heart problems and had surgery, there would have been different protocols."
The greatest concern, Stiles says, is "the damage we could do to someone who has the wrong [medical] history or if we can't identify and verify, what are we missing from another hospital [which has the patient's records]?"
'Drug-seeking' on increase
Although there is "an explosion of tourists" in the summer, with Bar Harbor just an hour's drive away, for the most part Ellsworth is an area where "you know your neighbors and your [ED] 'frequent flyers,'" she notes. "Drug-seeking is nationwide, and we've had increasing instances of that. Some of [those patients] are pretty crafty."
If the drug seekers use their own names, Stiles says, physicians can note that there's been a history of asking for medication for dental or back pain.
In cases where they can't confirm that there's a drug problem but are suspicious and believe the person might be using a made-up name, she adds, they may give a small amount of medication — "not enough for 10 days, but just a little. Some providers are more and more proactive."
While knowing the population provides "a huge leg up" in recognizing and dealing with patient identity issues, Stiles notes, admissions staff "have a difficult time working with the ED."
"We do the registration piece for the ED, but are not [located] there," she says. "Many of the people in my area have been here for a while, and if [a case] doesn't smell right, doesn't look right, we let [ED staff] know," Stiles adds. "We work closely with them."
(Editor's note: Kristen Stiles can be reached at [email protected].
If you have feedback on this or other issues of interest to access managers, please contact editor Lila Moore at [email protected].)
Like many health care providers across the country, Maine Coast Memorial Hospital in Ellsworth is struggling with the challenge of ensuring accurate identification of patients.Subscribe Now for Access
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