Staff are first to use palm scanners to ID patients

Misuse is virtually impossible

Instead of asking a patient to show you a driver's license, how about identifying patients by the unique vein patterns in their hands? A new palm scanning device is used by patient access staff at Carolinas HealthCare System, the first health care provider in the United States to implement this technology.

The palm scanning device, manufactured by Fujitsu, is used with a software system designed by the hospital that enables the scanner to interface with the hospital's patient registration database.

The scanners use near-infrared light to map the vein patterns in a patient's palm, which are considered more unique than a finger print. The digital image is converted into a number that correlates with the patient's medical records.

Before choosing the palm scanner, Carolinas looked at retinal scanners, but thought they would be too invasive for patients. Finger printing was considered, but wasn't chosen because of the wear and tear on the equipment caused by repeated cleanings, and the fact that actual fingerprint images are stored in those systems. Since a number, not an image, is stored with the palm scanner, there is no chance an image could be stolen and illegally reproduced.

The palm scanner is currently used at admitting, the emergency department, one-day surgery, and all inpatient and outpatient registration points. "Most recently, we have begun a rollout to physician practice settings for our physicians network," says Steve Burr, vice president of patient financial services.

This is the process: First, registration staff ask if patients have been scanned previously. If they have, patients are asked for their date of birth and their palm is re-scanned. Once patients are pulled up, staff verify that this is the correct person — thus far, it always has been — and make any updates to the registration data. If patients are not found, staff begin searching via normal demographic data.

If patients have not been scanned before, they are directed to place their middle finger between two metal prongs, to make sure their palm is properly positioned, and the scan is taken.

"Once the patient is located and verified, we can then scan the palm and link it to the record," says Burr. "Or, we can create a new registration and link the palm scan if the patient is not found or if they have never been here before."

Patients are safer

Patient safety was the primary motivation for this new technology. "With today's increasing use of electronic data in the delivery of health care, the need for linking the correct patient to the correct medical record has never been more important," says Burr.

Clinical decisions are being made through the use of multiple electronic systems, and most of them are dependent upon an accurate registration into the HIM system. "The use of the palm vein scanner allows us to ensure that we have selected the correct patient," says Burr. "This assists in alleviating patient overlays or use of incorrect information."

The system virtually eliminates the possibility that a person's personal information could be misused during the patient registration process. "Previously, we had no other validation process, other than checking ID or asking for pertinent demographic data, to ensure we had the correct patient," says Burr. In an emergency, a positive identification can now be made even if the patient is unconscious.

Another motivation for implementing this product is to increase efficiency for patients on return visits. "It is often commented that patients have to fill out numerous documents of the same information at any of our sites," says Burr.

However, with palm vein scanning, the patient's information is accessed via a global database on return visits. The patient only has to review the information that's already on file, instead of filling out new documents.

For subsequent visits, patients give their birth date and have their palm rescanned for a positive identification. The new process makes it impossible for anyone to hear or see sensitive personal information when it's given to the registrar, and prevents an individual from using someone else's Social Security number or health insurance card to obtain services.

Glitches were minor

It wasn't difficult for patient access staff to get used to the new device. "Patients have to be instructed where to place their hand, and to remain very still," Burr says. "The registrar then enacts the software at their desktop and if the scan is acceptable, it is linked to the record, and that is it."

A bigger obstacle was getting the registration staff to begin using the product at each registration. "Most of the push was due to it just being different," says Burr. "Once we began measuring the use, we motivated staff by competition and recognition."

Use of the scanner also has become one of their required functions that is measured and compensated in the employees' monthly goals. 

As for patients, most didn't have a problem with the new system. "Some patients were scared of the product at first, and many refused for fear or religious beliefs," says Burr. "However, most patients have no issues with using the device now and we have very few refuse."

Initially, the percentage of patients scanned was in the 20% range, and it is now more than 85%. "If patients refuse, we then re-educate about the safety reasons for scanning. If they continue to refuse, we do not force them," says Burr.

There were some technology glitches at first, with the device coming unplugged and with the weight of the device. However, later models have been made much lighter and with better wiring and have not posed any problems.

"All in all, the issues were very minor considering this was new technology being deployed for widespread use at a hospital system of our size and volume," says Burr. "We have seen increased efficiency on return visits and decrease in potential overlays, which leads to increased patient safety."

The scanner has made the registration process much faster. In the past, registrars would input information, and then select the correct patient from a list of patients with similar names or birthdays. The palm scanner zeroes in on the right patient immediately.

Burr says that Carolinas is still working on the best ways to measure improvement in terms of efficiency, so no metrics are available yet to demonstrate improvements.

"The big win will be once the physician practices are online with the technology," he says. "Most of our referrals come from our physician's network, and the patients will already be scanned and registered."

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