Finger imaging emerging for patient registration

It holds hope for better confidentiality

Within the next year, this could become a common scenario at registration desks around the country: Patient John Smith steps up to be admitted for treatment. The registrar enters his name in a computer and pulls up a dozen patients with the same name. But rather than ask a series of questions to make sure this is the right John Smith’s file, the registrar simply asks him to touch a scanner embedded in the computer keyboard.

Smith’s finger image then ties him to all of his records throughout not only that hospital, but its entire health system.

If John Smith is not in fact John Smith, but has borrowed a friend’s Medicaid card to attempt to pay for his care, that also will become apparent.

Finger imaging is moving rapidly beyond its roots in law enforcement, says Donna Gustafson, MBA, director of health care marketing for The National Registry Inc. (NRI), a St. Petersburg, FL-based supplier of finger imaging personal identification systems. The next logical step was government entitlement programs, where finger imaging is helping to ensure that food stamps and welfare checks reach their intended recipients, she adds.

Although still in the early stages in health care applications, finger imaging is rapidly emerging as a technology that could be a key to maintaining privacy and confidentiality in the age of electronic patient records, Gustafson contends.

"Most health care systems are focusing on how to communicate hospital-to-physician, hospital-to-outpatient center, system-to-payer, and system-to-system," she says. "One of the primary issues is how to communicate highly confidential information along a whole host of providers. The key is tying the patients to their information and then making certain the right providers and payers can get it and have a right to it."

New Jersey, which reimburses hospitals at the end of the year for the charity care they provide, recently issued a request for proposals for a finger imaging system to keep track of where recipients are receiving their health care, Gustafson notes. Fingerprinting also can be used to determine precisely which provider is caring for a patient, she adds.

One of NRI’s pilot sites is an institution with total electronic medical records, where finger imaging is attached to work stations in the examination rooms, she says. When a physician comes into the exam room, the nurse has the patient’s medical record on a computer work station. After the encounter with the patient, the physician types the appropriate information directly into the medical record.

Finger imaging also helps protect the confidentiality of that record. If the physician walks away, the record disappears from the screen, either automatically after a predetermined time, or manually through several key strokes. The physician then has to re-enter his or her finger image to access the record.

More secure than passwords

Finger imaging provides more security and simplicity than passwords, Gustafson contends. She tells of the struggle health care institutions face in convincing employees not to tape their passwords on their PCs. And each of the multiple computer systems in a hospital — order entry, ADT, general ledger, pharmacy, lab, etc. — can require its own password, she points out.

The NRI finger imaging system works by "taking a picture" of the finger with a scanner embedded in the keyboard, and storing that information in a 1,024-bite record, Gustafson explains. What is stored is not the image itself, but a number associated with it. That identifier becomes a part of the patient record, another way to tie the information to the person.

Sarasota (FL) Memorial Hospital, known for its affinity for cutting-edge technology, has tracked the use of finger imaging (also called biometric identification) for several years but until recently found it to be prohibitively expensive, says Jim Turnbull, chief information officer. After Turnbull happened upon some information about the RI system, and discovered that prices had decreased, Sarasota decided to embark on a pilot project using finger imaging.

"In the past year to 18 months, [finger imaging technology] has dropped in price by order of magnitude," Turnbull notes. "You can knock a zero off the end."

Although finger imaging is one feature of what is usually a total technology package, a ballpark price is about $500 per work station, including hardware and software. A year and a half ago the price was close to $2,000, according to the NRI.

Like most health care organizations, Sarasota now uses a two-level sign-on process for employees — user name and password, he says. But with the move toward the electronic patient record — and the accompanying public perception that because it’s electronic, it’s more accessible to unauthorized use — the hospital recognized the need to build in a couple of more layers of protection, Turnbull explains.

The first was a more definite audit trail. The hospital now has a system using finger imaging that makes it readily apparent when someone who normally wouldn’t have access to a patient’s record makes that access, he says. "If you want to access a chart you wouldn’t normally have access to, you get a message that says, ‘You don’t normally have access, but if you still want it, put in your reason.’ It doesn’t prohibit you from accessing if you need to, but it provides a very clear audit trail."

The second level of protection is the biometric identification system, Turnbull says. "One of the issues with passwords and user names is they can be shared — it’s difficult to share a fingerprint."

Sarasota’s first pilot project with the NRI technology relates to physician registration. Previously, physicians used a keypad to enter a four-digit number to get a list of patients and bed assignments; now they will use the touch of a finger. In the spring, the hospital will pilot finger imaging on one nursing unit in a computerized patient record system.

While he is aware of some hospitals that already are using finger imaging for patient registration, Turnbull says that is not on the horizon at Sarasota Memorial. "We want to take a step at a time, and do it in a controlled environment," he explains.

But Turnbull advises that this is a technology whose time has come. "I don’t think it’s a necessity, but you’ve got to look at its potential in the overall strategy of protecting patient records and other confidential records," he adds. "On its own, it’s not the solution, but part of the overall strategy."